INTERNATIONAL JOURNAL OF CLINICAL AND MEDICAL CASES (ISSN:2517-7346)

Possibly The immune system may recognize the tumor with extensive hypoxia as a diseased tissue as it would have recognized normal tissue with extensive hypoxic as a disease tissue. The diseased tissue may possibly trigger the immune system to remove the diseased tissue (malignant growth) with the development of immunity and the remission of cancer.

Possibly extensive hypoxia in a growing malignant tumor disrupts tumor hemostasis making the malignant tumor vulnerable to an immune response and followed by development of immunity against the malignant growth. Hypoxia may occur within the tumor and within the tumor microenvironment.

Possibly extensive hypoxia in a tumor due to low blood oxygen may have diminished the ability of tumor cells to manipulate the tumor microenvironment to abrupt immune responses. Resulting in the tumor becoming vulnerable to an immune response.

one may draw the conclusion that a remission of a cancer might be induced by depriving a growing malignant tumor within its microenvironment of oxygen thereby inducing extensive hypoxia in a growing tumor. The key point being the tumor growing rapidly in the presence of low blood oxygen to possibly induce further hypoxia.

It is noteworthy that in cancer patient’s immune response are suppressed by a malignant tumor particularly by the tumor microenvironment. Immune responses are not suppressed by a single cancer cell. Therefore, if a single tumor in a cancer patient becomes dysfunctional or vulnerable to an immune response then a remission of cancer may possibly occur.

The suggestion is that if extensive hypoxia is induced in a malignant tumor covered by a basement membrane, then possibly a remission will follow with the development of immunity. Aggressively growing tumor may respond better.

This is a suggested mechanism of the spontaneous remission of cancer.

Extensive tumor hypoxia, within the tumor microenvironment might be induced by different means such as using a syringe to draw blood rapidly from a growing tumor, injecting a tumor directly with iron chelators compatible with the malignant tissue, blocking or cutting a main vein delivery blood to a tumor, injecting a tumor with anti-angiogenesis drugs to temporary reduce blood delivery to a growing tumor, etc.

The basic hypothesis presented is as follows. if the growth of a single tumor in a cancer patient is retarded due to low blood oxygen and at the same time the malignant tumor is not affecting a vital organ and is induced to grow rapidly by any means other than increasing the blood oxygen than it is suggested that the malignant tumor may grow briefly and followed by a remission with the development of immunity against the malignant growth.

A clear example of this phenomenon is the spontaneous remission of hepatocellular carcinoma (2). Hepatocellular carcinoma may spontaneously disappear after hepatic artery embolism. The hepatic artery embolism prevents blood delivery (oxygen) to the hepatic tumor. The hepatic tumor having extensive hypoxia and becoming dysfunctional and being removed by the immune system. Afterwards metastatic tumor disappearing, and it may be followed by a prolonged and complete remission of  hepatocellular carcinoma (3).

The tumor microenvironment is the ecosystem that surrounds a tumor inside the body. The hypothesis is that if the tumor ecosystem and/or the tumor itself becomes extensively hypoxic it may lead to the spontaneous remission of cancer. This is supported by the observation that some of the reported cases of spontaneous remission of cancer of different types of cancer are preceded by a low blood oxygen.

Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition. Never disregard profession al medical advice or delay in seeking it because you have read this study. This is not intended to be a substitute for medical advice, diagnosis, or treatment in regard to any patient

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2. Niakan B. proposed biology of the spontaneous remission of hepatocellular carcinoma. Int J Cancer Clin Res. 2021 Sep; 8(4):1-3.

3. Huz Jonathan I, Melis M, Sarpel U. spontaneous regression of hepatocellular carcinoma is most often associated with tumor hypoxia or a systemic inflammatory response. HPB (Oxford). 2012 Aug; 14(8): 500–505.

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5. Moghaddam PA, Cornejo KM, Hutchinson L, Tomaszewicz K, Dresser K, et al. complete spontaneous regression of Merkel cell carcinoma after biopsy: A case report and review of the literature. Am J Dermatopathol. 2016 Nov;38(11):e154-e158.

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7. Sato Y , Fujiwara K, Nakagawa S, Kanishima S, Ohta Y, et al. A case of spontaneous regression of hepatocellular carcinoma with bone metastasis. Cancer. 1985 Aug 1;56(3):667-71.