Is there a magic five-year cancer cure?
Continuing with the theme of yesterday’s survivorship post, I want to look at the question today of cancer’s often-talked-of five-year survival rate.
When you first come out of treatment, you may count down the years until you reach this day. It takes on an almost mythical status – if you get to five years you are “cured”. I remember when I reached my own five-year milestone mentioning it to my oncologist at my check up and he swiftly replied there is no such thing as a magic “five-year cure”.
So where did the idea of five-year survival come from? It goes back to the 1930s when very few people survived cancer. The five-year survival rates were introduced because cancer specialists back then considered five-year survival a nearly unattainable goal. Thankfully we have moved on since then as survival rates have steadily increased.
The term “five-year survival” is one used in medicine for estimating the prognosis of a particular disease, most commonly cancer. Cancer survival rates are based on research that comes from information gathered on large numbers of people with cancer. Within this there are relative and absolute rates. While relative refers to patients who died of non-cancer causes (so have been removed from the survival rate for that treatment); absolute, describes the percentage of patients that are alive five years after their disease is diagnosed. Disease-free survival rate is the number of people with cancer who achieve a full remission; meaning means they no longer have signs of cancer in their bodies. Progression-free survival rate is the number of people who still have cancer, but their disease isn’t progressing.
While cancer survival rates are useful in giving you a general idea of your prognosis they can’t tell you about your situation specifically. Numbers are tools, not rules. While some people choose to know everything about their type of cancer, including statistical survival rates, others will find that the statistics are just numbers and some may even feel bewildered and frightened by them. You might wish to commemorate milestones and that is good, just don’t get hung up on the numbers.
Marie, I do hold that 5 year ‘magic number’ in my head as the golden ring that I am reaching for. I remember asking someone, a fellow cancer survivor or maybe my nurse practitioner at the oncologist, why 5 years? And that person said, well, because if it comes back before that it means the treatments didn’t do the job. So when I had a recurrence just 9 months after all my treatments I was devastated, on many levels. Not the least of which was that I had to ‘re-set’ the clock of my survivorship – on the count down to 5 years. So now I try my best to focus on each day. I know that getting to 5 years will be great and feel like an accomplishment, but I also know the fear will always be there. The best way for me to combat it is to make each day the best, to live fully in each day, and to be open to all the possibilities each day brings. Day by day I will get to 5 years…and beyond:) And so will you!
Love, Deb
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Marie,
While cancer is a force to be reckoned with, in many ways, it remains an intangible: Is it really gone, and if so, for how long? That uncertainty, doesn’t fit neatly into our statistic laden society. We want everything to fit neatly into a clearly defined category, labeled 98% fat free, 46% voter approval, 95% of households own a toaster, etc. It’s no wonder we cling to the 5 year magic survival number. It is quantifiable, reassuring and soothes that part of ourselves that needs to hear “everything will be alright.” But like Deb said, we also know that number cannot allay our fears. It will always be there, and that’s why we need one another, to encourage and help us over those rough spots of uncertainty.
Love,
Brenda
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I love Brenda’s insightful comment on this great post. How true that uncertainty, doesn’t fit neatly into our statistic laden society. We want everything to fit neatly into a clearly defined category, labeled 98% fat free, 46% voter approval! Well said Brenda. One of the things we have to learn with cancer is to let go of certainty and live for now.
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Dear Marie,
That is the one thing I “always knew” about cancer: if people made it to the 5 year point they were “safe” and we celebrated each and every 5th anniversary big time in my family, probably to keep the fear of another cancer related death far from us. No idea whether it is true (and as far as I can read in your blog it isn’t) it does give people a point to focus on and find a point where they can be less scared. It does have the bad side Debbie mentioned: if the disease reoccurs before the 5 year it might hit people hard.
But for me, I count the days in the lifes of my loved ones (including you and Debbie) untill they reach theat mgic 5 years and celebrate every day with them!
Love, Annemieke
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Marie,
I like this topic so much I’ll probably do a spin-off post at some point. You always get me thinking, moving, asking, going.
There are no magical cure numbers. The only magic we are truly blessed with is LIFE, whether it’s the life of today, or tomorrow, or the day we enjoy the day after tomorrow.
I think the five-year marker is a false indicator and as you pointed out — somewhat arbitrary. Under normal circumstances breast cancer takes approx. eight years to grow until it can be palpated. So for this model we see years in multiples of eight — so one year, eight, sixteen, etc.
So much has changed with the advent of HER-2, BRAC ! & 2 testing.
My oncologist told me that for me — Stage IIIB — should I arrive at three years w/o recurrence — that would be good. Good. Not fantastic, awesome, or out of the stadium.
I took that for what it was worth.
I passed three years. In the interim I started to exercise VIGOROUSLY (vigorous exercise is key — walking around the block does not cut it) took the prescribed medication (tamoxifen) and maintained my low-fat diet.
Subsequent yearstesting made me nervous until I realized: there truly were no markers. Five years “out” was arbitrary. Seven years “out” felt good. Fourteen years will be terrific.
What is essential is to get the right treatment and make the essential dietary/exercise adjustments from the beginning.
I do not want any woman with a a diagnosis of breast cancer to “waffle” on treatment. Learn. Read. Ask. And CHANGE your diet/exercise habits where you must. ALL of us have room for improvement.
Do everything you can to prevent any additional cancer from developing. Not every woman with cancer has this chance, but MOST women with breast cancer DO.
I say this from a survivor who has been at funerals for women with breast cancer that could NOT be stopped. This is rare. And I mean rare. Truly, the majority of BC survivors need to understand the advantage we have from treatments that made us sick yet helped us live.
So let’s move forward. Let’s move toward a place where we embrace the health we have today and take the steps we can to maintain it.
thanks for allowing all of us the opportunity to think about such an important topic,
Jody
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