10 year survival for common cancers - 1972 vs 2007

BrianD3

Saw this article, may be of interest from a Men's Health or just general health point of view
http://www.medicalnewstoday.com/articles/194406.php

The 10 year survival percentages are about halfway down the page. From this there has been a big increase in survival for many cancers. Obviously the 2007 stats are only estimates but are probably based on various statistics, eg it may be possible to make a good estimate of 10 year survival from 2 year survival.

It should be said that there may be some "lead time bias" and "overdiagnosis bias" in the 07 figures.

10 year survival for Lung and Pancreas cancer is only slightly less horrendous than it was in 1972. Seeing as it is widely recognised that most lung cancers and many pancreatic cancers are due to smoking, it underlines how important it is to avoid smoking.

CathyMoran

Good to see that my one (oesophageal) has gone up to 10% but sad to see how many are still horendous. I have never been a smoker and did not drink to excess but we really need to have a wake up call about smoking.

amacachi

We don't need a wake-up call about smoking, there's been enough bloody money spent on awareness about it and anyone who smokes is an idiot. Including me. One of the problems as I see it with Lung cancer is diagnosis, I've had two aunts die of lung cancer but in one case particularly all her complaints were dismissed as a bronchial condition until she was diagnosed 6 weeks before she died.

Surprised at the low rate for Brain cancers I must admit.

CathyMoran

amacachi wrote: »

We don't need a wake-up call about smoking, there's been enough bloody money spent on awareness about it and anyone who smokes is an idiot. Including me. One of the problems as I see it with Lung cancer is diagnosis, I've had two aunts die of lung cancer but in one case particularly all her complaints were dismissed as a bronchial condition until she was diagnosed 6 weeks before she died.

Surprised at the low rate for Brain cancers I must admit.

Well a relative I care deeply about has just been diagnosed with terminal lung cancer...another relative of mine did not give up the cigaretes until he decided to get married...the idiot. I agree that it is very difficult to get diagnosed - very often the doctors dismiss patients - the only reason why I was seen was that my then ex (now husband) made me go to two separate gp's, got me a referal to his gastroenetologist whom I trust...the rest is history...gps are not trained to recogise my type of cancer, what about the other ones?

lonestargirl

amacachi wrote: »

Surprised at the low rate for Brain cancers I must admit.

They are really difficult to treat, hard to surgically excise the whole tumour and RT dose is normally limited by the tolerence of normal tissue. Also the non-cancerous CNS tumours often have a much better oucome.


It shows the 10-year survival for prostate cancer at 68%. If I recall correctly the 5-year survival for local prostate cancer is >95% - i.e. get your PSA tests, catch it early and your survival chances are excellent.

Bottle_of_Smoke

CathyMoran wrote: »

Well a relative I care deeply about has just been diagnosed with terminal lung cancer...another relative of mine did not give up the cigaretes until he decided to get married...the idiot. I agree that it is very difficult to get diagnosed - very often the doctors dismiss patients - the only reason why I was seen was that my then ex (now husband) made me go to two separate gp's, got me a referal to his gastroenetologist whom I trust...the rest is history...gps are not trained to recogise my type of cancer, what about the other ones?

People couldn't be made more aware about smoking. They continue to smoke because they're addicted to nicotine. If anything fear of cancer probably makes them smoke more

This sounds terribly patronising but I don't think it is possible for you to understand it fully because you've never been a smoker. It isn't like chocolate where you can just decide to stop, the only enjoyable part of it is the nicotine hit you get for the first half of the cigarette, which is really just relieving the withdrawal effects of nicotine addiction.

Wibbs

amacachi wrote: »

One of the problems as I see it with Lung cancer is diagnosis, I've had two aunts die of lung cancer but in one case particularly all her complaints were dismissed as a bronchial condition until she was diagnosed 6 weeks before she died.

Its a big problem with lung cancer. Its usually very far advanced when picked up. If caught early enough it seems to be a very different thing. I know a guy who survived it. He felt something wasnt quite right. He was a very fit athletic type and felt his performance subtly change. His experience here in Ireland with the doctors he dealt with was they simply didnt want to know. He was 35, very fit, never smoked, didnt drink etc. So TBH I can understand the doctors. he went to the UK and got scanned and they found a tumour, cut it out and he's fine 10 years on. He basically had the "best" type. Small, localised and very early detection for that area of the body. What surprised him was how many people he met in the ward who had never smoked or had briefly smoked in college kinda thing. Not only smokers get it(though they would be the 90% majority). So if you have a worry, dont be too quick to dismiss it.

amacachi

Wibbs wrote: »

Its a big problem with lung cancer. Its usually very far advanced when picked up. If caught early enough it seems to be a very different thing. I know a guy who survived it. He felt something wasnt quite right. He was a very fit athletic type and felt his performance subtly change. His experience here in Ireland with the doctors he dealt with was they simply didnt want to know. He was 35, very fit, never smoked, didnt drink etc. So TBH I can understand the doctors. he went to the UK and got scanned and they found a tumour, cut it out and he's fine 10 years on. He basically had the "best" type. Small, localised and very early detection for that area of the body. What surprised him was how many people he met in the ward who had never smoked or had briefly smoked in college kinda thing. Not only smokers get it(though they would be the 90% majority). So if you have a worry, dont be too quick to dismiss it.

Aye, seems to be a common thing, though his doctors should be sued tbh, and I don't say that very often. In a way I can understand them dismissing someone who's been smoking forty a day for 30 years and has bronchitis anyway.

nkay1985

Might be a silly question but what is a 5-year survival rate and a 10-year survival rate? Is it the percentage of people diagnosed with those cancers that are still alive after 5 and 10 years respectively?

Otis Driftwood

nkay1985 wrote: »

Might be a silly question but what is a 5-year survival rate and a 10-year survival rate? Is it the percentage of people diagnosed with those cancers that are still alive after 5 and 10 years respectively?

Yep.

nkay1985

nedtheshed wrote: »

Yep.

Ok. So does that mean that the below comment doesn't make much sense?

lonestargirl wrote: »

It shows the 10-year survival for prostate cancer at 68%. If I recall correctly the 5-year survival for local prostate cancer is >95% - i.e. get your PSA tests, catch it early and your survival chances are excellent.

lonestargirl

Sorry for the confusion, the survival rate I quoted is for local prostate cancer, i.e. disease confined to the prostate. The figure of 68% is overall for people diagnosed with prostate cancer, unfortunately some people are only diagnosed once their disease has spread and the survival is much lower in this population. I was using this figure to illustrate how important it is to get your PSA tested and not to dismiss any signs or symptoms you might have. The earlier you catch your cancer the better your chance of survival.

nkay1985

lonestargirl wrote: »

Sorry for the confusion, the survival rate I quoted is for local prostate cancer, i.e. disease confined to the prostate. The figure of 68% is overall for people diagnosed with prostate cancer, unfortunately some people are only diagnosed once their disease has spread and the survival is much lower in this population. I was using this figure to illustrate how important it is to get your PSA tested and not to dismiss any signs or symptoms you might have. The earlier you catch your cancer the better your chance of survival.

Oh right but that is the rate for people who've survived for 5 years after being diagnosed with local prostate cancer and not 10 years which was the other figure for all prostate cancer, correct?

lonestargirl

1) 95% of men diagnosed with local prostate cancer will be alive 5 years later

2) 68% of all men dianosed with prostate cancer (incl both those with local and metastatic disease) will be alive in 10 years.

The two statistics are different and are not comparable with each other, they just illustrate the survival benefit of early diagnosis.

nkay1985

lonestargirl wrote: »

1) 95% of men diagnosed with local prostate cancer will be alive 5 years later

2) 68% of all men dianosed with prostate cancer (incl both those with local and metastatic disease) will be alive in 10 years.

The two statistics are different and are not comparable with each other, they just illustrate the survival benefit of early diagnosis.

This is what I don't get. How can two different statistics illustrate anything like that.

IRLConor

BrianD3 wrote: »

Saw this article, may be of interest from a Men's Health or just general health point of view
http://www.medicalnewstoday.com/articles/194406.php

The 10 year survival percentages are about halfway down the page. From this there has been a big increase in survival for many cancers. Obviously the 2007 stats are only estimates but are probably based on various statistics, eg it may be possible to make a good estimate of 10 year survival from 2 year survival.

It should be said that there may be some "lead time bias" and "overdiagnosis bias" in the 07 figures.

10 year survival for Lung and Pancreas cancer is only slightly less horrendous than it was in 1972. Seeing as it is widely recognised that most lung cancers and many pancreatic cancers are due to smoking, it underlines how important it is to avoid smoking.

Interesting numbers. I'd love to see breakdowns by stage at detection time. It would be useful to know if there are particular forms of cancer where there's a disproportionate benefit to early detection.

I was diagnosed with stage I Hodgkin's lymphoma approximately 11 years ago and, while the treatment wasn't exactly easy, I certainly had a much better time with treatment than those diagnosed at stage II or above.

lonestargirl

nkay1985 wrote: »

This is what I don't get. How can two different statistics illustrate anything like that.

I'm not explaining myself very well. 5-year survival is the standard metric used in cancer survival, it is considered the point at which you are unlikely to die from your disease. Thus I wouldn't expect the 10-year survival from local prostate cancer to be very different from the 5-year survival and I am basing my claim about early diagnosis on this assumption. I'm not sure why Cancer Research UK decided to use 10-years as nobody else does and it makes it difficult to compare the two.

lonestargirl

IRLConor wrote: »

Interesting numbers. I'd love to see breakdowns by stage at detection time. It would be useful to know if there are particular forms of cancer where there's a disproportionate benefit to early detection.

In general, survial is better for early stage across the board for all cancers. Some examples:

Uveal Melanoma - 10 year overall survival
Stage 1 - 80%
Stage 2 - 60%
Stage 3 - 30-40%
Stage 4 - less than 7 months survival

Oropharyngeal - 2 year survival
Stage 1 - 75%
Stage 2 - 70%
Stage 3 - 55%
Stage 4A - 40%
Stage 4B - 20%
Stage 4C - 10%

Lung Cancer (non-small cell) - 5 year survival
Stage 1A - 60-80%
Stage 1B - 50-70%
Stage 2 - 40-70%
Stage 2B - 30-50%
Stage 3A - 20-30%
Stage 3B - 5-10%
Stage 4 - median survival of 3-6 months with best supportive care, 8-10 months with chemo.

Breast - 5 year survival
Stage 1 - 98%
Stage 2A - 88%
Stage 2B - 76%
Stage 3A - 56%
Stage 3B - 49%
Stage 4 - 16%

Numbers are from 'Handbook of Evidence-Based Radiation Oncology'

BrianD3

IRLConor wrote: »

Interesting numbers. I'd love to see breakdowns by stage at detection time. It would be useful to know if there are particular forms of cancer where there's a disproportionate benefit to early detection.

Here's a different study which includes breakdown by stage for common cancers. The breakdown by stage is for 5 year survival though. IIRC there are also overall figures for 10 year survival in this article (i.e. not broken down by stage)
http://jco.ascopubs.org/cgi/content/short/25/22/3274

As for why the UK study used 10 year survival, it's good that they did. I think it reduces the significance of any lead time bias, it also takes account of cancers that are known for late recurrence such as breast cancer. It is relatively common for breast cancer to recur after a patient has been disease free for 5 years. Whereas a lung cancer patient that is disease free after 5 years is probably "cured".
edit: the article I've linked to doesn't appear to show that so the above paragraph may be wrong

Also to nkay1985, remember that all these figures are relative as opposed to absolute survival figures.

Bottle_of_Smoke

Wibbs wrote: »

What surprised him was how many people he met in the ward who had never smoked or had briefly smoked in college kinda thing. Not only smokers get it(though they would be the 90% majority). So if you have a worry, dont be too quick to dismiss it.

As far as I know there's also a rare type of lung cancer that isn't connected at all to smoking.

lonestargirl

Bottle_of_Smoke wrote: »

As far as I know there's also a rare type of lung cancer that isn't connected at all to smoking.

Mesothelioma - associated with asbestos exposure.

It's also estimated that up to 200 people per year in Ireland die from lung cancer associated with exposure to Radon. However smokers exposed to Radon are also at higher risk than non-smokers.

lonestargirl

Details of survival in the Irish population can be found on the national cancer registry site.

Wibbs

lonestargirl wrote: »

Mesothelioma - associated with asbestos exposure.

It's also estimated that up to 200 people per year in Ireland die from lung cancer associated with exposure to Radon. However smokers exposed to Radon are also at higher risk than non-smokers.

Apparently bracken spores have been implicated in the disease too. I read an interesting report years ago where a researcher had a theory that chest xray had an effect(and apparently an effect on heart disease too). There seemed to be something in what he was saying. You do get weird things with the lung cancer thing. Classic case is california. They had a long running survey of disease/death rates and such that kicked off in the late 50's up to the present. Whats interesting is that in the late 50's something like 60+% of men smoked and by the late 90's that was way down to under 10%. Yet the lung cancer rate remained remarkably stable over that time. Of course people lived longer and many of those were ex smokers, but it was interesting to see. Other factors like diet and vit D levels seem to have a part to play in giving some protection. Greece has the highest smoking rate in europe but among the lowest lung cancer rates. May have a genetic component too. The Japanese had a very high smoking rate among men, yet have very good longevity and again lower rates of lung cancer. I personally reckon if smoking disappeared tomorrow, then the rates would clearly massively reduce, but I suspect not quite as much as we might expect.

lonestargirl

Wibbs wrote: »

I read an interesting report years ago where a researcher had a theory that chest xray had an effect(and apparently an effect on heart disease too). There seemed to be something in what he was saying.

Radiation carcinogenesis is a well-known and described phenomen as is radation damage to normal tissue (incl heart muscle). A single chest x-ray is not really at the level to induce damage (you get an equivalent amount of radiation from cosmic exposure during a transatlantic flight). But multiple CTs and radiation therapy for cancer do certainly increase your risk.

Wibbs

I gather the doses were higher in the past too. I think his research was more about the safe limit being lower than was thought. The airliner comparison doesnt quite pan out. That's exposure more to high energy cosmic rays or more correctly particles. Different type of radiation.

lonestargirl

Wibbs wrote: »

The airliner comparison doesnt quite pan out. That's exposure more to high energy cosmic rays or more correctly particles. Different type of radiation.

Different types of particles but it's all ionising radiation. Calculations for absorbed dose do correct for particle type using LET (linear energy transfer). Not all radiation therapy is photons either, we also use electrons and protons (and we get neutrons when producing protons also).

lonestargirl

Wibbs wrote: »

I gather the doses were higher in the past too. I think his research was more about the safe limit being lower than was thought.

In theory there is no 'safe' limit, it's all about risk vs. benefit. I'm in the US and I am always shocked at how trigger happy they are to order a CT. If I crash my car no problem I'll consent but if you think I have appendicitis you can call radiology to bring an ultrasound. Of course they are terrified of being sued for missing something and as it's not possible to prove that a cancer is radiation-induced and the lead time is 20-40 years they don't worry about it. My experience in Ireland is that the radiologist will insist on you justifying a CT before it will be sanctioned, and rightly so imo.

There are two different kinds of radiation side-effect:
1) Deterministic: both the severity of the damage and the probability of it occuring are proportional to the dose - this would be the case if the heart was damaged for example.
2) Stochastic: the probabilty is proportional to the dose but the severity is independent of dose - this is the case for cancer induction, the smaller the dose the smaller the chances but there is always a chance.

Remember you get about 3mSv per year from a variety of sources, RPII have a calculator that allows you to estimate your annual dose.

nkay1985

lonestargirl wrote: »

I'm not explaining myself very well. 5-year survival is the standard metric used in cancer survival, it is considered the point at which you are unlikely to die from your disease. Thus I wouldn't expect the 10-year survival from local prostate cancer to be very different from the 5-year survival and I am basing my claim about early diagnosis on this assumption. I'm not sure why Cancer Research UK decided to use 10-years as nobody else does and it makes it difficult to compare the two.

That's all I wanted to know. Thanks!