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Cancer And Five-year Survival Rates

Q: Your article on BSE (breast self-exam) is really the best I've ever read.  Actually helpful, as opposed to many articles I've read that I find lecture-y and frustrating.

On the eve of my friend's mastectomy, I am curious to know what the "five-year survival rate" really means.  Is the idea that if you're still alive after five years, it's more likely to be smooth sailing?  Or does the death rate just keep increasing for six years out, seven years, etc.?  Does five years simply sound like a nice chunk of time?

-- HG, Brooklyn NY

Dr. Donnica:
Great question!  A "survival rate" is simply the percentage of people who live a certain period of time. Accordingly, the "5-year survival rate" refers to the percent of patients with any particular cancer who live at least 5 years after their diagnosis.  As explained by the American Cancer Society, 5-year rates are used by doctors and researchers to produce a standard way to discuss a patient's prognosis.  The good news is that for most cancers, the 5-year survival rates are improving, thanks to earlier diagnosis, as well as much better treatment regimens.  For example, the 5-year survival rate for women with localized (Stage I) breast cancer was 78% in the 1940s; in the l990s, it was over 97%; now it is 97%!  These data include all women who are still living five years after diagnosis, whether the patient was in remission, disease-free, or under treatment (still or again).

Five-year relative survival rates exclude patients dying of other diseases, and are considered to be a more accurate way to describe the prognosis for patients with a particular type and stage of cancer.  Remember also that 5-year survival rates are based on patients who were diagnosed and initially treated more than 5 years ago. Improvements in treatment -- even over a 5-year period of time -- can often result in a better outlook for recently diagnosed patients.

The downside of 5-year survival rates is that they are based upon a large, diverse population.  As with any statistics, they should only be used as a guide, and should not be seen as a predictor in an individual case.

Remember that in medicine, regardless of the "risk" or "incidence" of any disease, condition, complication or side effect in others, if it happens to you, your risk becomes 100%.

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Created: 2/25/2001  -  Donnica Moore, M.D.

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