People talk about cancer survival in 2, 5, 10 year intervals. When does the clock start?

Question by sonia: People talk about cancer survival in 2, 5, 10 year intervals. When does the clock start?
Does it start when the cancer is discovered? When they think the cancer started growing? If it has metastasized from somewhere else, does the clock start over again? My husband learned he had kidney cancer in 2007. He had a complete nephrectomy in October. The doctor told him that the tumor had probably been growing for two years before we found it. Last September the kidney cancer spread to the plural lining in his lungs. Now it has spread to his lymph nodes. If he has a 5 year expected survival rate, when did the clock start?

Best answer:

Answer by Dr. Frog, Flying High Again
the time of diagnosis in most cases.

What do you think? Answer below!

  1. Reply
    Sgt. Sarcasm May 14, 2013 at 8:01 pm

    Time of diagnosis usually. As in, from the moment the doctor said that the expected survival rate is 5 years.

  2. Reply
    Spreedog May 14, 2013 at 8:04 pm

    I’d like to see what Denisedds has to say about this if she sees this question. She is a tumor registrar – statistics expert. Stage IV renal carcinoma – what percentage five year survival rate did your medical oncologist tell you?

    No experienced oncology doctor would say a person has five years to live. We never know that so far in advance. We usually quote percentage five year survivals for people in similar situations with various types and stages of cancers.

    The “clock” as you put it starts when the biopsy diagnosis is made and the malignant disease is initially staged. The statistics do change when metastatic disease is later identified. You now know that the renal cancer cells had already spread to the pleura and the lymph nodes before the nephrectomy in 2007. The cancer cells were microscopic in the pleura and lymph nodes in 10/07 – too small to detect with any scans.

    BUT – Statistics never tell us what one special individual will do. Statistics are averages from the experiences of a large number of people who are not really alike even though they have the same general diagnosis. No two people I saw with renal carcinomas were exactly the same. No two women with breast cancers are ever the same.

    People may become too caught up in numbers or statistics from other people. No one can precisely predict the future of one person with statistics based on a large group of other people.

    The urologist who did the initial surgery in October 2007 could not have known how long that primary tumor had been growing. He or she was just making a guess. Our thinking is that most tumors go through ~70% of their cellular divisions or growth by the time they reach 1 cm in diameter – about the size of a marble. Most of the growth of a malignant tumor – either a primary or a metastatic lesion – occurs before we can see the tumor mass with any scans.

    Maybe your doctor meant that it may have been visible for two years before it was finally detected. That is the problem with kidney cancers (and pancreatic and lung and ovarian cancers). There often are no signs or symptoms until they are already advanced.

  3. Reply
    readpetspoetry May 14, 2013 at 8:45 pm

    generally the time of diagnosis, but it can also be the time that treatment is either stopped, or just stops working

  4. Reply
    blondie103 May 14, 2013 at 9:36 pm

    Excellent answer as always from Dr Spreedog wish he had a private practice in Europe

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