Survival Statistics

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One of the first questions that most patients ask their doctor or ask themselves is “How long do I have?” Cancer and dying are closely linked in our minds, and, whether we want to ask the question or not, worry about dying from colorectal cancer is always in the back of the mind of patients and caregivers.

Don’t be surprised if your doctor doesn’t give you a firm answer. Survival, even when cancer has spread and is at an advanced stage, is remarkably individual. And treatment options are improving all the time.  Your doctor may be able to provide you with statistics for people with diagnoses similar to yours, but your case is your own!


Survival Rate Terms

Doctors use different terms in discussing statistical chances for survival. Remember that these are only statistics and you are an individual! Statistical information about survival helps in developing new treatments for cancer and deciding their effectiveness. But, survival predictions for individuals are not always reliable and they can significantly add to your worry.

  • Five-Year Overall Survival: the percentage of patients alive at five years, including deaths from cancer and other illnesses
  • Five-Year Relative Survival: the percentage of patients alive at five years, not including deaths from other illnesses.
  • Median Overall Survival: the time at which 50 percent of patients are still alive after a diagnosis or particular treatment.
  • Median Disease-Free survival: the time at which 50 percent of patients are still alive without evidence of tumor recurrence.
  • Recurrence: A return of cancer after it has been initially treated  (for example, a person with stage II disease whose cancer comes back after treatment is said to have a ‘recurrence.’)

Doctors give survival statistics based on historical information, so the numbers do not reflect the current standards of care or recent improvements in chemotherapy, surgery and radiation therapy. Improvement of the treatments you get today recently increased the relative survival for people diagnosed at stage III, and the length of time that people with metastatic cancer will live. Remember: survival statistics may not predict the outcome of your case!


Five-Year Relative Survival Rate for Colorectal Cancer

Stage Distribution and Five-year Relative Survival by Stage at Diagnosis for 2003-2009, All Races, Both Sexes

Stage at Diagnosis

Stage
Distribution (%)

Five-year
Relative Survival (%)

Localized (confined to primary site) – stage I and II

40

90.3

Regional (spread to regional lymph nodes) – stage III

36

70.4

Distant (cancer has metastasized) – stage IV and recurrent cancer

20

12.5

Unknown (unstaged)

5

33.6

From: http://seer.cancer.gov/statfacts/html/colorect.html#survival

This survival chart offers one example of why survival statistics don’t always predict your case or display the most recent information. The chart shows that 70 percent of the people diagnosed with stage III CRC from 2003-2009 were alive after five years.

This is significant because cancer recurrence is most common within three years of diagnosis – so most of the people who survived are probably cancer-free.

Additionally, while there are no cures for metastatic cancer, new treatments have increased the time people live with advanced disease – and this chart does not show that information. In 1999, the average survival after a diagnosis of metastatic cancer was nine months, while today it is almost three years.
Unhappily, we don’t yet have a cure for all metastatic CRC patients, although some stage IV patients have been cured, particularly those with surgically removable metastases only to the liver.

Dr. Stephen Gould, an evolutionary biologist, wrote about the challenge of applying “average” statistics to an individual patient in his essay The Median Is Not The Message.

Content medically-reviewed by members of the Fight Colorectal Cancer Medical Advisory Board, February 2014

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