Cancer Doubts .com
  Information for patients researching their options

Learn about cancer and
Talk to your doctor with confidence

  Cancer information  

 
         
 Contents
01 What is cancer?
02 Cancer symptoms and screening (how cancer is detected)
03 Causes of cancer
04 Can cancer be prevented?
05 Cancer Stages
(how long do patients live?)
06 Cancer treatment and therapy (how cancer is treated)
07 Types of doctors who treat cancer
08 Choosing a doctor (or getting a second opinion)
09 Preparing for Chemotherapy and Radiotherapy
10 Cancer support (patient psychology and feelings)
11 Cancer suport - How friends can help
12 Is it important to do my own research? (or do I just follow doctor's orders)
13 Cancer information (research your treatment options)
14 Alternative and complementary treatments for cancer
15 Avoiding dubious treatments
16 How medical research is done (how to read medical research papers)
A About this site
 

How long do I have to live? (Cancer Stages)

Cancer can cause the body to die when tumors grow and prevent normal body organs from functioning. This can happen when tumors grow so large that they put pressure on normal body organs, or even grow into a normal organ and destroy it. If this happens, death can result. Tumors may also absorb nutrients from the blood stream, and release chemicals which can cause the body to start wasting away (a condition known as cachexia). This can weaken the body till it is unable to survive.

How long a patient has to live depends on (1) whether it is possible to completely remove the cancerous cells, leading to a complete recovery, or (2) if this is not possible, then how much treatment can slow down the growth of the cancerous cells and tumors.

Both these factors depend on how much the cancer has already grown in the body. If the cancer is still limited to a few cells (few is a relative term here, a small 1 cm tumor contains millions of cells) in a small tumor at its original growth site, then it could be possible to surgically remove the tumor mass and all the cancer cells from the body. In many such cases, a cure is a possibility.

Lympathic System

Image: The lymphatic system. Source: Wikimedia Commons, public domain image.

However if the tumor has grown bigger and eaten into a neighbouring organ, then surgery may be harder. Surgical removal is only viable if removing the tumor will not require so much of the organs to be cut away that they cannot function normally. (Tumors don't always grow in simple circular or oval shapes, they sometimes eat into a neighbouring organ like tree roots grow into soil, making it difficult to remove them without destroying the organ). The cancer may also have metastasized, meaning that cells have broken off the main tumor and travelled through the blood stream or lympathic system, and set up a new colony elsewhere in the body. In this case, it becomes harder to treat, because there are probably millions of cancer cells floating the bloodstream, able to attach themselves to any part of the body at any time and form a tumor. In such cases, it is often the case that medicine can only hope to slow down the progression of the cancer. Depending on the aggressiveness of the cancer cells, the current sites of tumor growth, and how well the body responds to treatment, a patient may have anywhere from a few weeks to years of comfortable living.

Whether someone survives cancer, and for how long, depends a lot on the specific circumstances of each cancer and how the patient's body responds to treatment. It is important not to let cancer statistics make you unnecessarily gloomy. Cancer survival statistics simply measure population averages and don't really tell you much about the circumstances around each case. For example, a survival statistic for colorectal cancer may say that only 20% of advanced cancer patients are alive after 5 years, but it doesn't tell you anything about their overall state of health during treatment or how they responded to different drugs. The statistics may also be for patients who used an older type of medicine. This is particularly relevant today, because pharmaceutical companies are constantly inventing new medicines which attack cancer cells and tumors using different mechanisms. Cancer statistics also don't capture the inherent differences in each persons cancer cells. While it simplifies things to say for example that someone has colon cancer, the reality is the cancer cell mutations for every colon cancer patient is different. Certain mutations may respond to certain drug treatments, while others may be extremely resistant. If a patient has a mutation which responds well to a certain drug, then his or her survival time will invariably be better than what the average statistics would suggest.

Published Survival Statistics
Nonetheless, it is useful to understand how to make sense of official cancer survival statistics. Cancer survival times are usually expressed in terms of cancer survival curves. Here's what a survival curve looks like:

[ IMAGE ]

A survival curve shows how long a particular group of patients survive after the first diagnosis of their cancer (ie. how long they survive after their cancer is first detected). The shape of the curve shows us that as the months go by, fewer and fewer patients continue to stay alive. In practice, there are usually different survival curves for patients depending on how advanced their cancer was when it was first detected. As you might expect, the survival curve for patients whose cancer was only detected after it reach an advanced stage is less promising that for patients who detected their cancers when it was still early.

Cancer Staging
Doctors use a system of stages to classify "how advanced a cancer was at the time of detection". There are many staging systems in use, and two of the common ones are: the Roman-Numeral system and TNM. (Cancers of the blood, such as lymphoma, can be difficult to classify into stages because they don't start in a "solid" organ. Such cancers are usually measured differently)

In the "Roman-Numeral" staging system, cancer is classified into 4 stages:

Stage I: the cancer is still a small tumor and is "inside" the organ that it started in.

Stage II: the cancer tumor has grown larger, and reached the edge of the organ or even grown into (invaded) a neigbouring organ.

Stage III: the cancer tumor have invaded a few lymph nodes (lymph nodes and part of the lympathic system, which is system of conduits that drain lymph fluid from different parts of the body. Cancer cells that get into the lymphatic system can travel to other parts of the body via this channel)

Stage IV: the cancer tumor now occurs in organs other than the original organ. In other words, the cancer has metastasized and is now mobile. This means that cancer cells are now in the bloodstream and liable to attach themselves to other parts of the body and grow new tumors.

Doctors use the staging system because it helps them categorize patient conditions. The treatment protocols (ie. a general consensus on how treatment should be carried out) tends to be different for each stage of cancer. In other words, the staging system is a system to help doctors organize and decide how to treat a cancer. Although in general patients with Stage 4 cancers do not live as long as patients with Stage 2 cancers, it does not mean that this is always the case. There can be cases of patients with Stage 4 cancers that live longer than patients with Stage 2 cancers.

The TNM staging system is a little more detailed. In this categorization system, each patient is assigned a TNM rating:

T = the size of the Primary Tumor (TX, T0, Ti, T1, T2, T3, T4)

N = the number of nearby lymph nodes that the primary tumor has invaded (NX, N0, N1, N2, N3)

M = whether or not the cancer has metastasized and spread to other parts of the body (MX, M0, M1)

With advances in medical science, doctors are now able to come up with more specific survival curves instead of organizing survival curves simply on the basis of cancer stages. For example, we are now beginning to understand that the differences in each person's genetic makeup can affect the way a person's body reacts to medicines and cancer cells. As a result, scientists are beginning to plot survival curves for persons with specific genetic markers. The one size fits all survival curve of the recent past is beginning to be seen as being too vague, because it does not take into account individual factors that affect a person's treatment.

I personally believe that it is important for patients not to read too much into the published survival statistics averages, because we are beginning to discover that there are many individual factors that affect survival. It is important not to read too much into survival statistics, or you may paint yourself a picture which is too gloomy. (I am not advocating blind optimism; I just think that published survival statistics can give a patient a misleading picture of his survival prospects)

 

 


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Medical information for cancer I am not a medical professional; please consult your doctor for a medical opinion. This is my attempt to explain cancer to anyone who is affected by it. If this site helps just one person, then it will have served its purpose.

 

 
 Cancer Links
Prominent research and treatment centers
Stanford Cancer Center
Memorial Sloan Kettering
M.D. Anderson Cancer Center
Kimmel Center at Johns Hopkins
Dana-Farber/Harvard
Mayo Clinic
 
Information on Drugs
Drugs at FDA
NCI Drug Info
 
Complementary and Alternative Medicine Information
Sloan Kettering
(Integrative Medicine Service)
Medline Plus
American Cancer Society
PDR (Herbals and Supplements)
 
Complementary Medicine and Supplement Suppliers
Cuesta Agaricus Mushrooms
Agaricus Farm Mushrooms
Mitobi Mushrooms
Freshes Mushrooms [Bulk]
AllStarHealth [Maitake D-Fraction]
Maitake Products [D-Fraction]
LifeStream [BRM 360 capsules]
Himalaya Herbals [Ashwagandha]
Vita Green [Yun Zhi extract]
 
Clinical Trials
Clinical Trials (NIH)
 
Research Papers
National Center for Biotechnology Information
Google Scholar
 
New Drug Approvals / Drugs in the pipeline
FDA approvals
 
Helpful Books and Sites
Chemotherapy and radiation therapy survival guide
Cancer Guide.org
The biology of cancer
 
Patient Stories
Andrew Grove
Steve Dunn

 


 

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Site Copyright © 2008 Wei-lung Wang. Top banner images from the Wikimedia Commons, and used under the terms of the GNU General Public License.