5 year survival stats for metastatic cancers

BrianD3

I was reading this paper by Hermann Brenner and thought it was interesting. The below figures are 5 Year relative survival by cancer site for cancers that have spread to distant sites.
Oral cavity 28.8%
Esophagus 4.8%
Stomach 5.4%
Colon 12.5%
Rectum 9.1%
Liver 4.6%
Pancreas 3.9%
Larynx 20.2%
Lung 3.6%
Skin melanoma 16.7%
Breast 28.0%
Cervix uteri 14.2%
Corpus uteri 25.6%
Ovary 29.5%
Prostate 31.7%
Testis 71.5%
Urinary bladder 7.4%
Kidney 8.9%
Thyroid 54.3%

Anyone want to discuss this. Obviously many of the figures are dismal but some are higher than I would have thought.

It may be that the majority of the patients who are alive 5 years after diagnosis still have incurable cancer. But perhaps if these figures improve in coming decades metastatic cancer will come to be regarded as something patients tend to live with rather than die from.

Vorsprung

Stats like that are interesting, but can't capture the morbidity associated with the various malignancies. Things like pain/pathological fractures come to mind.

kelle

OP, do these statistics mean the percentage of sufferers still alive after 5 years?

Ironic, since this month it's exactly 5 years since my mother and father were both diagnosed with cancer. Sadly, they both passed away within 5 months:(

I would have thought Prostate cancer had a higher survival rate.

tallaght01

kelle wrote: »

I would have thought Prostate cancer had a higher survival rate.

Bear in mind these are rates for metastatic ca.

Wibbs

Am I right in thinking that cancer is an umbrella term for rogue cells with highly variable growth speeds and capacities for metastasising and responses to treatment? That a one shot "cure" for cancer is unlikely because of that?

Also I'm wondering do they have any commonality in how they metastasise? How do they attach and put down roots for serious want of a better set of words.

I seem to recall watching some programme on sharks on Discovery(big shock:)) and one marine biologist said that while it was untrue that they never get cancer(like the quacks who sell shark pills to cancer patients claim), it was true that they tend not to die from it as their cartilaginous structure and how their vascular system works means that tumours find it dificult to get the blood supply they need to grow. Is that similar in humans? Do say skin tumours on noses and ears(even hands) have a lower metastatic rate or grow slower, compared to the same kind of tumour on the trunk? So on top of that is there any way of blocking the growth of vascularity in human tumours ?

SomeDose

Wibbs wrote: »

Am I right in thinking that cancer is an umbrella term for rogue cells with highly variable growth speeds and capacities for metastasising and responses to treatment? That a one shot "cure" for cancer is unlikely because of that?

Also I'm wondering do they have any commonality in how they metastasise? How do they attach and put down roots for serious want of a better set of words.

I seem to recall watching some programme on sharks on Discovery(big shock:)) and one marine biologist said that while it was untrue that they never get cancer(like the quacks who sell shark pills to cancer patients claim), it was true that they tend not to die from it as their cartilaginous structure and how their vascular system works means that tumours find it dificult to get the blood supply they need to grow. Is that similar in humans? Do say skin tumours on noses and ears(even hands) have a lower metastatic rate or grow slower, compared to the same kind of tumour on the trunk? So on top of that is there any way of blocking the growth of vascularity in human tumours ?

It's been a while since I studied any oncology, but I think all "cancer" cells have several unique features to differentiate them from normal cells i.e. uncontrolled growth & proliferation, invasiveness, loss of normal function and formation of metastases.

I'm pretty sure all tumours metastasise by the same basic mechanisms i.e. once a tumour reaches a certain size, it will starve itself of nutrients unless it can attract a blood supply (angiogenesis). This also allows them to travel to other sites in the body and form secondaries. I've no idea about the relative abilities of various tumours to metastasise though. To answer your final question, yes there are a number of new-generation drugs which inhibit angiogenesis e.g. bevacizumab and ranibizumab (which block the pro-angiogenic VEGF). These have been shown to be effective to an extent in certain types of cancer but come with the caveat that if you cut off a well-fed tumour's blood supply, it may stimulate angiogenesis by non-VEGF pathways and thus metastasise by other means.

Echani

Wibbs wrote: »

Am I right in thinking that cancer is an umbrella term for rogue cells with highly variable growth speeds and capacities for metastasising and responses to treatment? That a one shot "cure" for cancer is unlikely because of that?

Yes it's an umbrella term for tissue that proliferates abnormally. What differentiates benign cancers from malignant ones is that most malignant tumours tend to proliferate more uncontrollably, invading other tissues, and most will eventually metastasize to other locations via your body's lymphatic system or blood vessels.

Wibbs wrote: »

Also I'm wondering do they have any commonality in how they metastasise? How do they attach and put down roots for serious want of a better set of words.

Like SomeDose said they can essentially outgrow their blood supply and need to invade/metastasize to keep growing. The cancer cells aren't held together as well as most cells in your body, so they're more prone to breaking off and traveling through lymph/blood and lodging in other tissues. The middle part of this comic explains it pretty nicely.

How quickly they metastasize can be down to the type of tumour, but it varies a lot between cases. Basal cell carcinoma of the skin very very rarely metastasizes, instead it locally invades other tissues, while malignant melanoma metastasizes easily once it gets deep enough in the skin to get access to the lymphatics and blood vessels.

tallaght01

Whatever happened to the reintroduction of thalidomide as the next big thing in cancer treatment?

It has some hardcore anti-angiogenic properties that everyone was getting excited about a few years ago.

Not heard much recently about it.

Echani

tallaght01 wrote: »

Whatever happened to the reintroduction of thalidomide as the next big thing in cancer treatment?

It has some hardcore anti-angiogenic properties that everyone was getting excited about a few years ago.

Not heard much recently about it.

One of my haematology lecturers talked about thalidomide derivatives (lenalidomide) being approved for refractory multiple myeloma in the UK this year; not sure what the evidence is like though.

SomeDose

Both Thalidomide and Lenalidomide are now licensed for use in multiple myeloma in the UK. Our Haem/Onc people seem to be fans of them...although I dread the reams of paperwork that is required (understandably) for each prescription, and prescribing of them is very tightly regulated by the MHRA. Thalidomide is the first-line option, whereas Lenalidomide is only approved for people who (I think) have been unsuccessfully treated with 2 previous regimes. Cost, as always, is a major issue: a single 21-day course of Lenalidomide is over £4k and people can have up to 26 courses. Hence why it was the subject of a BBC documentary not so long ago, and also why the manufacturer has agreed to fund treatment for any patient who goes beyond 26 cycles.

The mode of action for both drugs is still far from definitive, although I think Lenalidomide has better anti-angiogenic properties.

tallaght01

Interesting. I've not heard of them being used here locally, though I don't deal with MM very often.

But there seemed to be much more optimism years ago about their potential in the aggressively metastatic cancers, which have a low cure rate.

I haven't seen the studies on other types of tumours. I wonder what other types, if any, they've been tried with.

Wibbs

Echani wrote: »

The middle part of this comic explains it pretty nicely.

:)Thanks, it does indeed. Objectively speaking it's a fascinating subject. It's from my (very)basic perspective an example how life can be so vigourous in trying to live, even when the host will often die. Taken alone, even though it's a damaged cell, it's so adaptable and in a strange way admirable on the cellular level, even when it can cause such terrible terrible misery on the human level. I seem to remember reading of a culture of cancer cells taken from a Black American woman IIRC waaaay back in the day(1930's) that sadly killed her yet are still alive and dividing in labs today.

What also intrigues me about that multi pronged adaptation is that it seems so vulnerable too. Interrupt just one of those and it would die or not spread it seems? I do remember as a kid in the 70's watching a programme where some US doctors and researchers reckoned that within 20 years they would be able to eradicate or massively control it as a disease and I can see now why they had such confidence. Yet it still survives in many cases. Albeit so much less than in the past. I do think many forget that even 20 years ago there were cancers that were game over then that aren't today and how treatments have improved massively in a remarkably short time. Maybe antibiotics and immunisation have left people thinking that one shot wonders are the way of medical science. The idea that if your GP doesn't go "ah yes cancer, here's a big purple pill, feck off go home you're cured" it means there isn't progress.

There was a good programme on Thalidomide, Horizon I believe a few years back. About how it was a drug with so much potential in many areas, but it's reputation naturally made people wary. Not dissimilar to nicotine in that addicts of it die from so many things yet it appears to have some positive effects on some neurological(ADHD, Parkinsons) and digestive conditions(ulcerative colitis in particular).

If I may ask another question of those in the know? Is it generally the case that the faster a cancer cell or cells grow(again for want of a better word) the easier it is to treat it? And that's why many cancer sufferers hair falls out as the therapy targets fast growing cells and hair cells(and gut cells IIRC) get caught up in the mix? That the slow growers(like certain prostrate cancers) may give a better 5 year survival rate but are hardest to irradicate?