Five years on

Selfie RAH Emergency- 2145 23rd August 2019

DW1

One of the most common metrics in cancer is 5 year survival. It is a tool with great utility, but significant limitations. A comparison value for cancer outcomes is vital. However the choice of the 5 year hurdle is pragmatic and arbitrary, rather than magical or definitive, something I have often had to discuss with my patients. It is rather self explanatory compared with other more complex terminologies such as remission, disease free survival, progression free survival, relative risk, response rates, the rather vague concept of all clear and of course cured. Five year survival allows comparison between types of malignancy and is an important yardstick for therapies, particularly during the introduction of new treatments. For some cancers the 5 year time frame is too long to be meaningful, for others it is too short to be much more than a good start. It can’t deal with the dreadfully difficult and personal questions of will this kill me or how long have I got. Focussing on periods of time also ignores important cancer outcomes such as cost, lifestyle impact, side effects, quality of life, general wellbeing and mental health. #Iamgratefultohavemadeagoodstart #letsmakelemonade