Monday 25 November 2013

Happy Cancerversary



At this time of year I tend to dwell on my first cancer diagnosis, because it’s my Cancerversary. Actually, I’m unlucky enough to have two of the occasions each year, with the second falling in the summer. Nicely spaced for a biannual reminder to count my blessings, I think, as I chalk another mark on my mental survival tally. Nine this year. 
So as I’ve made it to nine years, that must make next year the magic ten. After that, I fall off the chart because in the main, cancer survival statistics are based on living ten years post diagnosis. Naturally I’m glad to have made it this far, but I feel a bit uncomfortable about what happens next. What does ‘surviving’ really mean? If I die the day after my tenth Cancerversary, do I still register as a survivor? 


When you’re given a cancer diagnosis, if you want to hear the truth and it’s not already incurable, the doctor will possibly say something along the lines of: ‘Your chances of surviving ten years are around X%.’ Ten years. What does that mean – that we’re cured after ten, or that’s all we can ask? What if you’re only 32 when you get your diagnosis, like me, or only 22, like plenty of others? How does a good chance of seeing ten years look then? 


Although cancer is primarily a disease of the elderly, more and more of us are given a diagnosis well before middle age. At this stage in life, classing ten years as a reasonable lifespan seems a bit insulting. Why, even an octogenarian with a prognosis of ten years falls a decade short of their telegram from the queen. Ten years are never enough.


A common misconception is to treat even five-year survivors from cancer as cured. So often I hear something like ‘My mum just got the all-clear after five years’. Every cancer is different, and it’s true that for some – particularly for those with more aggressive types – to survive five years means the odds are excellent that it won’t be back to haunt you. But as a generalisation for breast cancer, survival continues to fall for many years, decades even. 


According to Cancer Research UK, 95.8% of us with breast cancer will live to see a year, 85.1% five years, 77% ten years and 64.5% twenty years. Of course breast cancer is a blanket term for many different manifestations of a disease, each with its own individual prognosis, but we’re talking averages. So although there are figures to predict twenty years, they’re rarely quoted. I suppose it’s difficult to keep up with survival rates because by the time ten years are up, treatments have improved so much that statistics are already out of date. 


I thought I was cured after five years in the clear, but what I didn’t know was that my cancer was in temporary remission. It’s the less aggressive and hormone receptive cancers you have to watch for sneaky returns. They’re the ones that lie dormant for years, resting with intent. Then, when conditions are perfect in their host - perhaps hormones are surging or immunity is low - they burst back into life, proliferating silently from microscopic and innocuous to invasive and deadly. 


After a recurrence of cancer, I can’t imagine relaxing into a state of mind that says ‘cured’. Recently, Jennifer Saunders got some stick from fellow cancer patients for announcing that she was cured of cancer. And statistics say she probably is cured, plus perhaps she's a glass-half-full kind of person. A positive attitude has long been considered a benefit. They told me the same, gave me a 93% chance of seeing ten years, told me after five years I should consider the cancer to be gone. And I believed it, until five and a half years after the first diagnosis, the cancer returned. Although I will never be guaranteed a cure, I am hopeful that medical progress will continue to offer long term management, should a malignancy make itself evident again.


Nobody wants a Cancerversary. But the ironic thing is, once you've had one, you're crossing your fingers every year for another. So Happy Cancerversary to me, and cheers to the next.


2 comments:

  1. Happy Cancerversary to you, Jane! I came across your blog through the article in the Daily Mail. I, too, had breast cancer during pregnancy, eight years after my original diagnosis. Unfortunately, the cancer became metastatic while I was pregnant and I have been undergoing treatment ever since (four years now).

    I hope you will stay well. Wish you all the best!
    Diana

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  2. Thank you Diana. Sorry to hear about the metastasis. I really hope the treatment is doing its thing, and you stay well too. x

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