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Musings on Five Years

Posted 8/24/2014

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  Here is the first thing to know about the five year mark: it does not mean much in breast cancer. There are a few cancers (e.g. leukemia) where, if you pass five years without a recurrence, you can almost count on being cured. In Breast Cancer World, the "cure" word is rarely to never used (frankly, I would be suspicious of it), and recurrences can happen anytime. For women with her2 positive breast cancers, going 5 or 6 or 7 years without a recurrence is very reassuring. The more aggressive cancers do tend to come back quicker--if they are ever going to do so. For those of us with ER positive, lower grade cancers, the "let part of your held breath out" part comes later, and these cancers can and do sometimes recur 10 or 12 or 17 years later.

  Research seems to be always be reported in five year increments; the study will say that X% of women are enjoying a "disease free survivial" (means no recurrence) after five or ten years. Those numbers were not chosen because of their particular importance vis a vis the disease, but because they are a handy and convenient study marker; they had to pick something.

  The old statistics of the usual prognosis after a diagnosis of metastatic breast cancer were very grim. Many women are now living much longer in this situation, and this is an essay by Ann SIlberman from her blog But Doctor, I hate pink describes this nicely:

Five years......
What can happen in five years?
A silly, long-haired 12 year old boy grows to become a lanky, bespectacled, scary-smart 6 foot tall man, packing for the start of his elite university education and possible career as a scientist. A young man, 22, struggles in a low paying retail job until he too attends school, gains a fiance, now has a career rather than a job and a bright, solid future ahead. A husband gets a little more slumped, a bit more grey, worry lines mixed with smile lines, but he retires from his own career and gets to play a little more golf and watch a whole lot of baseball. One stepdaughter finds her own sort of family and career success.
Another marries, grows more beautiful by the day, has a baby. And as the first of a new generation is born, the hopes of a crazy, disparate family are joined together, glued by that smiling, giggling baby face.
What will he see in his lifetime? It will surely be amazing.
But really, I'm glad he doesn't have my genetics.
And, me? I am still here. I have made it to the five year mark, as only 30% of women with metastatic cancer do


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