Anyone diagnosed with cancer naturally wants to know how long he or she will live? Though everyone with cancer curable or not, will have this question, This is more applicable in patients who are unlikely to be cured. So first determine the chances of your cure, then come to this question. The questions for a curable patient are very different from this situation (addressed in a different blog). It is very natural for anyone to ask this important question. Please do not feel embarrassed for asking this question and last of all never feel that it is a stupid question. Please do not feel intimidated ever by anyone for this question. The doctor or you may feel uncomfortable to address the question but does not matter! and You have a right to ask question as you have things to do and it is your life. It does not matter you may or may not get the accurate answer. But is important for you so please ASK !!
I would like to provide some tips before you ask this question. Firstly, ask the right most person, the best being your treating oncologist, and not a doctor who does not deal with such patients, or diseases. Otherwise, you may be stumped with an answer, that can scare you and I have seen many a times, a curable patient has been told by some doctor that he has short time to live !! When his oncologist told it is not so and he is curable, he did not believe it ! Then it takes a long time get over that feeling.
Secondly, prepare yourself to ask and to understand the answer correctly. Be ready to ask yourself many questions first ! Am I prepared to listen to that answer ? How will react if learn that I am going to die soon ! Do I have some short term or long term plans? Who should be accompanying me while I ask this question? Close relatives, spouse, friends? Can they hear and react appropriately by the answers? Can I discuss with my spouse and close relatives? Please do not have a weak hearted person with you who faints at the slightest provocation. I have seen people fainting or howling when they hear the answer. This is a serious discussion and the requires a serious preparation.
Thirdly, it is not a simple question but a complicated one with lots of ‘ifs’ and ‘buts.’ It is actually a total discussion and will take time to get the correct picture. For some, the estimated lifespan may in few months ! For every answer that oncologist gives, there will be several questions, what if etc !
Fourthly, the answers are based on the statistics of the patients like you but not you !! While you can be optimistic as much as you want, you have to be realistic also. I have seen some patients and relatives refusing to believe that they have an incurable cancers and have limited life span and they disbelieved in the science of medicine and the doctor. That is a very unpleasant situation and totally avoidable. It is not the fault of the doctor that someone has an incurable cancer or that cures are not existing for all the cancers!
Fifthly, it is always better to note down the points for discussion on a paper or notebook prior to the discussion, or else one may forget the questions in an emotional state.
Sixthly, go with an open mind and please do not read or browse the material that maybe irrelevant and go with a formed opinion. If you go with inappropriate mindsets, one may face difficult situations. Please go with an open mind!
Lastly, be sure you or relatives want to ask the question and want an answer. Rarely, this question may not have a relevance.
Who should ask the question ? patient himself or the close relatives? Mostly I have seen that relatives want to know about it and ask without the patient. They also insist that the patient must not be told at all. There is a point in it and one goes by the law, it is not appropriate. This situation may vary according to the literacy, intelligence, capacity to understand, social factors, culture of the patient, situation, and age of the patient.
Let us see what goes to get an answer to this question from the oncologist. . There is no app, software or any system to estimate the survival in your case. At best, it is a guess, an intelligent guess based on statistics of other patients of similar features and it can be somewhat nearer. Many factors are considered for the estimates.
Firstly, there is a natural history of cancers, as to how they behave in reality. While some allow the patients to live normally despite advanced stage, others even though in early stages have aggressive behaviour and have less survival. The medical literature, publications exist with survival periods. You must first understand the natural history of your cancer through your oncologist.
Secondly, the various treatment modalities, have survivals mentioned with most of them. Usually there is a variation in each publication due to many factors. And the term used is ‘median survival’ of the patients. Median survival is defined as the time after which 50 percent of people with a particular condition are still living, and 50 percent have died. For example, a median survival of 6 months would indicate that after 6 months, 50 percent of people with that condition would be alive, and 50 percent would have passed away. Keep guessing as to which category you belong to ! There is a range of survival, for example 4 months to 36 months with a median of 14 months. That means 50 % have lived for 14 months while some lived for 36 months ! Double the median !! It is very difficult for the oncologist to guess your life span accurately, and he may play with figures, statistics which sometimes confuse you and leave you nowhere.
The statement, “No two people are exactly alike,” certainly applies to people living with cancer.
What is a cancer survival rate?
Cancer survival rates or survival statistics tell you the percentage of people who survive a certain type of cancer for a specific amount of time. Cancer statistics often use an overall five-year survival rate. Survival rates are usually given in percentages. The 5-year survival rate tells you what percent of people live at least 5 years after the cancer is found. Percent means how many out of 100. The 5-year survival rate for all people with all types of lung cancer is 19%. The 5-year survival rate for men is 16%. The 5-year survival rate for women is 22%. Try to make out where you will fit in !!
Talking With Your Doctor About Prognosis
Maintaining open and honest communication with your doctor is an important part of your care. In fact, research has shown that people who have a good relationship with their doctor tend to be more satisfied with the care they receive.
Can doctors really predict how long one has to live? Unfortunately, doctors get it wrong more often than they get it right and most of the time they overestimate how long patients will live. I cannot forget a patient, who I thought would live for few months, and I met him after few years in his hometown living happily !! Imagine my plight as an oncologist !! Many physicians will shy away from making specific predictions. But patients and their families often want some idea about how long they might have left. And that desire to have a window on the future is certainly understandable.
When in doubt, both doctors and patients tend to err on the side of optimism, assuming that a treatment will work.
“No two people are alike.” A statistical prognosis is always just an estimate, not a firm prediction. Effective cancer treatments can sometimes dramatically improve a person’s well-being and survival. Although knowing your prognosis can be helpful for making important personal plans, it is just one of many factors to consider when you are striving to live fully with cancer. Doctors are human beings and attempt to provide you an information gained from their training, expertise, and experience. They can be right all the time and not wrong either about the estimates of survival ! They don’t control anything ! Nature does !