R. Fizek wrote:
> Hi,
>
> I had a visit to my oncologist's office today for a checkup - 2yrs & 2
> months post dx & all is well... so far (knock on wood, etc.) As you can see
> I'm still waiting for the other shoe to drop. I had a question that I'm
> sure Tim can answer, maybe others as well. My dr. said that I passed the two
> yr mark and now my risk is lower but that there is a peak at 1.5 yrs and at
> 4 yrs. We didn't get into the reason for this increased risk at yr 4 -
> anyone know why? Also, the "books" say that blah blah blah... 85% of women
> dx'd survive to 2 years,...something like 65% survive to 5 yrs. If my risk
> goes down why isn't there a survival curve to substantiate it? Tim???
>
> Anyway, I'm not looking a gift horse in the mouth - I'm happy for every one
> of the these days and I hope I have lots & lots more like them.
>
> Tammy
>
>
I'm not sure about the 4 years thing. I don't think its much of a bump.
Maybe you could ask your doctor for a literature reference. I seem to
recall having seen one somewhere. The answer should be there in the
SEER data, but I don't know of any available extract graph that
specifically shows this information.
http://seer.cancer.gov
The main reason why the risk curve starts low and initially rises is the
choice of staring point. At the time of surgery you are known to have
no symptomatic or detectable metastases, those patients that do aren't
part of these statistics. That means the likelihood of you developing
symptoms the next day is very small - you aren't being examined and
staged every day, and it takes a few months for any metastases to grow
from undetectable to symptomatic.
Beyond this 'statistical artefact' the incidence of recurrence generally
falls steadily over time as the population of residual cancer cells (or
cancer stem cells according to some theories) falls as they are mopped
up by the immune system. But it never falls as low as the general
population's base risk because some breast cells have shown a propensity
for going cancerous, and you've got billions more similar cells still in
your body, that might someday choose to take the same path.
In looking at survival curves you have to take into account general life
expectancy. If you consider women diagnosed with cancer at say age 80
it is hardly surprising that most don't survive beyond 20 years simply
because most people don't live to be 100, nothing to do with their
cancer. So for your purposes you are better to look at recurrence data
than survival data, unless you restrict the search to your own age group.
Tim
Visit to the Dr's today. 
Linear Mode
