At one time in the not-so-distant past, a cancer diagnosis was something close to a death sentence. That is far, far less true these days. As our understanding of the wide variety of cancers grows, and the spectrum of treatment options widens, a cancer diagnosis is no longer regarded as a death sentence. In fact, there is now a great deal of realistic hope for a long and healthy prognosis.
While we may have a ways to go in fully understanding the underlying mechanisms of cancer and in creating effective treatment options for all of them, we have in fact learned much about how cancer works, about what makes some forms of cancer more survivable than others, about what diagnosis procedures have the most promise in helping to create a near-guarantee of survival, and what treatments provide an extremely positive prognosis (estimate of outcome). Here’s a snapshot: the following table illustrates how much has changed in the cancer landscape, and what cancers are most “survivable”.
Table 1. The most survivable cancers according to the US SEER database of cancers diagnosed between 2005 and 2011.
|Cancer Type||Median age at diagnosis||5-year relative survival|
|Skin (basal & squamous)||unknown||99.9%|
|Melanoma of the skin||63||92%|
|All childhood cancers||0-14||83%|
|All cancers (excluding skin)||65||67%|
So, what are the most important factors in determining whether a particular form of cancer has a higher (or lower) rate of survivability? Let’s take a look at 3 of the top factors.
- Early detection of cancer means earlier treatment and a higher cure rate
In other words, how soon do you feel sick? If unpleasant, odd or unusual cancer symptoms manifest early on in its development, it has a much higher chance of being detected early on in its growth and development. Then, it has a much higher chance of being effectively and completely treated. This is very good news.
First, if the cancer is located in a solid tumor and has not spread when detected, it can much more easily be completely removed/destroyed by the surgeon’s knife or effectively treated with some type of targeted radiation therapy.
Second, if the cancer is a blood cancer (and thus not removable by surgery), if it’s detected early on, hope is quite high for an effective treatment. Blood cancers tend to manifest unpleasant symptoms early in their life, so they tend to be detected and diagnosed early on in the process of disease progression. Again, this contributes to a high probability of very effective treatment.
- The more diverse a cancer’s acquired mutations, the more resistant the cancer is to treatment
This factor overlaps with the first one to a degree. The longer a cancer progresses along undetected, the larger the number and more diverse the acquired genetic mutations that will accumulate. And in general, the greater the diversity of genetic mutations, the more likely that one or more of those mutations will prove to be resistant to non-surgical therapy.
So, early detection means more effective treatments and higher rates of survival. Cancers that are detected early on tend to have a smaller, limited number of mutations, making it more likely that a non-surgical treatment (e.g. chemotherapy) will be effective in targeting and killing the cancer cells.
Thus, earlier detection of solid-tumor cancers means a smaller degree of diversity of mutations. This means that early treatment has a greater chance of success, whether that treatment is surgery or a non-surgical treatment such as chemotherapy.
As mentioned earlier, immune system (blood) cancers tend to have unpleasant symptoms quite early in the cancer’s progression, which results in early detection. Again, this means that the cancer has had only a relatively short time (a few months to a few years) to accumulate treatment-resistant genetic mutations. And again, this means that non-surgical treatments for blood cancer such as chemotherapy have a much higher chance of success.
- Indolence (slow growth) is a good thing
Certain cancers, such as prostate cancer and thyroid cancer, tend to be very slow-growing. Autopsies done in the US have shown that around 80% of men over 70 years old have some cancer living in their prostate; however, few of them died from this! Small nodules (tumors) of cancer living in the thyroid are so commonplace that they are looked upon as “normal”! Autopsy studies have shown that around 8% of the US population have minute nodules of thyroid cancer, which were not the cause of death either. All of these cancers are very slow-growing.
Let’s look at how these factors play out in several common cancers.
Skin cancer has a 99.9% 5-year survival rate, and it’s not hard to understand why. First, while skin cancer is quite common, it is also very easy to remove surgically. Second, since they are on the surface of the skin, skin cancers are also quite easy to detect, early on in the progression of the cancer. Early detection means early treatment, which means a high survivability rate. Surprisingly, this includes melanomas, which are one of the most mutated forms of all the cancer types, and which spread easily to almost anywhere in the body. Yet, the overall 5-year survivability rate for skin melanomas is 98%. Again, this is due to early detection of a skin anomaly or lesion, early skin cancer diagnosis, and early skin cancer treatment (i.e. surgical removal).
Prostate cancer has a 99% 5-year survivability rate. This is because prostate cancers tend to be indolent (slow-growing): they either grow very, very slowly or do not grow at all. This often results in a treatment regimen called “watch and wait,” which means frequent exams to determine if the cancer has changed in any way, such as getting larger or more aggressive. If no change is detected, nothing is done until the next exam. If any change is detected, prostate cancer treatment is generally addressed through surgery or targeted radiation therapy, such as tomotherapy.
Thyroid cancer has a 5-year relative survival rate of 98–100 percent at stages 1 and 2. The thyroid is a gland in the neck that produces hormones to support healthy bodily functions.
Most thyroid cancers grow slowly, which allows more time for treatment to take place. Even when cancer spreads into surrounding tissues in the throat, removing the thyroid gland can be an effective method of eradicating it.
These three cancers are just a sample of those with a greatly improving outlook for a cancer diagnosis and its ultimate prognosis. We are no longer in the dark about many of the underlying mechanisms and processes of cancer and its development, and we are learning more about them every single day. New medications, new forms of chemotherapy, new forms of radiation therapy, immunotherapies, and even more forms of treatment are just beyond the horizon. And we are here to support you in accessing these new and powerful cancer treatments.
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