When Does the Survival Clock Start?

[Arrack979]

I just scheduled my first scan after completing treatment so I am pretty anxious and can't stop thinking about things. One actual question came to my mind:

Given that survival statistics are time conditional, when is the starting point for calculating survival time? I searched and read 2 different things on the internet:

1 - At the date of surgery.
2 - At the end of chemo.

Any thoughts or opinion?

[JDinNC]

I was told it starts at the time the main colon tumor was removed....but then others are told differently.

[LeonW]

I'm pretty sure it starts counting at time of diagnosis . . .

[vilca11]

Time is always counted from the time of dx - onset of symptoms is also important. Keep in mind, that after you have metastases, your clock start again - now from the time of the dx of mets. So, if you see stats about mCRC they will be at 5years survival from the time of mets dx.... Do not look at stats, it is personal, not business

[justin case]

Survival time starts when you start living as though it doesn't matter.

[jillbugs4110]

True that

[weisssoccermom]

According to the ACS, the 'clock' starts at the time of diagnosis.
According to many oncs....it starts at the time of the last treatment (whatever that treatment may be)

In the nine years since my diagnosis, those are the two most common times that I have heard of.

[KWT]

It's starts the day we're born. This game is rigged from day one. When you're felling good don't waste that time.

[kiwiinoz]

Inherently the survival clock starts from when you are diagnosed.
However if you are looking at the idea of "xxx years to cure" then it is measured from the last medical intervention, be that surgery or some sort of radiation or laser surgery.

[ranger]

I don't know either, but every day you're here is a win.
http://cancerissofunny.blogspot.com/201 ... there.html

[radnyc]

At MSK it's from your first clear scan. Usually after surgery to remove tumor.

[MamaN]

My onc told me it is my surgery date. When tumor was removed.

[Valorie]

I asked my Onc. He said first scan after chemo. Butt! Since I had a PET scan a month after surgery and was NED I'm going to use surgery date. I don't care what he says.

[Maggie Nell]

From the day you were a tadpole swimming upstream.

[PainInTheAss]

Very cute answers some of you, but the distinction is actually an important one as far as I'm concerned (although I hate the term "survival"... It should be "non-recurrence" to distinguish from overall survival). My diagnosis date is about a year prior to my last treatment date. Since the largest percentage of recurrences happen the first two years, are my two years up or do I have another year to go before I can breathe a slight sigh of relief? The distinction does make a difference because of how the stats are tracked with patients who have gone before us.

My port surgeon wanted to wait until 6 months after the end of treatment to remove my port. I asked my onc what the big deal about 6 months was and he told me that 30% of recurrences are discovered at the sixth month point. It seemed to be understood by both my onc and my port surgeon that this was 6 months after the end of treatment. I think I have another year to go before I am past the two year mark.

Patients who do not have chemo would have their nonrecurrence tracked from the date of tumor removal because that would be the end of treatment for them, so the tumor removal point is true as well for these patients if stats are based on the end of treatment.