lower survival rate for stage 2 than stage 3?

[effie26]

does anyone know why the survival rates for stage 2 colorectal cancer are lower than stage 3?it doesn't make any sence...

[peanut_8]

Hi effie,

To the best of my knowledge, it's most likely because many times stage 2 patients don't get adjuvant chemo. Stage 3 patients pretty much always do.

Best Wishes,
peanut

[Lee]

Hi effie,

To the best of my knowledge, it's most likely because many times stage 2 patients don't get adjuvant chemo. Stage 3 patients pretty much always do.

Best Wishes,
peanut

Yes, that is what I learned too. Or if they do get chemo, sometimes it's light chemo. I'm a firm believer, those diagnosed stage II should get a 2nd opinion at a major cancer treatment center. Simply because stage II has it's own situations. If you have an aggressive cancer or deep penetration, who to say, you don't have cancer cells floating around your body. Not in the lymph nodes, butt still floating around your body. Thus you should be treated as a stage III

Lee

[Deb m]

Yes, that is true in some cases. My husband was a stage IIbt4a. Our oncologist told us that somebody who's a stage IIIa, t3 or t2 would have a better survival than a stage IIbt4a. He said that bowl wall perforations are a bigger concern than just having one or two lymph nodes effected sometimes. He said that in stage II, the "t" rating is very important. If it's a t4, the survival rate is much lower than stage II's that are not t4's and also some stage III's that are not a t4. A little confusing at first, but when you think about it, when you have bowl perforation, the cells can go all over you entire abdominal cavity. I'm sure that fact that some stage II's don't get chemo also may play with the survival numbers.

[Lee]

Yes, that is true in some cases. My husband was a stage IIbt4a. Our oncologist told us that somebody who's a stage IIIa, t3 or t2 would have a better survival than a stage IIbt4a. He said that bowl wall perforations are a bigger concern than just having one or two lymph nodes effected sometimes. He said that in stage II, the "t" rating is very important. If it's a t4, the survival rate is much lower than stage II's that are not t4's and also some stage III's that are not a t4. A little confusing at first, but when you think about it, when you have bowl perforation, the cells can go all over you entire abdominal cavity. I'm sure that fact that some stage II's don't get chemo also may play with the survival numbers.

Thank you for your comment. I am smarted today, thanks to you. To me, stage II was a grey area, and now I know why some people need to be treated aggressively while others are ok with light or no chemo.

thank you,

Lee

[CRguy]

Agreed : the exact treatment regimen will most likely be more aggressive for advanced stages ... BUTT ...
ALSO there would be a much more aggressive monitoring protocol for follow ups, from what I have seen / experienced.

Regardless of Stage I or Stage IVb ... If nobody is looking for problems or potential problems...
I guarantee they will NOT find anything !!!!! which is my biggest
concern for lower stages : the NOT doing proper surveillance afterwards.

Cheers
CR

[weisssoccermom]

If memory serves me correctly, the studies that showed those figures specifically stated that it was stage IIB/C (stage IIA was not included) and yes, it was because too often, those in stage IIB+ didn't get adjuvant chemo.

In studies that didn't differentiate between the stage II's, it's really impossible to tell whether or not ALL stage II's have the same stats.

From the American Cancer Society's webpage:

The numbers below come from the National Cancer Institute’s SEER database, looking at people diagnosed with colon cancer between 2004 and 2010.

The 5-year relative survival rate for people with stage I colon cancer is about 92%.
For people with stage IIA colon cancer, the 5-year relative survival rate is about 87%. For stage IIB cancer, the survival rate is about 63%.
The 5-year relative survival rate for stage IIIA colon cancers is about 89%. For stage IIIB cancers the survival rate is about 69%, and for stage IIIC cancers the survival rate is about 53%.

Notice the very large difference between stage IIA and Stage IIB (I don't believe at the time there was a stage IIC ....it was all included in the stage IIB ). The numbers indicate that the stage IIA patients have a much higher survival rate than stage IIB and all of stage III. IMO, the T4 associated with the stage IIB/C is the determining factor.

[Swirdfish]

If memory serves me correctly, the studies that showed those figures specifically stated that it was stage IIB/C (stage IIA was not included) and yes, it was because too often, those in stage IIB+ didn't get adjuvant chemo.

In studies that didn't differentiate between the stage II's, it's really impossible to tell whether or not ALL stage II's have the same stats.

From the American Cancer Society's webpage:

The numbers below come from the National Cancer Institute’s SEER database, looking at people diagnosed with colon cancer between 2004 and 2010.

The 5-year relative survival rate for people with stage I colon cancer is about 92%.
For people with stage IIA colon cancer, the 5-year relative survival rate is about 87%. For stage IIB cancer, the survival rate is about 63%.
The 5-year relative survival rate for stage IIIA colon cancers is about 89%. For stage IIIB cancers the survival rate is about 69%, and for stage IIIC cancers the survival rate is about 53%.

Notice the very large difference between stage IIA and Stage IIB (I don't believe at the time there was a stage IIC ....it was all included in the stage IIB ). The numbers indicate that the stage IIA patients have a much higher survival rate than stage IIB and all of stage III. IMO, the T4 associated with the stage IIB/C is the determining factor.

I guess it all depends where you obtain your information from. I was always told chemo only increased your chances by 2 - 4 % in most cases in overall prognosis. However 63% is a lot different from 87%.

[peanut_8]

Hi Swirdfish,

I'm certainly no expert, butt if memory serves me correctly, that sounds like the added benefit you would get from the addition of oxaliplatin, as opposed to a 5_FU based treatment alone. 5-FU (Xeloda) adds a considerable benefit.

Best Wishes,
peanut

[Swirdfish]

Hi Swirdfish,

I'm certainly no expert, butt if memory serves me correctly, that sounds like the added benefit you would get from the addition of oxaliplatin, as opposed to a 5_FU based treatment alone. 5-FU (Xeloda) adds a considerable benefit.

Best Wishes,
peanut

What if I add broccoli to the mix? Another 2 - 5%?

[Lee]

What if I add broccoli to the mix? Another 2 - 5%?

OMG ! I can't believe you wrote that. So funny, butt based on the "that" other thread, "apricot pits" and "Amaretto" are the cure to cancer, forget the broccoli.

Sorry, could not resist

Carry on,

Sista Nut.

[Hey Daddy]

I have also read that there is evidence that indicates that stage II colon cancers may not just be less advanced than stage III but may actually be genetically different from stage III cancers and that this could also contribute to the counterintuitive differences between the prognosis of some IIs and IIIs.

[weisssoccermom]

peanut is correct....the 2-4% is for oxaliplatin (for the stage II patient...not sure if it is applicable for everyone)....not for overall chemo. The 5FU (or Xeloda) does the majority of the work of the chemo 'cocktail'.

Hey, if broccoli helps, how about adding some carrot juice to the mix??? Then we can wash it ALL down with some Amaretto, right??

Too funny.....but heck, we need some laughs around here!

[Lee]

Hey, if broccoli helps, how about adding some carrot juice to the mix??? Then we can wash it ALL down with some Amaretto, right??

Too funny.....but heck, we need some laughs around here!

Here's my problem with carrot juice. I was a little sister to a frat house in college. One of my frat brother juiced carrot juice, not a little, butt a lot! His skin tone was orange. Not a light skin tone orange, butt a "major" skin tone ORANGE That is when I learned there was such a thing as too much of a good thing being a bad idea, and maybe vegan is not always the best idea.

Sorry, not enough Apricot pit or Amaretto in his diet. Sorry can not resist

Carry on,

Good night one and all.

[PainInTheAss]

If memory serves me correctly, the studies that showed those figures specifically stated that it was stage IIB/C (stage IIA was not included) and yes, it was because too often, those in stage IIB+ didn't get adjuvant chemo.

In studies that didn't differentiate between the stage II's, it's really impossible to tell whether or not ALL stage II's have the same stats.

From the American Cancer Society's webpage:

The numbers below come from the National Cancer Institute’s SEER database, looking at people diagnosed with colon cancer between 2004 and 2010.

The 5-year relative survival rate for people with stage I colon cancer is about 92%.
For people with stage IIA colon cancer, the 5-year relative survival rate is about 87%. For stage IIB cancer, the survival rate is about 63%.
The 5-year relative survival rate for stage IIIA colon cancers is about 89%. For stage IIIB cancers the survival rate is about 69%, and for stage IIIC cancers the survival rate is about 53%.

Notice the very large difference between stage IIA and Stage IIB (I don't believe at the time there was a stage IIC ....it was all included in the stage IIB ). The numbers indicate that the stage IIA patients have a much higher survival rate than stage IIB and all of stage III. IMO, the T4 associated with the stage IIB/C is the determining factor.

I guess it all depends where you obtain your information from. I was always told chemo only increased your chances by 2 - 4 % in most cases in overall prognosis. However 63% is a lot different from 87%.

The benefits of chemo are on a sliding scale according to stage. I seem to remember that the benefit for IIa is only around 1 or 2%, and the risk of permanent grade 3 neuropathy from oxi is 1% which is why IIa patients often are not advised to do chemo. The benefit for IIb is higher and so on. It is NOT true that chemo adds 2 to 4% benefit for every stage. In my case, as a IIIc, I was told that chemo would add a 27% benefit which is quite significant. My Onc showed me his cancer center's chart which had the breakdown for each stage because I was so concerned about neuropathy. He really sold me. I don't remember the actual numbers now, but the benefit for IIIa and IIIb was actually higher than for IIb which may account for the differences.

It is really important to feel that chemo actually does something in order to go through with it. I would probably not have wanted to do it if I thought it was only going to add around a 2% benefit. The benefit for IIIb was something like 12 to 15% from what I remember, so pretty significant as well. But 2 to 4% for IIb sounds right.

Be aware that the SEER database includes elderly, frail patients who opted to skip chemo, radiation and sometimes surgery. You have to take those numbers with a grain of salt.