lower survival rate for stage 2 than stage 3?

[mtipte]

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.

Thanks Painintheass,

do you know the percentage of OS/or 5 years survival that is added with Oxi and/or 5fu to stage IIIB RC patients?

What if we add noni juice?

Cheers.

[Deb m]

My husband being a stage IIbt4a, our oncologist at MDA told us chemo,(folfox) was absolutely necessary if he wanted a chance at being cured. He said that because of the t4, we had to assume that cancer cells could be all over his abd. cavity. CRguy is correct in that just because you pathology report says stage II, does not mean you may be able to skip chemo and have a good outcome. You need to look at the specifics withing the stage II, especially the "T" rating. He is also correct in that the after surgery/chemo surveillance follow ups need to be just as aggressive as stage III's . We were seen every 3 months for the first two years for blood work, chest e-rays and ct scans. Then every 6 months and year five just one time. We were also told by our oncologist that there are studies going on that are indicating that some stage II"s are totally different than all other colon cancers. Don't know or understand the details on that. People need to be very careful about being to lax with stage II's, even oncologists!

deb

[PainInTheAss]

Thanks Painintheass,

do you know the percentage of OS/or 5 years survival that is added with Oxi and/or 5fu to stage IIIB RC patients?

What if we add noni juice?

Cheers.

I don't remember, exactly. I do remember that the benefit for Oxi for IIIc was actually higher than for 5FU, but I'm pretty sure that isn't the case with other stages. For IIIc it was 15% for Oxi and 12% for 5FU/Xeloda. His charts were based on patient results from cancer centers rather than trials so the data was based on thousands of patients whereas trials are sometimes just a few hundred or even less. There was also a difference in age with younger patients fairing better than elderly patients. My tumor was a T4b and there was a break down for that as well but he said those stats wouldn't apply to me since a vaginal invasion is very rare. Normally a T4b would be another organ invasion, like the stomach.

I can tell you that just about every patient is told different stats! Some stats are for all patients (like SEER) and others are based on the treatment they pursued. My doubts about the effectiveness of chemo actually came from reading stuff on this board. That saying you hear on here, "We are not doctors" is so very true, but sometimes our off hand knowledge can influence people. A person who is a IIa and told chemo doesn't make enough difference to even bother can influence a person who is a IIIc where chemo almost doubles your chances. That's exactly what happened with me and why my Onc had to convince me to do Oxi. Same with the "5FU is the workhorse." Not for a IIIc. All we really know about is our own cancer and our own experiences. Not that I'm opposed to advice, but making sure it's "stage transferable" is important.

Bear in mind that a 1% difference means one in a hundred people. So if a group of 100 people did chemo, one more would be cured if the whole group did chemo compared to if the whole group didn't. That is one life saved and 99 who did chemo for nothing. But whose life did it save? We will never know. If your loved one was that one person, isn't that worth every effort? I think so. I think that is the better way to look at it. Do everything you can to save your life and hope for the best. I figure that I was already unlucky enough to get colorectal cancer under age 50 at a less than 5% chance, why would I think I'd be lucky enough to not need the Oxi to be cured? I was not willing to roll those dice. The stakes are too high.

[mozart13]

Every little counts, some times it might mean surviving or not.
Chemo after surgery in some studies didnt make much difference in survivall rate, but still might give some people push over the edge.
Activity during therapy gave 12% edge in survival, comparing to non activity, as per some studies.
Just 3 doses of folfox post chemo/rad pushed cCR and pCR response much higher in rectal cancer.

When it comes to staging and treatment, its all whom you run in to, thats why second opinion is important.
It is important to educate yourself and be your own advocate.