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Q: Life expectancy of colon cancer patient ( Answered 3 out of 5 stars,   0 Comments )
Question  
Subject: Life expectancy of colon cancer patient
Category: Health > Conditions and Diseases
Asked by: borogravian-ga
List Price: $90.00
Posted: 19 Dec 2005 17:21 PST
Expires: 18 Jan 2006 17:21 PST
Question ID: 607716
Take an hypothetical man: he is north-american, was born in 1947,
smoked from the age of 20 to the age of 55, and is diagnosed with
advanced colon cancer January 1st 2006 but is otherwise fit, in
excellent health, and has access to all appropriate modern medical care.

I would like the probabilities of this man dying between 2006 and 2020
(inclusive), broken down as follows:
a) Probability of him dying in 2006;
b) Probability of him dying between 2007 and 2010, inclusive;
c) Probability of him dying between 2011 and 2015, inclusive;
d) Probability of him dying between 2016 and 2020, inclusive;
e) Probability of him surviving until 2021 and beyond.
Answer  
Subject: Re: Life expectancy of colon cancer patient
Answered By: webadept-ga on 19 Dec 2005 18:03 PST
Rated:3 out of 5 stars
 
Hi, 

First of all I want to call your attention to the disclaimer at the
bottom of the page which says we are Researchers, not doctors, and
certainly not the last word on this question. With that said...

There are a ton of treatments and surgeries for this type of cancer,
which will either prolong the life of the patient or even cure the
cancer completely. I kept this in mind for these numbers and the
research. If our hypothetical patient is not going to pursue any of
these he probably will not live out the year, as he has basically
given up already. With treatment, and doctors care, I think my numbers
are pretty good, or at least as good as anyone else I came across.

Here are some highlight areas of what my research turned up:

=="Colon cancer is the second leading cause of cancer deaths in the
United States with 149,000 cases annually and 57,000 deaths. More than
90% of these deaths are preventable due to slow polyp growth, which
typically takes five to seven years to become cancerous. Most colon
cancers can be prevented with routine colonoscopy, but only 10% of the
at-risk population has a colonoscopy. Fear of the procedure and its
complications along with its high cost have limited the potential of
colonoscopy to be used as an acceptable screening tool for colon
cancer."==
National Congress on Pre-Symptom Medicine
http://www3.oakland.edu/oakland/psm/why.asp

=="Whereas the median life expectancy for people with this condition
is in the range of 6 months without the use of any form of treatment
and is extended to 10 to 12 months when either fluorouracil alone or
fluorouracil combined with leucovorin is administered, the median
survival is increased to 14 to 16 months when either irinotecan or
oxaliplatin is added to a fluorouracil-based treatment regimen.
Survival appears to be further prolonged, to more than 20 months, when
all three drugs are used at some point in the care of the patient or
if a form of targeted therapy (e.g., bevacizumab) is combined with a
cytotoxic-drug combination (Figure 1). Data suggest that the
introduction of at least some of these combination regimens, when
administered as adjuvant treatment after surgery,82,83 may further
enhance the likelihood of cure."===
NEJM -- Systemic Therapy for Colorectal Cancer
http://www.meddean.luc.edu/depts/cme/NEJM%20--%20Systemic%20Therapy%20for%20Colorectal%20Cancer.htm

=="These patients still have a life expectancy of > 3 months and are
still well enough that they are able to take care of themselves most
of the time."===
San Antonio Cancer Institute
http://saci.uthscsa.edu/ClinicalTrials/SelectedPhase1.html

=="1 An individual's lifetime risk of dying of colorectal cancer in
the U.S. has been estimated to be 2.6%.2 About 60% of patients with
colorectal cancer have regional or distant metastases at the time of
diagnosis.1 Estimated 5-year survival is 91% in persons with localized
disease, 60% in persons with regional spread, and only 6% in those
with distant metastases.2 The average patient dying of colorectal
cancer loses 13 years of life.2 In addition to the mortality
associated with colorectal cancer, this disease and its
treatment-surgical resection, colostomies, chemotherapy, and
radiotherapy-can produce significant morbidity. Persons at highest
risk of colorectal cancer include those with uncommon familial
syndromes (i.e., hereditary polyposis and hereditary nonpolyposis
colorectal cancer [HNPCC]) and persons with longstanding ulcerative
colitis."==
Screening for Colorectal Cancer
http://cpmcnet.columbia.edu/texts/gcps/gcps0018.html

==="The clinicopathologic stage of the disease is the most important
determinant of survival after surgical resection. Five-year survival
rates vary from 90% for tumors confined to the mucosa and submucosa to
less than 5% for those with distant metastases. About 70% of patients
can be operated for cure; 10% of lesions are not resectable at the
time of operation, and another 20% of patients have distant
metastases."===
SSAT
http://www.jhbmc.jhu.edu/Surgery/gensurg/centers/ssat_coloncan.html


The distance between a localized tumor and distant metastases is
really what throws wrenches into the gears cranking out life
expectancy percentages here. So I'm not going to take the distant
metastases into account, since we are just throwing numbers around
here.


a) Probability of him dying in 2006;
5-25%

b) Probability of him dying between 2007 and 2010, inclusive;
30-60%

c) Probability of him dying between 2011 and 2015, inclusive;
55-75%

d) Probability of him dying between 2016 and 2020, inclusive;
60-90%

e) Probability of him surviving until 2021 and beyond.
5-10%

Another good page for information about Colorectal Cancer is here:
http://en.wikipedia.org/wiki/Colon_cancer

thanks, happy holidays and I hope the point spread is easily beaten. 

webadept-ga
borogravian-ga rated this answer:3 out of 5 stars
I was hoping for more of an actuarial answer, and harder numbers, but
the links given are for very relevant data, and I can probably make my
own mind reading the material provided.

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