Question for the Forum

DJC

Good Day Everyone:

I understand the 5 year mortality parameter allusion in this article - but can someone explain the 15 year longevity reference that is also mentioned here:


MSNBC.com
Breast cancer treatments improve survival
Chemo, hormone therapy help women live longer, research shows

Reuters
Updated: 9:08 p.m. ET May 12, 2005


LONDON - Treatments such as chemotherapy and hormonal therapy have greatly improved the survival of women diagnosed with early breast cancer, scientists said on Friday.

An analysis of 194 trials involving 145,000 women showed both therapies combined can halve the 15-year risk of death from the disease, which is the most common cancer in women.

“The standard chemotherapy and hormonal therapy that have long been used to prevent breast cancer recurrence not only have an effect on 5-year survival but they have a long-lasting effect on 15-year survival,” said Professor Sarah Darby, of the Radcliffe Infirmary, in Oxford, England.

“The benefits of chemotherapy and hormonal therapy can be added to each other,” she added in an interview.


More than a million women worldwide each year are diagnosed with breast cancer. Surgery will remove the cancer and radiotherapy is given to kill any residual cells in the breast.

Chemotherapy and tamoxifen, a hormone therapy for estrogen-sensitive cancers, are often recommended as extra treatment if appropriate, to stop the disease coming back.

The study, reported in The Lancet medical journal, analyzed the impact of treatments on women involved in clinical trials that began before 1995.

'Great progress'
It did not include new treatments such as aromatase inhibitors, which studies have shown may be more effective than tamoxifen, or drugs such as taxanes.“

“What we have got now is very good. It is better than people ever realized,” said Darby, adding that there have been massive decreases in breast cancer mortality rates since the 1990s.

Darby and her colleagues found that for women of all ages with early hormone-sensitive cancer, taking tamoxifen for five years could reduce their breast cancer death rate over the next 10-15 years by a third.

For middle-aged women, combining tamoxifen with chemotherapy halved the death rate.

“This is the largest follow-up study ever done in women with early breast cancer. It shows that we are making great progress in treating cancer increasingly effectively,” said Professor John Toy, of the charity Cancer Research UK, in a statement.

In a commentary on the analysis, Karen Gelmon of the British Columbia Cancer Agency in Vancouver, Canada described the findings as impressive.

She said the survival curves suggest that the therapies could cure a proportion of women with early-stage breast cancer, rather than simply delay recurrence of the disease.

Copyright 2005 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content is expressly prohibited without the prior written consent of Reuters.
© 2005 MSNBC.com
URL: http://www.msnbc.msn.com/id/7833702/
Thanks - and my best to everyone, Donna

Ellison

Hi DJC,

Good question... I had chemo and radiation. Was given tomoxifin after treatment. Last Oct., not even a year later, I was told my cancer had matasised. They took bone marrow form the back of the pelvic. Now stage 4 and was given 2 to 5 years to live. I am now on Femera. Just had a bone scan. Go next week to see what the results are. Hoping the Femera can give me some good results.

What I was thinking is that maybe some are given a better chance of survival time than I was given... Or maybe the survival rate without a reacurance is 15 yrs with that combination.

L. Ellison

KHarrison

I think what it means is, let's say that your chance of dying within 15 years of a bc diagnois is 30%. The treatment regimen has halved that chance down to 15%. I think the basic premise is that chemo plus hormone therapy is effective both short term and long term.

It's worded rather strangely but I think that's what it means.

Karen

inkblot

Hi DJC:

I think what the 15 year survival improvement, for women with estrogen positive, early bc, means is this: The study followed women who had early bc, estrogen positive only and had chemo, plus took TAMOXIFEN, and were followed for 15 years only. Thus the results are stated for that time period. The info you posted does not state any previously "expected" survival percentage at 15 years, for comparison. Yet a figure had to have been used, otherwise they could not have arrived a 1/3, 1/2, etc..

The study only states the percentage who were still alive 15 years later in this study. It does not state whether the participants were "disease free" at the 15 year mark and does not state whether any women succumbed (during the study period) to long term side effects of chemo and/or radiation. If so, then they may have, at that point, been eliminated from the study and thus not counted at all or still counted since they had not died of cancer. The study states that they were alive and had not died for the 15 year time period and nothing else.

Note that women of all ages (with early, hormone positive cancers) "could" reduce the death rate by 1/3 in the next 10-15 years with the therapy approach involved in the study. Key word, "could". It further states that middle aged women who had chemo plus Tamoxifen, "halved" the death rate. It doesn't clarify whether
the stats for the middle aged women are also based upon estrogen positive cancers only. We can probably assume that this is the case though, since Tamox. is not typically recommended for women who have no ER Pos. component to their cancers.

So, while at a glance, it seems encouraging, we know that everyone is different and has different experiences with the same drugs and same dx. I'd be interested to know what the criteria for participation in the study may have been. That info would be valuable in helping us better assess the reported outcome of the study.

It occurs to me that since some women are more strongly hormone positive, at dx, than others, would that effect the study outcome? Did the study differentiate between the strongly estrogen positive participants/weakly estrog.pos., or take it into account at all? What about women who are estrogen positive and also Her2/neu positive? It leaves that to our imagination and since the study is somewhat dated, (had to have begun 15 years ago) it doesn't, as it states, take into account any of the newer drugs now being used, such as AI's and Taxanes. Interesting report and as Karen noted, strangely written.

Love, light and laughter,
Ink