Breast Cancer Mind Games

Five years. Five! That number stuck in my head and kept replaying over and over and over again. Sitting on a little stool beside me, the oncologist gave me this prognosis right after I’d received my diagnosis. I had no idea it was a standard prognosis, one oncologists dish out to their patients with breast cancer. I thought it was a prognosis specific to me and my type of cancer. I was completely ignorant about breast cancer two-and-a-half years ago. The only think I did know was that breast cancer was not good. I’ve come a long way since then.

After being diagnosed, I became a detective. I wanted to learn any and everything I could about breast cancer. I dubbed myself the breast cancer sleuth as I poured over internet articles, medical journals and books. Hours upon end, I studied. I learned so much and felt I was more knowledgeable about this dreaded disease than I wanted to be.

No matter how much I learned about my specific cancer and stage of diagnosis, I couldn’t shake that five-year statement that had imbedded in my brain. It had crawled in there like a parasite and embedded itself deep. I wondered if my doctor realized the power his words had over me. I don’t think playing mind games was his intention, but his words were forever etched upon my mind.

I’ve just recently reached the halfway point to that ominous five-year mark and I’ve felt some trepidation. I’ll be honest, the fear of recurrence has constantly haunted me since day one, but I’ve tried my best not to dwell on that fear. I want to place the blame for my fear on the prognosis issued by my doctor but I’m not sure that’s fair to him.

According to an article by the American Cancer Society, “Survival rates tell you what portion of people with the same type and stage of cancer are still alive a certain amount of time (usually five years) after they were diagnosed. They can’t tell you how long you will live, but they may help give you a better understanding about how likely it is that your treatment will be successful.” The article goes on to say, “Survival rates are often used by doctors as a standard way of discussing a person's outlook (prognosis). Statistics on the outlook for a certain type and stage of cancer are often given as five-year survival rates, but many people live longer — often much longer – than five years. The five-year survival rate is the percentage of people who live at least five years after being diagnosed with cancer. The outlook for women with breast cancer varies by the stage (extent) of the cancer. In general, the survival rates are higher for women with earlier stage cancers. But remember, the outlook for each woman is specific to her circumstances.

The five-year relative survival rate for women with stage 0 or stage I breast cancer is close to 100%. For women with stage 2 breast cancer, the five-year relative survival rate is about 93 percent.

The five-year relative survival rate for stage 3 breast cancers is about 72 percent. But often, women with these breast cancers can be successfully treated. Breast cancers that have spread to other parts of the body are more difficult to treat and tend to have a poorer outlook. Metastatic, or stage IV breast cancers, have a five-year relative survival rate of about 22 percent.”

These survival rates are only estimates. They can’t predict the future or what will happen to any individual. So why do doctors freely hand out the five-year prognosis? Don’t they realize the power their words convey to the newly diagnosed?

If I could offer one piece of advice to doctors, from a hindsight point of view, I’d like to suggest they avoid doling out a specific time frame, no matter how open ended it may seem, to a newly diagnosed patient. We don’t need a number to hold onto and it’s not fair to give us false hope by allowing us to think if we pass that magic five-year mark we’re home free. It would be better to honestly say, when asked about the expected prognosis, “I’m sorry, I just don’t know but we’ll fight this thing together.” That solidarity would be more beneficial and would allow the patient to understand there is no way a doctor can predict the future.

I’m doing my best not to think about the five-year mark but it’s hard. Two-and-a-half years have passed and there are only two and a half more to go to reach that five. The thought, if I make it to five, I’ll be OK is real and seems to give me a goal of hope. But I know I shouldn’t be focused on tomorrow. The Bible says, in Matthew 6:34 “Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.”

What a powerful statement! I think I’d do well to forget the five-year statement and just focus on the 14,400 minutes I’ve been given today. My goal for the new year is to learn to live in the moment without regard for the future and to forget the five-year bit. I hope I can do it. I’m certainly going to try.