Macmillan reveals cancer survival lottery

22 November 2011
<p>A new study of cancer survival figures by Macmillan Cancer Support has found that people now live nearly six times longer after their cancer diagnosis than was the case 40 years ago.</p>

But the report also highlights a "woeful" lack of progress for some types of the disease, such as brain and stomach cancer.

Drawing on research by the London School of Hygiene and Tropical Medicine, the study looked at survival times and estimates for 20 cancers going back four decades.

Cancer survival is usually presented by counting the number of people to reach certain milestones; one, five or 10 years after diagnosis. But this doesn't always show big, proportional increases in the number of people reaching a particular milestone. It can still mean there has been little actual improvement in the average survival time.

Median survival time is the time since diagnosis when relative survival is at 50% and Macmillan interpreted this as the time when half of the patients have survived. The figures show an improvement in overall median cancer survival, from one year for patients diagnosed in 1971-72 to nearly six years for those diagnosed four decades later.

Six of the cancers now have median survival times of more than ten years. The biggest improvement has been for colon cancer, with a 17-fold increase in median survival time from seven months to ten years. There is a 10-fold increase for non-Hodgkin lymphoma.

Breast cancer median survival time has doubled since the 1970s and has been more than 10 years since at least the early 1990s.

However, the data also showed that for nine cancers there has been little improvement over the past four decades. Lung and brain cancer median survival times have barely risen, from 11 to 20 weeks; and from 13 to 28 weeks respectively. Pancreatic cancer median survival time has increased by just three weeks (from nine to 12 weeks).

Macmillan says the figures will shape the patient-GP conversation, "How long have I got?" While there is no straightforward answer to this for an individual patient, looking at median survival times can shape how this issue is discussed.

Ciaran Devane, chief executive of Macmillan Cancer Support, says: "This research is a huge breakthrough in seeing the real picture of how long people are living after a cancer diagnosis.

"But the good news is tempered by the shocking variation between cancer types. Though we can celebrate increasing median survival times for some cancers such as breast and colon cancers, there has been lamentably poor progress made for lung and pancreatic cancer. It is clear that much, much more money needs to be put into research, surgery and treatment for the cancers with the poorest prognosis."

Macmillan Cancer Support also says that while it is good news that more cancer patients are living longer, many are struggling with long-term health problems caused by their treatment. These include fatigue, infertility, and damage to the lungs and heart. Some cancer survivors also need psychological support.

The charity says this poses a huge challenge for the NHS in planning better services.

Cancers where the mean survival time is more than five years:

  • breast
  • cervical
  • colon
  • Hodgkin's
  • kidney
  • larynx (males)
  • melanoma
  • non-Hodgkin's lymphoma; 
  • rectal; 
  • testicular and of the uterus. 

Cancers where the mean survival time is three years or less:

  • adult leukaemia
  • brain
  • lung
  • myeloma
  • oesophageal
  • other rarer cancers
  • ovarian
  • pancreatic and stomach cancer.


Macmillan's research briefing paper 'Living After Diagnosis'

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