Doctors who give advanced breast cancer patients an average survival time & # 039; was wrong 80% of the time & # 039;
Doctors who give patients with incurable breast cancer a survival prediction are wrong almost 80 percent of the time, research shows.
Leading GPs ask patients to get the best and worst time frames to paint a more accurate picture of their future.
The majority of patients with a fatal diagnosis want to know how long they are still alive, according to Dr. Belinda Kiely, an oncologist at the University of Sydney.
This is usually the case so that they know whether they should stop working or sell their house, or whether they can attend a loved one's wedding, she claims.
But the doctor said that the average life expectancy they get is only 20 to 30 percent of the time.
Doctors in the UK and US, similar to Australia, use their experience to predict how long patients will survive. There is not one fixed model.
Doctors who give patients with incurable breast cancer an average survival time are wrong almost 80 percent of the time, research shows
They take into account the age of the patient, the physical condition and how aggressive their cancer is before referring to it with average survival times and adjustments.
The problem with the average survival times is that there is a 50 percent chance that the patient will survive, according to Dr. Kiely.
At the Fifth International Consensus Conference on Advanced Breast Cancer in Lisbon, she said: & Every week I meet women of all ages with advanced breast cancer in my clinic.
& # 39; They often ask: & # 39; How long do I still have? & # 39; They have very practical concerns and ask what they want help with.
& # 39; For example, they want to know if they need to cancel a planned vacation, whether they can attend their daughter's wedding, or whether they should stop working or sell their house.
& # 39; Oncologists are sometimes not sure how they can help. They may be worried … whether it is possible to provide accurate information and how best to talk about it without destroying hope. & # 39;
Dr. Kiely's research has shown that it is better to provide estimates for the best-case, worst-case and typical survival times. She said this was more accurate and useful for patients.
It involves physicians estimating the expected survival time for a patient, dividing it by four to get the worst-case scenario and multiplying it by three to get the best case outcome.
The typical life expectancy for advanced breast cancer patients is between half and twice the doctor's estimate.
Dr. Kiely told the conference: & # 39; If we tell a patient that her estimated median survival time is six months, that gives no hope of a possibly longer survival, although she has a 50 percent chance of living longer.
& # 39; On the other hand, providing three & # 39; s scenarios helps patients to prepare for the possible worst case and at the same time hope for the possible best case.
& # 39; This is more useful for patients who make plans and decisions for the future. & # 39;
Dr. Kiely and her colleagues conducted a trial with 33 oncologists who spoke to 146 patients with advanced cancer about their expected survival times.
Each patient received a printed one-page summary of their individual best-case, typical and worst-case scenarios.
Ninety-one percent of patients said they found the printed information useful, 88 percent said it helped them make plans, and 88 percent said it improved their understanding.
Seventy-seven percent of patients said the scenarios were the same or better than they had expected.
Based on their findings, Dr. Kiely and her colleagues now promote the & # 39; three-scenario & # 39; approach by oncologists in Australia. They hope to encourage doctors around the world to do the same.
Dr. Fatima Cardoso, director of the breast department at the Champalimaud Clinical Center in Lisbon, Portugal, endorsed the conference approach.
Leading GPs ask patients to get the best and worst time frames to get a more accurate picture of their future
The physician, who was not involved in the study, said: This tool for calculating and sharing the three scenarios offers physicians the help they need to interact with patients in a realistic and useful way. to communicate.
& # 39; Research shows that patients who discuss these problems with their physicians have a better quality of life, are less likely to undergo aggressive resuscitation and are less likely to die in the hospital.
& # 39; But we also know that many patients do not have these conversations.
& # 39; Most patients with advanced cancer want some information about how long they are likely to live, although many say they find it difficult to ask this question. & # 39;
One in eight UK and US women will develop breast cancer at some point in their lives, according to statistics from Cancer Research UK.
In the UK, triple negative breast cancer accounts for 15 percent of cases of the disease – around 7,500 people a year.
And in the US, according to Breastcancer.org, it is responsible for 10 to 20 percent of breast cancer
The chances of long-term survival are better the earlier the cancer is diagnosed.
About nine out of ten women live older than five years if they are diagnosed with the first phase of breast cancer.
Phase one describes a tumor less than 2 cm long and cancer that has not spread throughout the body.
But the five-year survival rate dropped to one in 10 for those diagnosed with stage four breast cancer – when cancer has spread to other organs in the body.
WHAT IS BREAST CANCER, HOW MANY PEOPLE FIND IT AND WHAT ARE THE SYMPTOMS?
Breast cancer is one of the most common cancers in the world. Every year there are more than 55,000 new cases in the UK and the disease claims the lives of 11,500 women. In the US, it hits 266,000 each year and kills 40,000. But what causes it and how can it be treated?
What is breast cancer?
Breast cancer originates from a cancer cell that develops in the mucosa of a duct or lobule in one of the breasts.
When breast cancer has spread into the surrounding breast tissue, it becomes an & # 39; invasive & # 39; called breast cancer. Some people are diagnosed with & # 39; carcinoma in situ & # 39; with no cancer cells growing beyond the canal or the lobes.
Most cases develop in women older than 50 years, but younger women are sometimes affected. Breast cancer can develop in men, although this is rare.
The cancer cells are classified from phase one, which means slow growth, to phase four, which is the most aggressive.
What causes breast cancer?
A cancerous tumor starts with one abnormal cell. The exact reason why a cell becomes cancer is unclear. It is thought that something damages or changes certain genes in the cell. This makes the cell abnormal and multiplies & # 39; out of control & # 39 ;.
Although breast cancer can develop for no apparent reason, there are some risk factors that can increase the risk of breast cancer, such as genetics.
What are the symptoms of breast cancer?
The usual first symptom is a painless lump in the breast, although most breast lumps are not cancerous and are fluid-filled cysts that are benign.
The first place that breast cancer usually spreads to is the lymph nodes in the armpit. If this happens, you will get a swelling or lump in the armpit.
How is breast cancer diagnosed?
- First assessment: a doctor examines the breasts and armpits. They can perform tests such as a mammography, a special x-ray of the breast tissue that may indicate the possibility of tumors.
- Biopsy: A biopsy is when a small piece of tissue is removed from a part of the body. The sample is then examined under the microscope to search for abnormal cells. The sample can confirm or exclude cancer.
If it is confirmed that you have breast cancer, further tests may be needed to assess whether it has spread. For example, blood tests, an ultrasound scan of the liver or an X-ray of the breast.
How is breast cancer treated?
Treatment options that can be considered include surgery, chemotherapy, radiotherapy and hormone treatment. A combination of two or more of these treatments is often used.
- Surgery: breast-conserving surgery or removal of the affected breast, depending on the size of the tumor.
- Radiotherapy: a treatment that uses high-energy radiation beams, aimed at cancerous tissue. This kills cancer cells or prevents cancer cells from multiplying. It is mainly used in addition to surgery.
- Chemotherapy: a treatment for cancer by using anti-cancer drugs that kill cancer cells or prevent them from multiplying
- Hormone treatments: some types of breast cancer are influenced by the & # 39; female & # 39; hormone estrogen, which can stimulate cancer cells to divide and multiply. Treatments that lower the level of these hormones or prevent them from working are often used in people with breast cancer.
How successful is a treatment?
The outlook is best for those who are diagnosed when the cancer is still small and has not spread. Surgical removal of a tumor at an early stage can then give a good chance of a cure.
The routine mammography that is offered to women between the ages of 50 and 70 means that more breast cancer is diagnosed and treated at an early stage.
For more information visit breastcancercare.org.uk or www.cancerhelp.org.uk
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