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What if Five Isn't the Magic Number?


For many years, breast cancer survivors have focused their hope on the number five. With the help of their oncologists, they've taken a big sip of this medical Kool aid. But are we hoping in an untruth? This survivor shares her perspective.

Numbers are important. Just ask anyone. If you're lucky enough to win the title of number one, you've just earned the accolades of being the best at something. If you're given the title, number two, you've missed the mark. You were almost number one, but not quite. No one really pays attention to any number ranking past three and they certainly don't focus on someone being fourth or fifth. But the number five has great significance for those who identify with breast cancer, specifically those who have been labeled as breast cancer survivors.

Why is the number five so important in the world of breast cancer? Oncologists refer to this number when speaking of the likelihood of recurrence. Most breast cancers, it's said, will return within five years. So naturally, five becomes a very important number.

When I first completed treatment for breast cancer, I began to watch the calendar. Counting the days, weeks and months, I knew every moment that my goal was to make it past the magical five-year mark. For some reason, I assumed if I made it there, I would be home free — no more cancer for me! But now, as I am about to pass the four-year mark, I continue holding my breath. So far, so good, I tell myself. One more year to go.

But what if five isn't the magic number?

Apparently, the idea of the magical five-year mark began sometime in the 1930s. During that time, very few people survived the disease of cancer. Doctors who specialized in the field of cancer, during that time, felt a five-year survival was rarely attainable. Without the medical advancements we have today, treatments often failed, and patients died.

Today, oncologists use the term "five-year survival" as a predicted prognosis for some cancer cases. While the number isn't widely mentioned, those affected by breast cancer have heard of the magic number at some point in time.

The number five has become a sort of end goal. Making it five years post-diagnosis, one might mistakenly think they've passed the most important milestone in their cancer battle, but nothing could be further from the truth. Just because a person passes the five-year mark doesn't guarantee there will be no recurrence of cancer.

So why do we get hung up on numbers? Why do we focus so on the number five? According to my doctor, if a patient manages to live without a recurrence during and up to the five-year mark, this means the chances of recurrence have greatly diminished. Most recurrences of breast cancer will appear within the first five years post-diagnosis. The cancer may not appear in breast tissue however, if breast cancer metastasizes somewhere else in the body, it's still considered a recurrence of the original cancer.

With breast cancer, the magical number five also takes on more credence if the patient participates in a recommended adjuvant therapy. Medications such as Tamoxifen, Aromasin, Arimidex and Femara are particularly effective in treating cancers fed by the hormones estrogen, progesterone or HER2. Doctors have typically prescribed these medications for a period of five years post-surgery but now some doctors are recommending treatment for a period of ten years or longer.

No matter what statistics show, many survivors hold tightly to the number five and while this so called magical number might give a good idea of a person’s prognosis, it cannot predict a specific situation.

Numbers, while important, are merely tools. Choosing to get hung up on a specific number might cause feelings of fear or bewilderment. And while some survivors find comfort in passing each milestone, a false hope in the number five can be detrimental to one’s health.

In July, I’ll celebrate my four year cancerversary. To-date, I remain cancer free. The oncologist tells me I am in remission, or NED (no evidence of disease). I am very thankful to claim that status but I won’t lie. I’m nervous about my upcoming visit to the cancer treatment center in August. There’s a small voice whispering in the back of my mind saying, “What if…”

Will I make it to the elusive five-year mark and still hold the status of being cancer free? Who knows? Only time will tell. I prefer not to focus on numbers but I can’t seem to help it. Somewhere along the way, I was subtly brainwashed to accept the number five as being magical and while I know it’s not true, I keep hoping it just might be.

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