What Affects Rectal Cancer Survival Rates?

Overview of Rectal Cancer Prognosis and Survival Rates

A rectal cancer cell
What is the life expectancy for rectal cancer and what variables affect survival?. STEVE GSCHMEISSNER/Getty Images

What factors influence the survival rate for rectal cancer, and what is the current life expectancy based on these statistics?

Rectal Cancer Survival and Life Expectancy

When faced with the uncertainty of cancer, it's human nature to want to learn as much as possible about the disease and to try to figure out how it's all going to play out. The purpose of the rectal cancer survival rates presented here is to help give you a sense of the problem at hand, but it is important to remember that survival rates are generalizations and individual chances of survival may be quite different.

It's also important to point out that these numbers are statistics based on survival in the past. For example, a 5-year survival rate recorded in 2017 would refer to people who were diagnosed in 2012 or earlier. Since many new treatments have become available for cancer in the past few years, these survival rates may not reflect how someone will do today with the treatments we now have available.

Variables Which Cannot be Controlled

There are several variables over which we have no control which may play a factor in survival. Some of these are noted below.

Rectal Cancer Survival Rates in Different Countries

According to an article published in the European Journal of Cancer, rectal cancer survival rates vary by country. While the overall five-year survival rate for rectal cancer in America is 59 percent, it's 42 percent in Europe. The quality of care may be one reason, but another could be colorectal cancer screening programs.

In general, the earlier rectal cancer is detected, the easier it is to treat. This study was conducted in 2006, and it's likely that survival in both the U.S. and Europe has improved since that time.

Rectal Cancer Survival Rate and Stage at Diagnosis

The stage at diagnosis greatly impacts rectal cancer survival rates.

The average life expectancy depending on stage is listed below, but again it's important to note that there are several variables in addition to the stage which plays a role.

Rectal Cancer Survival and Race

In general, the survival rate for African Americans with rectal cancer is lower than for whites with the disease. Again, there are several other variables which may contribute to this disparity, including health insurance.

Gender and Rectal Cancer Survival Rate

Gender is another factor that may influence rectal cancer survival rates. Studies have found that, unlike many other cancers, women tend to have lower rectal cancer survival rates than men.

Tumor Markers

In addition to the other variables, there are tests such as tumor markers which may give information about prognosis with rectal cancer. We won't go into these specific measures, but it's helpful to realize that the molecular makeup of your tumor can play a role in survival. In the future, it's likely that these molecular characteristics will further help estimate prognosis and guide the aggressiveness and types of treatment for individual cancer.

Variables Which We Have Some Control Over

While it can be frustrating knowing that some variables can't be controlled—you can't change your age or the stage at your diagnosis—there are some variables that you do have some control over. Focusing on these variables, versus becoming saddened over the others, may help you not only cope with your disease but could possibly make a difference in your outcome.

Rectal Cancer Survival Rate and Exercise

Most of the factors mentioned are out of your control. You live where you live, you're the gender you were born with, and you caught it when you caught it. So, what can you do to improve your chances of survival now that you have it? Researchers at the Dana-Farber Cancer Institute in Boston found that moderate exercise can significantly increase the survival rate of colorectal cancer patients. Learn more about the impact of exercise on colorectal cancer survival.

Insurance Coverage

Those who have medical insurance tend to have better outcomes than those who are uninsured. This is not a variable which can be changed according to insurance coverage at onset, but those who are uninsured or underinsured during treatment should consider their options. Your cancer center social worker may be a good place to start in determining what options you have.

Talk to Your Doctor About Aspirin

Some studies suggest that taking aspirin improves the survival rate from colorectal cancer. It is very important to talk to your doctor, however, as aspirin may interfere with other treatments for cancer.

Talk to Your Doctor About Vitamin D

As with aspirin, there are some studies which imply that vitamin D can play a role in colorectal cancer survival. Add to this that the majority of Americans are deficient, and there is a good chance your levels are too low as well. Thankfully there is a simple blood test which can tell you your level, and your doctor can recommend taking a supplement of vitamin D3 if necessary. Always talk to your doctor, however, before taking any nutritional supplements. Some vitamin and mineral preparations can interfere with cancer treatments.

Find a Support Group or Support Community

It hasn't been looked at specifically with rectal cancer, but people who have advanced lung cancer are thought to live significantly longer when they have more social support. Keep in mind that you can get support even if you're not feeling well enough to go out. There are many rectal cancer communities online through which you can not only get support but talk, to people who are facing similar challenges.

Know the Symptoms of Blood Clots

Blood clots in the legs (deep vein thrombosis) which can break off and travel to the lungs (pulmonary embolism) are a significant cause of illness and death for those living with any kind of cancer. Learn about the symptoms of blood clots as well as what you can do to lower your risk of blood clots with cancer.

Other Conditions Which Influence Survival Rate

In addition to some of the variables above, there are many different factors which can influence the survival rate with colon cancer. These can include:

  • Your age - In general, younger people tend to do better than older people with the disease, although this can go both ways. Younger people may be more likely to have a genetic predisposition, and in such, have more aggressive tumors.
  • Your performance status - Performance status is a measure that tries to tell how well someone is able to conduct the normal activities of daily living. Though it is used most often to determine if a person can qualify to take part in a clinical trial, it is also associated with prognosis.
  • Your overall health - How healthy you are aside from cancer may determine which treatments you are able to tolerate and can also influence whether you are able to exercise, a habit which improves survival.
  • Treatments received and how your tumor responds to treatment.
  • The molecular profile and grade (aggressiveness) of your cancer.
  • Perforation or obstruction of the bowel due to the cancer is associated with poorer survival.

Why Statistics May Not Be Accurate

It's important to note that, even taking into account all of the variables above, it is difficult to know how long any one person will live with rectal cancer.

Statistics can give averages, but people are not numbers. In general, statistics tell us how someone did with rectal cancer some time ago. For example, the most recent statistics we have are often already four or five years old. In the last five years, we have made significant progress in the treatment of cancer. In essence, then, survival rates can tell you how someone with a similar diagnosis did with an older treatment for the disease. It will take several more years to know how the average person will do with the newer treatments available.

Rectal Cancer Life Expectancy Statistics

Rectal cancer is often linked together with colon cancer to give colorectal cancer survival statistics.

According to the American Cancer Society, 5-year survival rates for colorectal cancer are as follows:

  • Stage I - 92 percent
  • Stage 2A - 87 percent, stage IIB - 63 percent
  • Stage 3A - 89 percent, stage 3B - 69 percent
  • Stage 4 (metastatic) - 11 percent

Since these are 5-year survival rates, it's noteworthy that those who were evaluated were diagnosed and treated at least five years ago, before newer treatments were available. It's also notable that this data is likely flawed in that it's doubtful that stage II truly has lower survival rates than stage III tumors, even if stage II cancers were treated more aggressively.

Bottom Line on Rectal Cancer Survival Rates

Again it's important to realize that all of the numbers mentioned here are statistics—and people are not statistics. What some of these studies point out is that there are many factors which play a role in survival. Newer treatments have been approved in recent years and more are being studied in clinical trials.

A final bottom line is that newer treatments are becoming available, and all of these treatments must be evaluated in clinical trials before they become available to the public. The National Cancer Institute suggests that people consider whether a clinical trial would be an option for their care. There are many myths about clinical trials, but the truth is that many of the best treatments available five years from now may be only available in clinical trials at this time.

Sources:

American Cancer Society. What are the Survival Rates for Colorectal Cancer, By Stage? Updated 01/20/16. https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/survival-rates.html

Gattaj, G. and Ciccolallo, L. "Differences in Colorectal Cancer Survival Between European and US Populations: The Importance of Sub-Site and Morphology." European Journal of Cancer 39.15 (Oct. 2003): 2214-2222. PubMed. 21 Jun. 2006.

Morales-Oyarvide, V., Meyerhardt, J., and K. Ng. Vitamin D and Physical Activity in Patients With Colorectal Cancer: Epidemiological Evidence and Therapeutic Implications. Cancer Journal. 2016. 22(3):223-31.

Tawk, R., Abner, A., Ashford, A., and C. Brown. Differences in Colorectal Cancer Outcomes by Race and Insurance. International Journal of Environmental Research and Public Health. 2015. 13(1):ijerph13010048.

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