Within a short time of diagnosis, doctors will be able to determine whether the tumour shows any sign of spread. The earlier the diagnosis is made, the less likelihood there is of spread and the greater the chance of cure. A cancer is usually staged at the time of initial surgery when the degree of spread is evaluated.

Some cancers, such as skin cancers show themselves early. Others, such as ovarian cancer are more silent so that diagnosis is likely to be relatively late in the disease process. There are databases from which we can determine the number of patients likely to survive five or ten years based on staging but there is wide variation between patients. The 5-year survival for stage 1 ovarian cancer is 98% whereas the 5-year survival for stage 3 and 4 is less than 30%.

The pathologist who examines cancer tissue can provide some indication of how virulent the tumour looks: A well differentiated tumour looks closer to normal than a poorly differentiated tumour. Again, there are statistics telling us the percentage of patients likely to be cured or survive over a year or five years but these cannot accurately tell us how well an individual may fare.

From my own earliest experience I learned about the unpredictability of cancer. My family was advised six years before I was born, that an aunt was unlikely to survive no more than a few months. She lived to see the arrival of my two younger cousins and they are six years junior to me. 

A lady in her late sixties had abdominal symptoms and proved to have an advanced ovarian cancer. Many years earlier she underwent hysterectomy (hysteectomy) and her ovaries had been conserved. At initial laparotomy, the tumour was too advanced for removal. The tumour responded rapidly to chemotherapy and most of the tumour was removed at a second laparotomy some months later. She enjoyed a further four years of active life.

The course and outcome of cancer will vary from patient to patient. Some cancers, for example, respond to treatment such as chemotherapy (the use of drugs that destroy malignant cells) and others do not.

There are claims that 50% of cancers can be cured and that modern treatment significantly increases the quality and duration of life for many of the other 50%.

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