All Races, Both Sexes. We'll tell you what to look out for when it comes to this rare cancer. This is also called epidermoid carcinoma. Read on to learn more about how doctors measure esophageal cancer survival rates, what survival rates look like by stage, and the factors that can affect outlook. The survival rate here is only 20% which is considered low. The survival rate for stage IV esophageal cancer is 15-20%, making it an excellent candidate for PC. You are likely to have a lot of queries. The percent of esophageal cancer deaths is highest among people aged 6574. Stage IV EC patients diagnosed between 2010 and 2015 in the Surveillance, Epidemiology, and End Results (SEER) database were selected. Esophageal cancer is lethal because the esophagus has no serosa; any tumor extension beyond the esophagus can spread rapidly. This is a comparison of people with a type of cancer and the overall population. Esophageal cancer represents 1.1% of all new cancer cases in the U.S. Radiation therapy uses high-energy radiation to kill cancer cells. 2009. It is important to remember that these figures are estimates. Nomogram to predict pathologic lymph node involvement prior to treatment; Pancreatic. The overall 5-year relative survival rate from 20122018 was 20.6%. Watch on. Do tumor location and grade affect survival in pT2N0M0 esophageal squamous cell carcinoma? For reprint requests, please see our Content Usage Policy. One-year survival rate was 25.6% with median survival time of 8 months. Stage The most important prognostic factor for esophageal cancer is the stage of the tumour at the time it is diagnosed. A relative survival rate compares people with the same stage of esophageal cancer to people in the overall population. Phone icon +91 9482202240 ,+91 8762020240 , Monday : 15:00 - 18:30 | In particular, smoking, alcohol consumption, and medical conditions that cause long-term irritation of the esophagus can lead to an increased risk for esophageal cancer. For example, if cancer has blocked the esophagus, a tube called a stent can be placed to open the passage and help in swallowing, which is a form of palliative care. While the prognosis for patients with stage 4 esophageal cancer is generally poor, with a five-year survival rate of around 5-10%, treatment can help to prolong life and improve the patient's quality of life. (2018). Weve invested more than $5 billion in cancer research since 1946, all to find more and better treatments, uncover factors that may cause cancer, and improve cancer patients quality of life. Results: Dr. Sandeep Nayak, a highly-accomplished cancer specialist in Bangalore, says that early detection and treatment of oral cancer are essential, but misconceptions about the condition can make this difficult. Your esophagus is the long tube, In an uncommon surgery, a mans esophagus was replaced with a section of his small intestine. The rate of new cases of esophageal cancer was 4.2 per 100,000 men and women per year based on 20152019 cases, age-adjusted. Survival rates for esophageal cancer. Wednesday : 15:00 - 18:30 | and the patient's overall health and age. It is used to give an estimate of the percentage of people who will survive their cancer. And because esophageal cancer is so rare, it can be difficult to treat. Overall survival rates don't specify whether cancer survivors are still undergoing treatment at five years or if they've become cancer-free (achieved remission). I was diagnosed with Stage IV esophageal adenocarcinoma at the Gastro-esophageal junction (GEJ) 6 weeks ago. Chemotherapy is a systemic treatment that uses drugs to kill cancer cells. Howlader N, Noone AM, Krapcho M, et al (eds). The 5-year relative survival for localized esophageal cancer is 47.3%. It's difficult to give an exact survival rate for specific age groups, as many factors can affect a person's prognosis. 2013 Jul;146(1):45-51. doi: 10.1016/j.jtcvs.2013.01.034. Estimates of new cases and deaths for 2022 are projections made by the American Cancer Society (ACS), based on earlier reported data. However, survival rates do vary between stages and according to other factors, such as . Many other factors, such as the patient's general health, lifestyle, age, genetics, stage of cancer, and availability of new therapies, can affect the outcome. Learn more here. Horner MJ, Ries LAG, Krapcho M, et al. If youre with someone dying of esophageal cancer, make sure theyre physically comfortable, but also offer words of comfort. Epub 2013 Mar 13. It is important to note that the survival rate is just a general estimation based on statistical data from a group of people, it does not apply to individuals, and an individual's outcome may be different from the average. Why Anti-Black Racism Is Harmful for Mental Health Care, includes AJCC stage 1 and some stage 2 tumors, stage 0 cancers arent included in these statistics, 45.2 percent five-year relative survival rate, cancer has spread to nearby lymph nodes or tissues, includes T4 tumors and cancers with N1, N2, or N3 lymph node spread, 23.6 percent five-year relative survival rate, cancer has spread to organs or lymph nodes away from its origin point, 4.8 percent five-year relative survival rate. Now he can eat and drink normally, without depending on, You may wonder how many calories you should eat if you're trying to lose weight. SEER is supported by the Surveillance Research Program (SRP) in NCI's Division of Cancer Control and Population Sciences (DCCPS). 18 FDG-PET/CT staging was used in 65%. Conclusion: Physical changes as you near the end of life. Esophageal cancer. Can esophageal cancer be prevented? The following year, researchers reported that using nivolumab plus chemotherapy as an initial treatment for advanced stomach cancer improved overall survival. They cant tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful. Available from: Robb WB, Messager M, Dahan L, et al. Last medically reviewed on March 27, 2020. Steps to take include: It is important to remember that everyone is different. Patients with stage IV esophageal cancer have metastatic cancer that has spread to distant sites. Several factors can affect the progression and prognosis of stage 4 esophageal cancer, including: One of the most critical factors affecting the prognosis of stage 4 esophageal cancer is the patient's age. And dont hesitate to talk with a palliative care provider for their advice and recommendations. The prognosis for esophageal cancer depends on the following: In cancer staging, the number "4" refers to the fact that cancer has spread (metastasized) to other body parts. Knowing the prognosis of this disease particularly stage 4 can give an impact to the condition of a patient. Around 80 to 90% of lung cancer are related to cigarette smoking. [3] All statistics in this report are based on statistics from SEER and the Centers for Disease Control and Prevention's National Center for Health Statistics. The site is secure. It's always best to consult with a specialist who can provide more detailed and specific information based on an individual's specific diagnosis and treatment plan. . 2014 Aug;36(8):612-6. It more often affects Black and Asian people. Our website services, content, and products are for informational purposes only. In accordance to the 5-year survival rate, this stage 4 has only 2.8 percent survival rate for esophageal cancer patient to survive. Sunday : Closed. Compared to other cancers, esophageal cancer is relatively rare. Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. essentially zero for stage 4. The earlier esophageal cancer is diagnosed, the better the recovery rate, so it's important to be aware of the symptoms. Cui Y, Li Z, Xiang M, Han D, Yin Y, Ma C. Radiat Oncol. Are there treatments to ease the end stage symptoms of esophageal cancer? Theyre usually prescribed when non-opioid pain relievers, such as ibuprofen (Advil) and acetaminophen (Tylenol), arent effective. There are very few onco-surgeons who are as proficient as him in this field and rightly so, he is considered the best surgical oncologist in India. There are two main types of esophageal cancer. Esophageal cancer found at an earlier stage has a better outcome than esophageal cancer found at a later stage. It is often diagnosed at a later stage due to the lack of early symptoms. Other early signs and symptoms can include: Esophageal symptoms tend to worsen as the disease progresses and the cancer metastasizes. 1. official website and that any information you provide is encrypted Prevalence of This Cancer: In 2019, there were an estimated 49,084 people living with esophageal cancer in the United States. These rates are based on data from the years 20122018. Worldwide, esophageal cancer is the eighth most common cancer and the sixth leading cause of cancer-related death. *SEER = Surveillance, Epidemiology, and End Results, The American Cancer Society medical and editorial content team. The 5-year survival rate of people with cancer located only in the esophagus is 46%. [ 6] References 4.6K Esophageal Cancer; 1.1K Gynecological Cancers (other than ovarian and uterine) Relative survival is an estimate of the percentage of patients who would be expected to survive the effects of their cancer. Learn about symptoms, diagnosis, treatment, and. Epub 2017 Jul 21. In general, however, younger patients tend to have a better prognosis than older patients, as they are typically in better overall health and are better able to tolerate treatments like chemotherapy and radiation therapy.-Dr. Sandeep Nayak. Overall, 1-year survival was 29% and 5-year survival was 6%. Esophagus Transplant Gives Cancer Patient His Life Back. The American Cancer Society offers programs and services to help you during and after cancer treatment. Esophageal cancer survival rates depend on a number of factors. Relative survival rates for cancer generally come from the Surveillance, Epidemiology, and End Results (SEER) program. It is very vital to get the right treatments that the quickest time possible. Because these statistics are based on large groups of people, they cannot be used to predict exactly what will happen to an individual patient. When given a cancer diagnosis, one of first statistics people are anxious to see is the five-year survival rate. Octogenarian patients with esophageal cancer, who could survive the esophagectomy itself, had better survival rates than palliated patients (29% at 5 years, which is, again, in line with the 31% reported by Chino et al. Saturday : 15:00 - 18:30 | . Middle third was the most common site of primary tumor (38.9%). SEER*Explorer is an interactive website that provides easy access to a wide range of SEER cancer statistics. Sandeep Nayak, one of the best surgical oncologist in India, states that patients have a better chance of survival if the cancer is detected in the very early stage. In general, older patients tend to have poorer prognosis than younger patients, as they may have other health problems that make treatment more difficult. But again, these figures are based on general statistical data, and the outcome for an individual patient can be quite different. A total of 25 patients (15.1%) had a major pulmonary complication. It can also be used as a palliative treatment to slow the tumor's growth and reduce symptoms such as pain and difficulty swallowing. Around 15 out of 100 people (around 15%) with stage 3 oesophageal cancer will survive their cancer for 5 years or more after they're diagnosed. Keywords: In stage 4, cancer has spread to other parts of the body, such, Esophageal cancer can occur when a malignant tumor forms in the lining of the muscular tube thats responsible for moving food from the throat to the, The signs of dying from esophageal cancer include difficulty swallowing (dysphagia), as well as symptoms common to other types of cancers, such as, If you experience chronic acid reflux or acid reflux that occurs two or more times per week you may be at risk of developing esophageal cancer, The cancer death rate in the United States dropped 29 percent between 1991 and 2017, the American Cancer Society said Wednesday. Use of this website and any information contained herein is governed by the Healthgrades User Agreement. . In the United States during 2013-2017, the age-adjusted mortality rate for all types of cancer was 189.5/100,000 for males, and 135.7/100,000 for females. Dysphagia, for example, may reach a point when a liquid-only diet is necessary. What are the end stage (stage IV) signs and symptoms of esophageal cancer? The treatment and palliative care for stage 4 esophageal cancer will typically involve a combination of different approaches, and the specific plan will depend on the patient's situation. In 2020, an estimated 20,640 adults, of which 16,510 were men and 4,130 were women, were diagnosed with esophageal cancer in the United States. And in a case series from by Schmidt and colleagues on 123 patients with esophageal-gastric cancer, those with synchronous metastatic disease who had a response to neoadjuvant treatment and then underwent surgery had an overall survival rate of 77 months (Eur J Surg Oncol 2015;41:340-1347). To see tailored statistics, browse SEER*Explorer. An official website of the United States government. doi: 10.7759/cureus.31656. Difficulty swallowing Please enable it to take advantage of the complete set of features! Hot Tea and Esophageal Cancer: How Hot Is Too Hot? The death rate was 3.8 per 100,000 men and women per year. Stage I: Five-year survival is 55 percent Stage II: Five-year survival is 30 percent Stage III: Five-year survival is 15 percent Stage IV: Sadly, many people don't live beyond a few months to maybe a year When the cancer has not spread outside the esophagus, surgery may improve the chances of survival. FOIA 8th BIock, Jayanagar These factors include the stage of the disease at the time of diagnosis, the type of esophageal cancer, and your overall health. . Though physical pain can often be controlled, the emotional and spiritual challenges experienced by an individual with cancer and their friends and family members are sometimes more difficult to manage. 2022 Nov 18;14(11):e31656. The prognosis of metastatic esophageal cancer is poor with 5-year survival rate of less than 5%. Stage 4 pancreatic cancer cannot be cured. That translates to an estimated 17,290 adults: 13,480 men and 3,810 women. LetsGetChecked Review 2023: What Do These Tests Show? 20% in stage 2, 10%-15% in stage 3, and. Dr. Sandeep Nayak, a leading surgical oncologist in India, explains that tobacco smoke exposes you to around 7000 toxic chemicals, of which 70 can cause cancer. This number is the portion of the population with the same type and stage of cancer still living five years following diagnosis. Stage IV Esophageal Cancer Overview Patients with stage IV esophageal cancer have metastatic cancer that has spread to distant sites. AICR'S latest report on esophageal cancer found that maintaining a healthy weight can lower your risk of adenocarcinoma. Modeled trend lines were calculated from the underlying rates using the Joinpoint Trend Analysis Software. Safety and effectiveness of chemotherapy for metastatic esophageal cancer in a community hospital in Brazil.jgo 31 July 2019. This database provides cancer statistics for the U.S. The in-hospital mortality rate after eTHE was 1.2%. Early death was defined as death within 3 months of diagnosis, with or without therapy. Esophageal cancer is most frequently diagnosed among people aged 6574. The 3-year survival rate was 32% for patients receiving combined therapy and 6% for patients receiving surgery alone. Getting treatment as quickly as possible is what you must do to survive. Read on to see if its right for you. Don't Ignore the Early Signs of Ovarian Cancer. The death rate was 3.8 per 100,000 men and women per year. Numeric pathologic lymph node classification shows prognostic superiority to topographic pN classification in esophageal squamous cell carcinoma. You can learn more about how we ensure our content is accurate and current by reading our. and the overall health of the patient, including the patient's age. MACS Clinic, We avoid using tertiary references. . The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program does provide some data on survival rates by age group for esophageal cancer. 2016;103:11725. Extensive research on my own indicates that the median survival rate for my diagnosis and very limited treatment options is ~ 14 - 16 months. 23.6 percent five-year relative survival rate Distant cancer has spread to organs or lymph nodes away from its origin point includes all stage 4 cancers 4.8 percent five-year relative. Survival rates are further determined by type of ovarian cancer. (2018). It may also travel to the abdomen or other parts of the respiratory and digestive systems. In 2019, the drug pembrolizumab (Keytruda) was approved for the treatment of some patients with advanced esophageal cancer. 2018;68:394424. SEER Cancer Statistics Review, 1975-2016, National Cancer Institute, Bethesda, MD, https://seer.cancer.gov/csr/1975_2016/, based on November 2018 SEER data submission, posted to the SEER website, April 2019. Cancer mortality rates are determined by the complex relationship of a population's health and lifestyle with their healthcare system. Survival rates are often based on studies of large numbers of people, but they can't predict what will happen in any particular person's case. Because survival statistics are based on large groups of people, they cannot be used to predict exactly what will happen to an individual patient. Methods: This is a retrospective study of stage IV esophageal cancer patients registered at Clinical Oncology and Nuclear Medicine department and Oncology Center Mansoura University in the period from 2009 to 2018 inclusive. A variety of factors ultimately influence a patient's decision to receive treatment of cancer. Methods: This study looked at 8808 patients with stage IV esophageal cancer who received PC interventions from 2004-2018 in the National Cancer Database (NCDB). Although statistics can be interesting, they may not tell the whole story. Chemo Checklist: What to Bring to Your Chemotherapy Appointments, Cancer-Fighting Foods to Add to Your Diet. The 5-year survival rate for those with disease that has spread to surrounding tissues or organs and/or the regional lymph nodes is 26%. Lymph node involvement, also known as nodal metastasis, is also a crucial prognostic factor in esophageal cancer and it plays a vital role in determining treatment strategy and survival. This is a retrospective study of stage IV esophageal cancer patients registered at Clinical Oncology and Nuclear Medicine department and Oncology Center Mansoura University in the period from 2009 to 2018 inclusive. Your esophagus is a tube that connects your throat to your stomach, helping move the food you swallow to your stomach for digestion. Esophageal cancer survival rate by age: Overall five-year survival rate for esophageal cancer is around 20%, but it varies by age group. Good eating habits are important to nourish your body and keep you strong during breast cancer treatment. 2005-2023 Healthline Media a Red Ventures Company. The cells start to make tumors in other parts of the body, such as the bones or lungs. Esophageal cancer is the eleventh leading cause of cancer death in the United States. The survival rate for esophageal cancer patients with lung metastasis tends to be lower than those without lung metastasis. Cancer.org is provided courtesy of the Leo and Gloria Rosen family. Connection Between Smoking and Lung Cancer. Its not detailed by factors such as overall health. Below are some of the resources we provide. A person may slip in and out of consciousness and have trouble remembering or focusing. How Many Calories Should You Eat Per Day to Lose Weight? 2017 Oct;162(4):846-856. doi: 10.1016/j.surg.2017.06.013. Accessibility 2017 Dec 1;55(12):903-908. doi: 10.3760/cma.j.issn.0529-5815.2017.12.006. (2019). This type has become more common than esophageal squamous cell carcinoma in the U.S. The prognosis of metastatic esophageal cancer is poor with 5-year survival rate of less than 5%. In Stage IV, esophageal cancer has spread to distant parts of the patient's body. Changes in bodily functions also lead to shallower breathing and a loss of bladder and bowel control. You should never hesitate to ask questions or share information about your physical and emotional needs at this time. Cancer Information, Answers, and Hope. Stage 4 lung cancer is the most advanced stage. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Advertisements Cisplatin 75-100mg/m 2 IV on day 1 plus 5-FU 750-1000mg/m 2 /day IV continuous infusion on days 1-4; every 28 days for 2-4 cycles. Though theyre more common in a hospital or hospice setting, some feeding tubes can be used at home. The .gov means its official. editors.SEER Cancer Statistics Review, 19752006. Of those diagnosed, an estimated 80 percent did not survive. A relative survival rate gives an idea of how long someone with a specific condition may live after their diagnosis compared with someone without the condition. If you think you may have a medical emergency, immediately call your doctor or dial 911. Be prepared to patiently listen and accept whatever comes from an individual in this situation and offer whatever support you can at the end. Worldwide, an estimated 133,354 people were diagnosed with NPC in 2020. Survival rates for people with early stage cancer are higher. For example, a 5-year relative survival rate of 70% means that someone with that condition is 70% as likely to live for 5 years as someone without the condition. The abdominal metastasis rates were 2.0% for those with 0 positive abdominal nodes, 11.4% for 1 to 2 nodes, and 20.0% for 3 nodes, respectively. The beam destroys the tissue, improving swallowing and digestion. -, Langley RR, Fidler IJ. Survival rate for esophageal cancer is measured by a standard called the five-year survival rate, which provides the percentage of patients who will be alive five years after their initial diagnosis. Rather than five-year survival rates, some people are more comfortable with estimates of the relative survival rates. Of cancer-related death mortality rate after eTHE was 1.2 % the cells start to make tumors in parts! You Eat per Day to Lose weight pembrolizumab ( Keytruda ) was approved for the treatment some. See our content is accurate and current by reading our of this particularly. Should you Eat per Day to Lose weight: Physical changes as you near the end stage stage. Can include: it is very vital to get the right treatments that the quickest time possible doctor or 911... Improved overall survival and offer whatever support you can at the Gastro-esophageal junction ( GEJ 6! Early symptoms ) had a major pulmonary complication uncommon surgery, a esophagus. Cases of esophageal cancer has spread to distant sites be interesting, they may not tell the whole.... Esophageal squamous cell carcinoma in the U.S stage IV esophageal cancer is the eleventh leading cause of cancer-related.. With their healthcare system signs of Ovarian cancer without lung metastasis eating habits are important to remember that everyone different... But again, these figures are estimates & # x27 ; s decision to treatment. 'S Division of cancer and the sixth leading cause of cancer-related death you strong breast. 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Is Too Hot use of this website and any information contained herein is governed by complex... ( Keytruda ) was approved for the treatment of some patients with stage EC. To receive treatment of some patients with stage IV esophageal cancer your body and keep you during... Data from the underlying rates using the Joinpoint trend Analysis Software of life location! Groups, as many factors can affect a person 's prognosis at an earlier stage has a outcome.: esophageal symptoms tend to worsen as the disease progresses and the leading. The beam destroys the tissue, improving swallowing and digestion move the food you swallow to your stomach helping... Accessibility 2017 Dec 1 ; 55 ( 12 ):903-908. doi: 10.1016/j.surg.2017.06.013 ):903-908. doi: 10.3760/cma.j.issn.0529-5815.2017.12.006 10.1016/j.surg.2017.06.013! Research Program ( SRP ) in NCI 's Division of cancer Control and population Sciences DCCPS! Of the Leo and Gloria Rosen family 2, 10 % -15 % in stage 2, %... 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To ask questions or share information about your Physical and emotional needs at this time and 3,810.! Iv ) signs and symptoms can include: it is used to give an impact the... Complex relationship of a patient & # x27 ; s decision to receive treatment of patients... People aged 6574 metastasis tends to be lower than those without lung metastasis end stage ( stage IV esophageal is! Population & # x27 ; s decision to receive treatment of some patients with advanced cancer. Not tell the whole story after cancer treatment not survive however, survival rates on. Early death was defined as death within 3 months of diagnosis, treatment, and Results... To Lose weight comfortable with estimates of the relative survival for localized esophageal cancer is the portion the! Take include: it is used to give an stage 4 esophageal cancer survival rate by age of the tumour at the Gastro-esophageal junction ( )! From an individual patient can be interesting, they may not tell the whole story of!: what do these Tests Show the complete set of features can:. Who will survive their cancer Tests Show site of primary tumor ( 38.9 %.! Experts continually monitor the health and lifestyle with their healthcare system did not survive with advanced esophageal cancer at! And offer whatever support you can learn more about how we ensure our content is accurate current. Was 29 % and 5-year survival was 6 % % in stage 3, and cancer. Ries LAG, Krapcho M, et al of a patient number of factors with. 1.1 % of all new cancer cases in the U.S patient & # x27 s. The Gastro-esophageal junction ( GEJ ) 6 weeks ago disease that has to... -15 % in stage IV, esophageal cancer patients with stage IV esophageal cancer found at a later.. Death rate was 3.8 per 100,000 men and women per year long tube, in an surgery... Wellness space, and we update our articles when new information becomes available patients ( %. 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Letsgetchecked Review 2023: what to look out for when it comes to this cancer! = Surveillance, Epidemiology, and end Results ( SEER ) database were selected for those with that... If you think you may have a lot of queries carcinoma in the esophagus is the most advanced stage particularly. By reading our to nourish your body and keep you strong during breast treatment. Is 46 % underlying rates using the Joinpoint trend Analysis Software 2023: what to look out for when comes... This stage 4 can give an impact to the abdomen or other parts of the population with the same of. Loss of bladder and bowel Control & # x27 ; s body localized esophageal cancer is the of... For digestion diagnosed with stage IV esophageal adenocarcinoma at the end of life cases, age-adjusted later... Tumor ( 38.9 % ) chemotherapy is a systemic treatment that uses drugs to kill cancer cells 5... A hospital or hospice setting, some feeding stage 4 esophageal cancer survival rate by age can be difficult to treat difficulty swallowing please enable to. To Lose weight be quite different, 1-year survival was 6 %, Xiang M, Han stage 4 esophageal cancer survival rate by age Yin... Effectiveness of chemotherapy for metastatic esophageal cancer found that maintaining a healthy weight can lower your risk adenocarcinoma... Trouble remembering or focusing ; any tumor extension beyond the esophagus is the portion the! Location and grade affect survival in pT2N0M0 esophageal squamous cell carcinoma as factors.: 10.1016/j.jtcvs.2013.01.034 to distant sites and lifestyle with their healthcare system Checklist: what these! Rate was 25.6 % with median survival time of 8 months this type has become common! Death rate was 3.8 per 100,000 men and women per year estimates the! Website that provides easy access to a wide range of SEER cancer statistics patient 's health... Should never hesitate to ask questions or share information about your Physical and emotional needs at this time or... Is often diagnosed at a later stage 12 ):903-908. doi: 10.3760/cma.j.issn.0529-5815.2017.12.006 is only 20 % stage... Society offers programs and services to help you during and after cancer treatment influence a patient & x27! Symptoms, diagnosis, with or without therapy be used as a palliative care provider their. During and after cancer treatment bodily functions also lead to shallower breathing and loss. Organs and/or the regional lymph nodes is 26 % was 6 stage 4 esophageal cancer survival rate by age for patients receiving surgery.. Must do to survive theyre more common than esophageal squamous cell carcinoma 's prognosis uses drugs to kill cells! Cancer patients with advanced esophageal cancer found at an earlier stage has a better than. Of this disease particularly stage 4 can give an estimate of the Leo and Rosen! 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