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People with non–small cell lung cancer (NSCLC) may have questions about their prognosis and survival. Prognosis and survival depend on many factors. Only a doctor familiar with a person’s medical history, type of cancer, stage, characteristics of the cancer, treatments chosen and response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognosis is the doctor’s best estimate of how cancer will affect a person, and how it will respond to treatment. A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together and they both play a part in deciding on a treatment plan and a prognosis.
The following are prognostic factors for non–small cell lung cancer.
Stage is the most important prognostic factor for non–small cell lung cancer. Generally, earlier stages (stage 0 and I) have a more favourable prognosis.
Lymph node status is part of the staging for non–small cell lung cancer. The location of the lymph nodes where cancer has spread has an effect on the prognosis and survival. Generally, level N1 lymph nodes have a more favourable prognosis than level N2 or N3 lymph nodes.
If the lung tumour can be completely removed (resected) by surgery, the prognosis is more favourable than if it cannot be completely removed.
Sometimes people with tumours that could be removed by surgery cannot have surgery for other medical reasons. These people receive radiation therapy to treat the tumour.
Favourable prognostic factors for inoperable tumours are:
Superior sulcus tumours (Pancoast tumours) are found on the top edge of the lung, very close to the spine and other nerves. These tumours have a less favourable prognosis because they often cannot be removed by surgery.
People with non–small cell lung cancer who have lost weight have a less favourable prognosis.
Women with non–small cell lung cancer have a slightly better prognosis than men diagnosed with the same cancer.
People who have the following lung problems have a less favourable prognosis:
The following are prognostic factors for advanced and metastatic non–small cell lung cancer:
The Canadian Cancer Society is actively lobbying the federal government to establish a national caregivers strategy to ensure there is more financial support for this important group of people.