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Prognosis and survival in ovarian cancer
If you have ovarian cancer, you may have questions about your prognosis. The prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type, grade, stage and other features of your cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognostic factor is an aspect of the cancer or a characteristic of the person (such as whether they smoke) 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. They both play a part in deciding on a treatment plan and a prognosis.
The following are prognostic and predictive factors for ovarian cancer.
Stage is the most important prognostic factor for most types of ovarian cancer. Women diagnosed with early stage ovarian cancer have a better prognosis than women diagnosed with cancer at a later stage.
Cancer cells in ascites or peritoneal washings
If ovarian cancer cells are found in fluid that has built up in the abdomen (called ascites) or in the washings of the peritoneum taken during surgery, the prognosis is poorer.
Ovarian tumours can spread to and grow onto another organs or another surface near the ovary. If there are a large number of tumours within the pelvis and abdomen, the prognosis is poorer.
Some types of ovarian cancer have a better prognosis. The characteristics of a particular type of tumour often relate to the grade or stage of the tumour. For example, most ovarian stromal tumours are low grade and have a good prognosis.
The grade of the tumour is an important prognostic factor for ovarian cancer. Low-grade tumours are associated with a better prognosis than high-grade tumours.
Cancer that remains after surgery
The amount of cancer that remains after surgery is called residual disease. No residual disease has a better prognosis than if there is cancer remaining after surgery.
Younger women who have ovarian cancer have a better prognosis than older women.
Performance status is a measure of how well a person is able to perform ordinary tasks and carry out daily activities. A woman with a good performance status is more likely to respond to treatment, experience fewer and less severe side effects and have a better prognosis.
Response to chemotherapy
If the treatment is having an effect on the cancer after the first cycle of chemotherapy, it is considered a good prognostic factor.
Cancer antigen 125 (ca125) level
A lowered level of CA125 after chemotherapy is a good prognostic factor.