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Prognosis and survival for bone cancer
If you have bone cancer, you may have questions about your prognosis. A 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 and stage and other features of the 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.
The following are prognostic factors for bone cancer.
If the cancer has spread
Cancer can spread from the place where it started to other parts of the body. This spread is called metastasis. Whether or not cancer has already spread when it is diagnosed is the most important prognostic factor for bone cancer. Metastasis is linked with a poorer prognosis.
Where the cancer has spread is also an important prognostic factor. Bone cancer that has spread only to the lungs has a better prognosis than metastasis to other parts of the body.
Location of the tumour
Tumours that are found in the bones of the leg or arm (distal tumours) have a better prognosis than tumours that are found in the bones of the pelvis, chest, skull or spine (proximal tumours). This may be because tumours in the arms and legs are easier to completely remove with surgery. Tumours in the chest, pelvis or spine are usually found later, are often larger and are closer to important organs. Those factors make it harder to remove them completely with surgery.
Grade of the tumour
Low-grade tumours have a better prognosis than high-grade tumours.
Size of the tumour
Bone cancer tumours that are smaller than 8 cm have a better prognosis than tumours larger than 8 cm.
People who are younger than 40 when they are diagnosed with bone cancer have a better prognosis than people over age 40.
Response to chemotherapy before surgery
Chemotherapy given before surgery is called neoadjuvant chemotherapy. It is given to make the tumour smaller so it is easier to remove with surgery. It is often used to treat osteosarcoma, the most common type of bone cancer. The amount that a bone cancer tumour shrinks with chemotherapy affects the prognosis. Tumours that respond well and get smaller with chemotherapy have a better prognosis than tumours that do not respond very well to chemotherapy.
Great progress has been made
Some cancers, such as thyroid and testicular, have survival rates of over 90%. Other cancers, such as pancreatic, brain and esophageal, continue to have very low survival rates.