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Prognosis and survival for cervical cancer
If you have cervical 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 their age or 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 cervical cancer.
Tumour size, tumour volume and local extent
Tumour size is the tumour’s widest part. Tumour volume refers to all 3 dimensions of the tumour – how high, wide and thick it is. Smaller tumour size and volume is a better prognostic factor than larger tumour size and volume.
Local extent is how far the tumour grows into the supporting connective tissue layer of the cervix and into tissues surrounding the cervix. The farther the tumour has grown into these tissues, the poorer the prognosis.
Spread to lymph nodes
Spread of the cancer to the lymph nodes is one of the most important prognostic factors. Cervical cancer that has not spread to lymph nodes has a better prognosis than cervical cancer that has spread to lymph nodes.
The stage of cervical cancer is an important prognostic factor. Early stage cervical cancer has a better prognosis than later stage cervical cancer. Tumours that grow into the sides of the pelvis, the connective tissue around the cervix and uterus or other areas in the body have poorer outcomes than cancer that is only in the cervix.
Lymphovascular invasion means that there is cancer in the tumour’s blood vessels or lymph vessels (tubes through which lymph fluid travels in the body). Cancer that has not spread into the blood or lymph vessels is linked with a better prognosis than cancer that has spread to the blood or lymph vessels.
Age and general health
Younger women tend to have a better outlook than older women. Women who have good general health other than the cancer also tend to have a better prognosis.
Women with anemia seem to have a poorer outcome than women who do not have anemia. Women with anemia also don’t respond as well to radiation therapy. It is not understood why anemia has this effect on women with cervical cancer. A blood transfusion usually doesn’t work well to reverse this effect.
Women who smoke tend to have a poorer prognosis than women who don’t smoke.
Women who have human immunodeficiency virus (HIV) tend to have aggressive cervical cancer with a poor prognosis.
Unlike with most cancers, it is unclear if grade has a role in determining prognosis in women with cervical cancer. Some studies have shown that higher grades of cervical cancer are linked with poorer outcomes but other studies have not shown the same link.