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Prognosis and survival for laryngeal cancer
If you have laryngeal 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, stage and characteristics 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 or drink alcohol) 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 laryngeal cancer.
The stage of laryngeal cancer includes the size of the tumour and how far it has grown into other tissues around the larynx. An earlier stage cancer has a better prognosis than one that is diagnosed at a later stage.
Location of the tumour
Cancer that starts in the glottis has a better prognosis than if the cancer starts elsewhere in the larynx.
Spread to the lymph nodes
Cancer that hasn’t spread to the lymph nodes in the neck has a better prognosis than cancer that has spread to the lymph nodes. The prognosis is better if the lymph nodes with the cancer are small and if the cancer has spread to lymph nodes on only one side of the neck.
Depth of tumour growth
Tumours that grow inward and deeper into the tissues of the larynx have a poorer prognosis than tumours that grow along the surface of the larynx.
Your general health
Your general health – including your performance status, your nutritional status, how well your lungs function and other health problems – has an effect on how well you will cope with treatment for cancer of the larynx.
People with a history of heavy tobacco and alcohol use tend to have other medical conditions (called comorbidities), such as liver cirrhosis, cardiovascular disease, lung problems and poor nutritional status. People with these types of conditions may not be able to cope with the standard treatments. This influences treatment outcomes.
Smoking during radiation therapy can cause side effects or make them worse and can therefore affect how successful the treatment will be. If smoking and drinking alcohol continues during treatment, side effects of treatment can be worse. This can cause treatment delays and affect the outcome of treatment.
In general, higher grade tumours tend to spread (metastasize) more readily than lower grade tumours and have a poorer prognosis.
The measure of how well a person is able to perform ordinary tasks and carry out daily activities.
Examples of scales used to evaluate performance status include the Eastern Cooperative Oncology Group (ECOG), World Health Organization (WHO) and the Karnofsky performance status scale.