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Prognosis and survival for lung cancer
If you have lung 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 overall health) 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 lung cancer.
The stage of lung cancer is the most important prognostic factor. Early stages of lung cancer (stages 0 and 1) have a better prognosis than later stages (stages 2, 3 or 4).
With small cell lung cancer, limited stage cancers have a better prognosis than extensive stage cancers.
People who have lost more than 5% of their body weight before treatment starts have a less favourable prognosis than people who haven’t lost much weight.
Performance status measures how well a person can do their daily activities and everyday tasks. People with a higher performance status have a better prognosis than people with a lower performance status score.
Women with lung cancer have a slightly better prognosis than men who are diagnosed with the same cancer.
People who are in better overall health are more likely to be able to have surgery to remove the lung cancer, which may improve survival. They may also be able to tolerate chemotherapy and radiation better than people in poor health.
People with lung and heart problems have a less favourable prognosis when diagnosed with lung cancer.
Genetic changes to the cells
Tissue tests are done on lung cancer cells during diagnosis to see if there are certain changes (mutations) to the genes of the cancer cells. Lung cancers that have certain genetic changes may respond better to treatments that are designed to target that specific change.
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.