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Prognosis and survival for oropharyngeal cancer
If you have oropharyngeal 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. 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 oropharyngeal cancer.
The stage is the most important prognostic factor for oropharyngeal cancer. The earlier the tumour is found, the better the prognosis.
Spread to lymph nodes
If oropharyngeal cancer has spread to the cervical lymph nodes, the prognosis is poorer. Oropharyngeal cancer that has spread to more than 3 lymph nodes in the neck or to lymph nodes in the lower areas of the neck also has a poorer prognosis.
Spread to surrounding tissues
Oropharyngeal tumours that have grown into surrounding tissues have a poor prognosis. These tissues include muscles, nerves, bone, cartilage and blood vessels. Tumours can grow inward and deeper into the tissues of the oropharynx or outward, toward the surface of the oropharynx. The deeper the tumour has grown into surrounding tissues, the poorer the prognosis.
The margin is the area of healthy tissue around a tumour that is removed along with the tumour during surgery. If there are cancer cells in the margin, it is called a positive surgical margin. If cancer cells are not found in the margin, it is called a negative margin. Tumours with negative surgical margins have a better prognosis.
Human papillomavirus (HPV)
Your doctor will do tests to check for HPV infection. People with oropharyngeal tumours linked to HPV infection have a better prognosis.
A history of heavy tobacco and alcohol use is often connected with a poor diet, which can lead to poor nutrition. People who have poor nutrition may not be healthy enough to have treatment for oropharyngeal cancer. This can affect their outcome.
Tobacco and alcohol use
People who continue to smoke and drink alcohol during treatment for oropharyngeal cancer tend to have more complications from treatment. These complications can affect the treatment schedule and the outcome. Smoking during radiation therapy can make the treatment less effective.
Performance status is how well you can carry out common daily activities. The healthcare team uses different performance status scales to assess how the cancer is affecting you and your ability to tolerate treatment. People who have higher performance status scores may tolerate the effects of treatment better than those who have lower scores.
People who are under 60 tend to have a better prognosis than people who are over 60.
Other health problems
People who have other health problems, such as heart or lung disease, have a poorer prognosis. These other health issues are called comorbidities.
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.