AFTER CANCER: WHAT IS MY PROGNOSIS AFTER TREATMENT?
Your prognosis is the statistical prediction of how you will do. Your overall prognosis is your long-term chance of survival.
Many types of cancer have a good short-term prognosis but a poor long-term prognosis. For example, your cancer may be incurable with current forms of therapy, but is so slow growing that you are expected to survive for many years. Or your type of cancer may be expected to respond well to initial treatments, but has a high rate of recurrence and loses this responsiveness.
Prognosis may be described in general statements such as “Your prognosis is very good” or “Your prognosis is poor.” Oftentimes, when you want to hear something more specific, you will be given a percentage, such as “Your prognosis for a five-year survival is 60 percent.”
To say that you have a 60 percent chance of staying in remission for at least five years means that for every 100 persons with your type of cancer who received your type of treatment and achieved remission, 60 will stay in remission for at least five years and 40 will develop recurrent cancer. In five years each individual patient will either be in 100 percent remission or have a recurrence.
To say that you have a 60 percent chance of surviving for at least five years means that for every 100 persons in your situation, 60 will be alive in five years. Some of those 60 will be disease-free, some will have had recurrent disease and be back in remission, and some will be living with active cancer.
Your prognosis after treatment may be different from that when you were first diagnosed. This is because your doctors have two important pieces of information that were unavailable before you were treated: they know whether your cancer responds to treatment, and they know how healthy you are after treatment.
For illustration, let us say that when you were originally diagnosed, you were told that you had a 50 percent chance of surviving at least five years. If you did well with treatment, you may now be told that you have a 95 percent chance of surviving at least five years. This improvement in your chance of survival has occurred because the original figure of 50 percent included those people who would not respond to the therapy as well as those who would die of complications before achieving remission. At the time of your diagnosis, doctors knew your chance of responding, but could not know how your cancer would in fact respond. The figure of 95 percent given to you after your treatment is derived from information showing that, of the people who did as well as you did, 95 percent were alive five years later.
One thing to keep in mind is that your prognosis keeps changing as your situation changes. The prognosis given to you when you were first diagnosed is not as relevant or meaningful as the prognosis based on your current situation.
Factors that help determine your prognosis include
• your type of cancer
• the stage of your cancer at the time you were diagnosed
• your cancer’s response to treatments
• your level of physical fitness
• the presence or absence of other medical conditions
• available indicators specific for your type of cancer, such as tumor markers and hormone receptors
• many factors that we cannot measure, such as your “will to live”
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