Prognosis and survival for laryngeal cancer

A prognosis is the doctor’s best estimate of how cancer will affect you and how it will respond to treatment. Survival is the percentage of people with a disease who are alive at some point in time after their diagnosis. Prognosis and survival depend on many factors.

The doctor will look at certain aspects of the cancer as well as characteristics of the person (such as whether they smoke or drink alcohol or their age). These are called prognostic factors. The doctor will also look at predictive factors, which influence how a cancer will respond to a certain treatment and how likely it is that the cancer will come back after treatment.

Prognostic and predictive factors are often discussed together. They both play a part in deciding on a prognosis and a treatment plan just for you. 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 and chances of survival.

The following are prognostic 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 early-stage cancer has a better prognosis than one that is diagnosed at a later stage.

Cancer that starts in the glottis (middle part of the larynx that includes the vocal cords) has a better prognosis than cancer that starts elsewhere in the larynx.

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.

If the cancer has spread to the lymph nodes, the prognosis is better if:

• the cancer has only spread to lymph nodes on the same side of the neck as the tumour
• the cancer in the lymph nodes is less than 3 cm

Tumours that grow deeper into the tissues of the larynx have a poorer prognosis than tumours that grow on the surface of the larynx.

Your general health – including your performance status, nutritional status (how well the nutrients you get meet your bodyʼs needs), lung function and other health problems – affects how well you will cope with treatment for laryngeal cancer.

People with a history of heavy tobacco and alcohol use often have other medical conditions (called comorbidities). These may include liver cirrhosis, cardiovascular disease, lung problems and poor nutritional status. Standard treatments for laryngeal cancer may be less effective for people with these types of health problems.

Smoking tobacco during radiation therapy can worsen side effects and make treatment less effective.

Higher grade tumours generally spread (metastasize) faster than lower grade tumours and have a poorer prognosis.