Prognosis and survival for pharyngeal cancer

A prognosis is the doctorʼs 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.

Your doctor will look at certain aspects of the cancer as well as your characteristics and habits, such as your nutrition and whether or not you smoke. These are called prognostic factors. The doctor will also look at predictive factors that influence how a cancer will respond to 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 on your treatment plan. 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 and predictive factors for pharyngeal cancer.

The stage is the most important prognostic factor for pharyngeal cancer. The earlier the tumour is found, the better the prognosis.

If pharyngeal cancer has spread to the lymph nodes in the neck, the prognosis is poorer. Pharyngeal cancer that has spread to more than 2 lymph nodes or to lymph nodes in the lower areas of the neck also has a poorer prognosis.

Pharyngeal tumours that have grown into surrounding tissues have a poor prognosis. These tissues include muscles, nerves, bone, cartilage and blood vessels. 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’s called a positive surgical margin. If cancer cells aren’t found in the margin, it’s called a negative surgical margin. Tumours with negative margins have a better prognosis.

If the positive surgical margin has cancer cells within 5 mm of the edge of the healthy tissue removed, it has a less favourable prognosis.

Your doctor will do tests to check for HPV infection. People with pharyngeal tumours linked to an HPV infection have a better prognosis than people who have HPV-negative tumours.

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 pharyngeal cancer. This can affect their outcome.

People who continue to smoke tobacco and drink alcohol during treatment for pharyngeal 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.

People who have other health problems, such as heart or lung disease, have a poorer prognosis. These other health issues are called comorbidities.