Is it helpful to know the prognosis?
Cancer patients and their loved ones face many unknowns. Understanding their disease and what to expect can help patients and their loved ones make decisions about treatment, supportive and palliative care, rehabilitation, and personal matters, such as financial matters. Seeking information about prognosis is a personal decision.
Many people with cancer want to know their prognosis. They find it easier to cope when they know the likely course of their disease. Some patients may ask their doctor about survival statistics or search for this information on their own. Other people find statistical information confusing and frightening, and they think it is too impersonal to be of value to them. It is up to each patient to decide how much information he or she wants.
A doctor who is most familiar with a patient’s situation is in the best position to discuss his or her prognosis and explain what the statistics may mean.
Because everyone’s situation is different (see Question 2), this question can be difficult to answer. Also, information used in making a prognosis often comes from studies that have compared new treatments with existing treatments rather than with “no treatment.”
Therefore, it is not always easy for doctors to accurately estimate the prognosis of a patient who decides not to have treatment. However, as mentioned above (see Question 4), a doctor who is most familiar with a patient’s situation is in the best position to discuss his or her prognosis.
There are many reasons why patients may decide not to have treatment. Some patients may be concerned that the benefits of cancer treatments will be outweighed by the side effects. Patients should discuss this concern with their doctor or other health care provider. Many medications are available to prevent or control the side effects caused by cancer treatments.
Some patients may decide at some point not to have treatment if they know that their type and stage of cancer has a poor prognosis, despite treatment. Patients who choose not to have active cancer treatment should talk with their doctor to ensure that they get palliative treatment to help with the symptoms caused by their disease.
In these cases, patients may want to think about clinical trials. Clinical trials are research studies that involve people. They test new ways to prevent, detect, diagnose, or treat diseases. People who take part in cancer clinical trials have an opportunity to contribute to scientists’ knowledge about cancer and to help in the development of improved cancer therapies. They also receive state-of-the-art care from cancer experts.
People interested in taking part in a clinical trial should talk with their doctor. Information about clinical trials is available from NCI’s Cancer Information Service at 1–800–4–CANCER (1–800–422–6237) and in the NCI booklet Taking Part in Cancer Treatment Research Studies. This booklet describes how research studies are carried out and explains their possible benefits and risks.
Additional information about clinical trials is available on NCI’s Clinical Trials page. This page contains a link to NCI’s clinical trials search form, which can be used to find clinical trials that are currently accepting patients.
What is the difference between a cure and a remission?
A cure means that treatment has successfully eradicated all traces of a person’s cancer, and the cancer will never recur (return). A cure does not mean, however, that the person will never have cancer again. It is possible that another cancer, even the same type of cancer, will develop in the person’s body at some point in the future.
A remission means that the signs and symptoms of a person’s cancer are reduced. Remissions can be partial or complete. In a complete remission, all signs and symptoms of cancer have disappeared.
If a patient remains in complete remission for 5 years or more, some doctors may say that the patient is cured. However, some cancer cells can remain undetected in a person’s body for years or even decades after apparently successful treatment, and these cells may eventually cause a recurrence. Although most types of cancer usually recur within the first 5 years after diagnosis and treatment, later recurrences always remain a possibility. Therefore, doctors cannot say with any certainty that an individual cancer patient is cured. The most they can say is that there are no signs of cancer at this time.
Because of the possibility of recurrence, doctors continue to monitor patients for many years and do tests to look for signs of cancer’s return. They will also look for signs of delayed adverse effects from the cancer treatments received.
Source: National Cancer Institute (NCI) Website, http://www.cancer.gov/