What is a cancer prognosis?
A prognosis can give you an idea about whether the cancer can be cured and what may happen in the future. Find out more about how healthcare teams estimate a prognosis.
What does a cancer prognosis mean?
Prognosis means the likely outcome of a person’s illness. If you have been diagnosed with cancer, this might be something you ask your cancer doctor or specialist nurse about. Or you may decide that you do not want or need information about your prognosis. Some health professionals might talk about your outlook rather than your prognosis. They usually mean the same thing.
Your doctor cannot predict exactly what will happen in the future. But they can usually make an estimate. This is a general idea of your prognosis based on certain things like the type and stage of the cancer. It might be based on other people's experiences with the same cancer, and your own situation.
For example, a prognosis might tell you:
- the likelihood of fully recovering and being cured
- how likely it is that the cancer will come back (recurrence)
- how long someone might be expected to live with incurable cancer.
About your prognosis
If you want information about your prognosis, it is best to ask your cancer doctor. Everyone is different, so it is important to tell your cancer doctor and specialist nurse how much you want to know. Asking for more or less information will not affect the treatment or care you have. It is also okay to change your mind and ask for more information later.
Some people prefer not to have information about their prognosis. Other people want more detailed information.
If you decide to talk to your doctor, it might help to write down your questions. You do not have to ask everything all at once if you decide you have enough information.
It is natural to feel anxious or nervous when asking about prognosis. You may find it helpful to have someone with you. This could be a family member or friend. Or it could be another healthcare professional who you are comfortable with.
Prognosis is a sensitive issue to talk about. Your cancer doctor or specialist nurse will usually ask you some questions to find out what you understand. This helps them to know what information you need and to communicate it clearly. If you do not understand, ask questions or ask them to explain again.
What prognosis might help with
Knowing more about your prognosis might help you when you are thinking about:
- making decisions about your treatment
- what to tell your family and friends
- your work life
- your finances and any legal matters
- making decisions about your future care (advance care planning).
Prognosis is only an estimate of what might happen, based on the best information available at that time. This means it is possible for it to be wrong, or to change. Some people might live longer than the estimated time and some people might live for a shorter time. Because of this it is important to be careful with certain things. For example, if you are making big personal or financial decisions based on your prognosis.
How doctors might estimate prognosis
Your cancer doctor can usually give you a general idea of your prognosis based on certain things like the type and stage of the cancer. They also look at cancer survival statistics (see 'Cancer survival statistics' below).
These may show the cancer is likely to respond well to treatment. Your cancer doctor may tell you that you have a good outlook or prognosis. They might be able to give you statistics to support this.
If the cancer is very hard to control, they may tell you that you have a poorer outlook or prognosis. This is a difficult thing to learn. We have information on how to get emotional support.
Prognostic factors
Your cancer doctor can tell you about the factors that affect your prognosis and what they mean for you. These are sometimes called prognostic factors. They include:
- the type of cancer you have and where it is in the body
- the stage of the cancer – the size of the cancer and whether it has spread
- the grade of the cancer – how quickly the cancer may grow
- if the cancer cells have certain proteins or genetic changes that mean certain treatments will work well for you
- how the cancer responds to treatment
- your age and general health.
Cancer survival statistics
Your cancer doctor also uses cancer survival statistics to give more information about your prognosis.
These are taken from research studies. Over many years, these studies follow large groups of people who have the same type and stage of cancer.
They can give an idea of the likely outcome of treatment.
Cancer survival statistics cannot tell you what will happen to you as an individual. Everyone is different and can respond to treatment in different ways.
Cancer survival statistics are also based on numbers from several years ago. They may not show what is likely to happen with newer ways of treating cancer.
As new statistics become available, your doctor’s opinion on your prognosis may change.
If you decide not to have treatment, it may be more difficult for your cancer doctor to estimate a prognosis. Survival statistics are usually from studies that compare treatments with each other.
Studies do not usually compare having treatment with not having treatment. Your doctor can still talk to you about prognosis, but it might be hard for them to give clear information
Different types of survival statistics
Statistics can be complex and difficult to understand. When you talk to your cancer doctor, it may help to have a family member or friend with you. Or you could write the statistics down and talk about them later with someone you trust and who you feel comfortable with.
If you find the statistics complex, ask your cancer doctor to make the information easier to understand. You might want to use percentages, charts or diagrams instead.
Many research studies only give 5-year or 10-year survival rates. This means they measure the number of people alive 5 or 10 years after a cancer diagnosis. Some people will live much longer than this, but the study may not collect this longer-term information.
If you are looking for detailed information about cancer statistics, you might want to know more about these terms. They describe the percentage of people with a certain type and stage of cancer in different situations.
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Cancer-specific survival
This is the percentage of people who have not died from their cancer during a defined time after diagnosis.
Most research studies measure cancer-specific survival at 5 years. If certain cancers do not come back within 5 years after treatment, the cancer may be cured.
Cancer-specific survival does not include people who have died from other causes, such as heart attacks or strokes.
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Overall survival
This is the percentage of people who have not died during a period of time after their diagnosis. The people who are not alive could have died from cancer or from another cause.
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Disease-free survival
This is the percentage of people who have no signs of their cancer during a period of time after treatment. It can sometimes be called recurrence-free survival.
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Progression-free survival
This is the percentage of people with cancer that is stable and has not got worse over a period of time.
Cure or remission
Your cancer doctor may use tests and scans and any symptoms you have to help to measure how well a treatment has worked. They might use some of the following terms to describe how effective a treatment has been.
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Cure
This means there are no signs of the cancer, and it never comes back following treatment. You may need to wait a few years before your doctor can talk to you about whether the cancer is likely to be cured. Even after coming back, certain cancers might be cured with further treatment.
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Remission
Sometimes the aim of treatment is to get the cancer into remission rather than to cure it. Complete remission is when there are no symptoms of the cancer, or any signs of it on tests. In some cancers, complete remission may be long-lasting. After some years, the person is cured.
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Partial remission
This is when cancer has shrunk with treatment. Although it is still there, it is stable and not growing or spreading. Your cancer doctors and specialist nurses will monitor this closely.
If the cancer cannot be cured
If your cancer doctor tells you the cancer cannot be cured, you may find it difficult to ask what will happen, or how long you have to live. Remember, not being cured can mean different things.
Even if a cancer cannot be cured, people may live with it for many years with different treatments. During this time, newer treatments may become available to keep it under control.
Some people may want to know as closely as possible how long they have to live. They may want to make plans about their care. Your cancer doctor cannot give an exact prognosis for you as an individual. Usually, they will only be able to give a range of time.
Getting support
Finding out you have a poor prognosis can be very difficult. You may feel:
- shocked and numb
- frightened
- angry
- very sad and upset
- a combination of these feelings.
This can be hard to cope with, but help is available.
You might prefer to talk to someone close to you about your feelings. If you would rather talk to someone else, your cancer doctor or specialist nurse may be able to refer you to someone who can help. This may be a counsellor or psychologist.
You can also:
- speak to one of our cancer support specialists on 0808 808 00 00
- visit our Online Community to talk with people who are dealing with cancer, share your experience, and ask an expert your questions.
About our information
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References
Below is a sample of the sources used in our cancer registry information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk
Lelorain S. Discussing Prognosis with Empathy to Cancer Patients. Current Oncology Report. 2021, 14;23(4):42. Last accessed January 2023.
Sommovilla J, Kimberly E et al. Discussing Prognosis and Shared Decision-Making. Surgical Clinics of North America, 2019, Volume 99, pages 849-858. Last accessed January 2023.
National Institute for Health and Care Excellence. Shared decision making. NICE; 2021. NICE guideline [NG197]. Available from: www.nice.org.uk/guidance/ng19. Last accessed January 2023.
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This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been approved by members of Macmillan’s Centre of Clinical Expertise.
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