Determining Your Prognosis

Your prognosis is a prediction of the outcome of your disease. What is the risk of succumbing to the cancer or the risk of its coming back? These are the big questions on most people’s minds after receiving a diagnosis of oral cancer. In general, doctors know there are several characteristics of the tumour that can tell you something about your chances of being cured.

The following aspects of the cancer may affect your prognosis.

 

Stage This is the most important factor that affects your chances of being cured.
Spread to Lymph Nodes This goes along with stage, but even without other factors, if there is spread to lymph nodes in the neck, it’s a worse chance of cure, especially if there is evidence of growth of cancer outside of the lymph node.
Tumour Margins The ability to completely remove the tumour can be a very important factor that will indicate whether you will be cured or not.
Depth of Invasion How deep the tumour goes beyond the surface can impact the chance of cure.
Spread into Local Structures Spread into large nerves, vessels, lymphatics or even the skin of the cheek might make your prognosis worse.

It is very difficult to discuss prognosis without understanding all the details of your cancer, and this is a conversation you’re better off having in person with your doctor. To give you a percentage chance of cure is difficult because cancer research looks at all sorts of different types of cancers and may include patients from long ago.

In general, for patients with cancer of the floor of the mouth, studies have shown the following:

 

Estimated Disease-Specific Survival at Five Years Estimated Disease-Specific Survival at Ten Years
Floor of Mouth Cancer Floor of Mouth Cancer
Stage I 73% 53%
Stage II 60% 44%
Stage III 36% 26%
Stage IV 30% 20%

Estimated Disease-Specific Survival is the percentage of people with a specific cancer who are alive at a given time point, such as five years after diagnosis. It excludes people who may have died from a disease other than their cancer. It is probably the best estimate we have in these large national databases as to the prognosis of a cancer at each stage.

For patients with cancer of gums and other locations in the mouth (excluding the tongue, lips and floor of mouth), studies have shown the following:

 

Estimated Disease-Specific Survival at Five Years Estimated Disease-Specific Survival at Ten Years
Gum and Other Mouth Cancer Gum and Other Mouth Cancer
Stage I 81% 69%
Stage II 62% 49%
Stage III 45% 28%
Stage IV 40% 29%