Melanoma: Asking About Your Prognosis
A prognosis is a calculated guess about how or whether a person will recover from a disease. It’s a question many people have when they learn they have cancer.
Making a choice
The decision to ask about your prognosis is a personal one. It is up to you to decide how much you want to know. Some people find it easier to cope when they know their prognosis and the statistics for how well a treatment might work. Other people find statistics confusing and frightening. Or they might think it is too general to be useful.
A doctor who is most familiar with you is in the best position to discuss your prognosis with you and explain what the statistics may mean for you. At the same time, you should keep in mind that a prognosis may change. A favorable prognosis can change if the cancer progresses. An unfavorable one can change if a treatment is successful.
What goes into a prognosis
Your doctor will consider all the things that could affect the cancer and its treatment. Your doctor will look at risk estimates about the cancer. These are based on what researchers have found out over many years about thousands of people with melanoma. When possible, your doctor will use statistics for groups of people whose situations are most like yours, to estimate your prognosis.
If your cancer is likely to respond well to treatment, your doctor will say you have a favorable prognosis. If your cancer is likely to be hard to control, your prognosis may be less favorable. It is important to keep in mind that a prognosis states what is probable. It is not a prediction of what will definitely happen. No doctor can be fully certain about an outcome.
Your chance of recovery depends on:
The type and location of the cancer
The stage of the disease
Your overall health
Understanding survival rates
Survival rates show the percentage of people who live for a certain length of time after being told they have cancer. The rates are specific to people with a certain type and stage of cancer. Often, statistics refer to the 5-year or the 10-year survival rate. That’s the percentage of people who are living 5 years or 10 years after diagnosis. The survival rate includes people at these different stages:
People who are free of disease
People who have few or no signs or symptoms of cancer
People who are getting cancer treatment
Survival rates for melanoma
When found early and treated properly, melanoma is highly curable. These are the survival rates by stage according to the American Cancer Society, based in part on the 2008 American Joint Committee on Cancer Melanoma Staging Database:
Stage IA. The 5-year survival rate is around 97%. The 10-year survival rate is around 95%.
Stage IB. The 5-year survival rate is around 92%. The 10-year survival rate is around 86%.
Stage IIA. The 5-year survival rate is 81%. The 10-year survival rate is around 67%.
Stage IIB. The 5-year survival rate is 70%. The 10-year survival rate is around 57%.
Stage IIC. The 5-year survival rate is around 53%. The 10-year survival rate is 40%.
Stage IIIA. The 5-year survival rate is around 78%. The 10-year survival rate is 68%.
Stage IIIB. The 5-year survival rate is around 59%. The 10-year survival rate is around 43%.
Stage IIIC. The 5-year survival rate is around 40%. The 10-year survival rate is around 24%.
Stage IV. The 5-year survival rate is around 15% to 20%. The 10-year survival rate is 10% to 15%. This rate is higher if the cancer has spread only to the skin or distant lymph nodes and not to vital organs.
Factors other than stage also affect survival. For example:
In general, survival declines with age, especially after age 70.
Survival can be shorter if the melanoma occurs on a foot, palm, or nail bed.
People with melanoma who have had an organ transplant or who have HIV infection are also at higher risk of dying from melanoma.
Although African Americans are less likely to get melanoma than whites, their survival rates are lower when they do get it.
Remember, these statistics are based on large groups of people and cannot be used to predict what will happen to a certain patient. No two people are exactly alike, and treatment and responses to treatment vary.