Statistics and prognosis for cancer of the larynx

Cancer statistics in general
There is a section explaining more about the different types of cancer statistics in the cancer statistics section of CancerHelp UK.  Unless you are very familiar with medical statistics, it might help to read this before you read the statistics below.

Remember – statistics are averages based on large numbers of patients.  They cannot predict exactly what will happen to you.  No two people are exactly alike and response to treatment will vary from one person to another.

You should feel free to ask your doctor about your prognosis, but not even your doctor can tell you for sure what will happen.  You may hear your doctor use the term ‘5 year survival’.  This doesn’t mean you will only live 5 years.  It relates to the proportion of people in research studies who were still alive 5 years after their cancer was diagnosed and treated.  Doctors follow what happens to people for 5 years after treatment in any research study.  This allows them to make comparisons between the results of different studies.

Doctors quote figures for 5 years because, if it is going to come back, a cancer is most likely to do so within this time.  If a cancer of the larynx has not come back within 5 years, there is only a small chance that it will come back after that (unless you continue to smoke).  Doctors don’t like to say you are cured, because there is that small chance.  So the term ‘5 year survival’ is used instead.

Overall outlook
As with many other types of cancer, the outcome depends on how advanced your cancer is.  In other words, the stage of your cancer.  The outlook of laryngeal cancer also depends on which part of the larynx is involved.  The statistics below are general, for all types of laryngeal cancer.  For information that is more detailed you will have to talk to your own specialist.

Of all those people diagnosed with cancer of the larynx, 65 out of every 100 diagnosed (65%) live for at least 5 years.

About 56 out of every 100 people diagnosed (56%) will live for 10 years.  These people will almost certainly have been cured of their larynx cancer.

Fortunately, most laryngeal cancers are still in the early stages (stage 1 or 2) when they are found.  For these people, 80 out of every 100 diagnosed (80%) will live for at least 5 years.

The figures do vary, depending on where the cancer is in the larynx.  Most laryngeal cancers in the UK are glottic - that means they started in the glottis within the larynx.  Glottic cancers tend to be picked up at an early stage as a hoarse voice is a common early symptom.  About 90 out of every 100 people with T1 glottic cancers are cured with radiotherapy alone.  But most of the remaining 10 out of every 100 will be cured with surgery after their radiotherapy.

For T2 glottal cancers, the cure rate with radiotherapy is about 70 out of every 100 (70%).  At least half of the rest will be cured with surgery after their radiotherapy.  So overall, the cure rate is about 85 out of every 100 (85%).

For the small number of people diagnosed in the advanced stages (stage 3 and 4) of cancer of the larynx, the outcome is not as good.  It does also depend on where the cancer is in the larynx.  Between 25 and about 60 people out of every 100 (25 – 60%) will live for 5 years.  The outlook also depends on how many lymph nodes are involved and if the cancer has spread to other organs in your body.

Stage 0 or CIS

This stage of cancer of the larynx is easy to treat by removing the abnormal cells.  But the cancer cells can come back.  If the cancer keeps coming back, you may need some radiotherapy.  Just about everyone with this stage of laryngeal cancer will be cured.  The 5 year survival is more than 96 out of every 100 people (over 96%).

Stage 1 and 2

About 6 out of every 10 people diagnosed with cancer of the larynx have stage 1 or 2 disease.  Treatment for this stage is radiotherapy or surgery.  If you have radiotherapy, it successfully treats

  * More than 9 out of 10 people (over 90%) with stage 1 cancer of the larynx    
  * More than 7 out of 10 people (over 70%) with stage 2 cancer of the larynx

Partial laryngectomy has success rates that are just as good.  You may have better voice quality after your treatment if you have radiotherapy.  But with modern surgical techniques, there probably isn’t all that much difference in voice quality between surgery and radiotherapy.

Stage 3 and 4
If you have stage 3 or 4 laryngeal cancer, it means that the cancer is large enough to have affected the movement of your vocal cords.  It may also have spread to your lymph nodes and possibly to other organs in your body (although this is not common with cancer of the larynx).

Your outlook depends partly on the degree of cancer spread, including whether the cancer has spread through the covering of the lymph nodes.

Again the figures vary, depending on where the cancer is found in the larynx.  About 1 in 3 larynx cancers start in the supraglottis.  Some sources quote as many as 6 out of every 10 people (60%) survive at least 5 years after treatment with T3 supraglottic cancer.  Overall, the 5 year survival for T3 laryngeal cancers may be much lower, at about 1 in 4 (25%).

The figures will be lower still for a cancer that has spread beyond the neck area to another part of the body.  This can happen in a small number of people.  Even with a locally advanced cancer that has spread elsewhere in the body, your doctor has treatments that can relieve your symptoms, may slow the growth of the cancer and will give you a reasonable quality of life for a time.  It is unusual to live for much more than a year with a very advanced cancer, but it is very difficult to generalise.  You will need to talk to your own specialist to get an idea of the outlook if you have a very advanced cancer.

Other factors affecting prognosis

Other factors can affect the outcome of your treatment, apart from the stage of your cancer

  * Whether you continue to smoke    
  * How well you are overall  
  * The grade or differentiation of your cancer - grade is how the cancer cells look under the microscope

If you continue to smoke after cancer of the larynx, there is a high risk that you will develop a second cancer.  Continuing to smoke can also increase the likelihood of side effects after radiotherapy, and it can affect how well the treatment works.  As many cancers of the larynx have a high cure rate, it is obviously really important that you stop smoking!

You need to keep as well as possible.  Some people with cancer of the larynx have a history of heavy drinking, as well as smoking.  We know that people who drink heavily often don’t look after themselves.  They tend not to eat properly, for one thing.  Your body needs good nutrition to help recover from treatment.  So if you are getting over cancer of the larynx, try to cut down on your drinking and make sure you eat regularly and well.

Doctors have a scale to describe how well you are.  They call this your ‘performance status’.  A score of 0 means you are completely able to look after yourself.  A score of 1 means you can do most things for yourself, but need some help.  The scores continue to go up, depending on how much help you need.  Performance status score is important in laryngeal cancer because the cancer can cause general symptoms such as

  * Weight loss    
  * Extreme tiredness

Head and neck cancer specialists know that people who do NOT have these symptoms have a better outlook (prognosis) than people who do have these symptoms.  Performance status will be affected by these symptoms.  If you are weak from losing weight and very tired, you will need more day-to-day help, so your performance score will be at least 1.  You may see performance status written ‘PS’.

How reliable are cancer statistics?

No statistics can tell you what will happen to you.  Your cancer is unique.  The same type of cancer can grow at different rates in different people for example.  The statistics are not detailed enough to tell you about the different treatments people may have had.  And how that treatment may have affected their prognosis.  Many individual factors will determine your treatment and prognosis.  If you are fit enough to have treatment, you are likely to do better than average.  This is particularly true for those with advanced cancers.

Clinical trials

Taking part in clinical trials has been shown to improve prognosis. No one is completely sure why this is, but it has been shown time and time again. It is probably partly to do with having a closer eye kept on you by your doctors than you might if not in a trial - more scans and blood tests for example. But it might also be something to do with morale. You may feel more positive if you are taking part in a trial because it is more obvious to you that something is being done to help you.

There is more about clinical trials in the Research section of CancerHelp UK.  You may also like to search our clinical trials database for larynx cancer trials.  Use this link or click on the blue trials button to the left of any CancerHelp UK screen.  Then select ‘head and neck’ from the drop down menu box and click ‘find’. 

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