Melanoma: Your Chances for Recovery (Prognosis)

What is a prognosis?

Prognosis is the word your health care team may use to describe your chances of recovering from cancer. Or it may mean your likely outcome from cancer and cancer treatment. A prognosis is a calculated guess. 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’s up to you to decide how much you want to know. Some people find it easier to cope and plan ahead 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 statistics are too general to be useful.

A doctor who is most familiar with your health is in the best position to discuss your prognosis with you and explain what the statistics may mean in your case. At the same time, you should keep in mind that your prognosis can change. Cancer and cancer treatment outcomes are hard to predict. For instance, a favorable prognosis (which means you’re likely going to do well) can change if the cancer spreads to key organs or doesn’t respond to treatment. An unfavorable prognosis can change, too. This can happen if treatment shrinks and controls the cancer so it doesn’t grow or spread.

What goes into a prognosis

When figuring out your 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 exact type and stage of the cancer you have. These estimates are based on what results researchers have seen over many years in thousands of people with the same type and stage of cancer.

If your cancer is likely to respond well to treatment, your doctor will say you have a favorable prognosis. This means you’re expected to live many years and may even be cured. If your cancer is likely to be hard to control, your prognosis may be less favorable. The cancer may shorten your life. It’s important to keep in mind that a prognosis states what’s likely or probable. It is not a prediction of what will definitely happen. No doctor can be fully certain about an outcome.

Your prognosis depends on:

• The type and location of the cancer

• The stage of the cancer

• Your overall health

• Your treatment decisions

• How well your cancer responds to treatment

Understanding survival rates

Survival rates show how many people live for a certain length of time after being told they have cancer. The rates are grouped for people with certain types and stages of cancer. Many times, the numbers used refer to the 5-year or the 10-year survival rate. That’s how many people are living 5 years or 10 years after diagnosis. The survival rate includes people at these different stages:

• People who are cancer-free or cured

• People who still have signs of cancer. These people may or may not be getting treatment for their cancer.

What are the 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.

• 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. People with HIV have a weakened immune system.

• Although African Americans are less likely to get melanoma than whites, their survival rates are lower when they do get it.

Talking with your healthcare provider

You can ask your healthcare provider about survival rates and what you might expect. But remember that statistics are based on large groups of people. They cannot be used to say what will happen to you. No two people are exactly alike. Treatment and how well people respond to treatment vary.