Prognosis - can cancer be cured?

One of the most important questions that a cancer patient wants answered is how serious the disease is and what the chances of survival are, and this is precisely what the prognosis of the disease tells us. The prognosis can be influenced by numerous factors, including the type of cancer and its location, the stage of the disease (you can read more about the stage of the disease in a separate article), the grade of the tumor (indicating the extent to which the tumor cells differ from normal cells, which indicates the degree of aggressiveness of the disease), certain characteristics of the tumor cells themselves, the patient's age, his general condition and other previous and currently active diseases, and the response to the applied therapy. Many patients want to know their prognosis, because they cope with the disease more easily when they have more information. Other patients, on the other hand, are afraid of statistics on survival or believe that they are too general. It is up to the patient to decide how detailed information about their disease they want to have.

Doctors estimate prognosis based on statistical data obtained over a long period of years on a large number of patients with the same type of oncological disease, where several parameters related to prognosis can be analyzed. Cancer-specific survival refers to the proportion of patients (%) with a specific type and stage of cancer who have not died of cancer during a certain period after diagnosis (most often referred to as five-year survival). It is based on data on causes of death. Overall survival (OS) is one of the most widely used parameters, and it refers to the proportion (%) of patients with a specific type and stage of cancer who have not died (regardless of cause) during a certain period after diagnosis. Disease-free survival (DFS) refers to the proportion of patients (%) who have no signs of disease after completing a certain type of oncological treatment. Progression-free survival (PFS) refers to the proportion of patients (%) whose disease does not progress after the use of a certain therapy. It is important to remember that since statistical data are derived from large populations of patients, they cannot accurately determine the prognosis of an individual patient; This is only a rough estimate because each patient is unique. Patients can discuss their prognosis with their doctor, and online data is also available. Prognostic data from the American Cancer Patient Database can be found at the following link.​

Figure 1. Talking to a doctor about the prognosis of a disease can be extremely stressful for some patients. Each patient has the right to decide how much detailed information about their disease they want to receive.

Can cancer be cured? Although cancer mortality is still relatively high today, significant progress has been made in the treatment of malignant diseases in recent years. This enables an increasing number of patients to be cured, but it should be borne in mind that the success of treatment depends on many factors, primarily the advanced stage of the disease at diagnosis. It is for this reason that national cancer screening programs are being introduced, in order to diagnose the disease at an early stage. Even in the metastatic stage, many patients can be treated to extend their lifespan, but in general the main goal is to stop the growth of the tumor and relieve symptoms, or to preserve or improve the quality of life. Today, several treatment methods are available, including chemotherapy, surgery, radiotherapy, immunotherapy, targeted therapy, hormone therapy, and inclusion in clinical trials. The above methods can be used individually or in combination, at the discretion of the attending physician. Some of the new treatment methods, especially immunotherapy, offer hope for a cure for some patients with metastatic disease.

Also, the time component is very important in the success of cancer treatment. According to Western European recommendations, you should never wait longer than 2 weeks from the moment your family doctor suspects you have cancer based on your symptoms until the treatment and first examination by an oncologist. When cancer is indeed confirmed, no more than 31 days should pass from the decision on treatment to the day the therapy actually begins. Extending these deadlines negatively affects the success of treatment and the prognosis of the disease. Do not waste time because it means life! Our team exceeds even these high standards - we organize the first examinations for most patients within 48 hours of reporting, and the therapy begins within 7 days of the completion of treatment.

Additional interesting facts

Although a large number of people die from cancer today and it is the 2nd leading cause of death in the world, not everything is so bleak in cancer treatment. It can be said that the results of treatment have improved significantly over the years. For example, in the period from 1975 to 1977, the five-year survival rate from cancer was 49%, while this figure rose to 68% for the period from 2004 to 2010! It is not ideal, but progress is visible. It can therefore be concluded that the increase in people dying from cancer is a consequence of the increase in the number of patients, especially progress in treatment.

When we look at Croatia, Eurostat data from 2016 by country are worrying - in the whole of Europe, Croatia is in 2nd place in terms of standardized cancer mortality rate. Only Hungary is worse than Croatia! The data clearly indicate that a more precise and targeted approach to the treatment of this serious disease is needed.​​

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