Prognosis and survival for lung cancer

If you have lung cancer, you may have questions about your prognosis. A prognosis is the doctor's best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.

A prognostic factor is an aspect of the cancer or a characteristic of the person (such as their overall health) that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.

The following are prognostic and predictive factors for lung cancer.

Stage

The stage of lung cancer is the most important prognostic factor. Early stages of non-small lung cancer (stages 0 and 1) have a better prognosis than later stages (stages 2, 3 or 4).

With small cell lung cancer, limited stage cancers have a better prognosis than extensive stage cancers.

Weight loss

People who have lost more than 5% of their body weight before treatment starts have a less favourable prognosis than people who haven’t lost much weight.

Performance status

Performance status measures how well a person can do their daily activities and everyday tasks. People with a higher performance status score have a better prognosis than people who have a lower performance status score.

Sex

Women with lung cancer have a slightly better prognosis than men who are diagnosed with the same cancer.

Overall health

People who are in better overall health are more likely to be able to have surgery to remove the lung cancer, which may improve survival. They may also be able to tolerate chemotherapy and radiation better than people in poor health.

People with lung and heart problems have a less favourable prognosis when diagnosed with lung cancer.

Genetic changes to the cancer cells

Tissue tests are done on lung cancer cells during diagnosis to see if there are certain changes (mutations) to the genes of the cancer cells. Lung cancers that have certain genetic changes may respond better to treatments that are designed to target that specific change.

Expert review and references

  • Stephen Lam, MD, FRCPC
  • Goldstraw P, Chansky K, Crowley J, et al. The IASLC lung cancer staging project: proposals for the revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM Classification for Lung Cancer. Journal of Thoracic Oncology. 2015: 11(1):39–51.
  • American Cancer Society. Lung Cancer Early Detection, Diagnosis, and Staging. 2019: https://www.cancer.org/cancer/lung-cancer/detection-diagnosis-staging.html.
  • Brundage M, MacKillop W. Lung cancer. Gospodarowicz MK, O'Sullivan B, Tobin, LH, et al. (Eds.). Prognostic Factors in Cancer. 3rd ed. Hoboken, NJ: John Wiley & Sons, Inc.; 2006: 19:159-163.

Survival statistics for non–small cell lung cancer

Survival statistics for non–small cell lung cancer (NSCLC) are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular person’s chances of survival.

Survival statistics for small cell lung cancer

Survival statistics for small cell lung cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular person’s chances of survival.