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Mesothelioma Life Expectancy and Survival Rate by Stage

Mesothelioma is a rare type of cancer that many people don’t know about or understand very little. It is overwhelmingly diagnosed in people who have been exposed to asbestos. Approximately 2,500 to 3,000 people per year develop mesothelioma and are given this terrible diagnosis. It can be overwhelming to face, but having information empowers patients to make better choices for care and expenses.

One of the most frequently asked questions posed by those who have been diagnosed with mesothelioma has to do with their prognosis. People want to know what their life expectancy is, and whether there is anything that they can do to extend it. They also want to know what their future with the disease holds and how their lives will change. Realistic expectations are important for coping and planning for the future.

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Factors Affecting Life Expectancy

One of the most important questions patients have after receiving a diagnosis of mesothelioma is how long they will survive or if the cancer can be cured. Unfortunately mesothelioma is rarely curable. Most patients can be given an general idea of life expectancy, though, which depends on several factors:

  • The kind of mesothelioma that has been diagnosed (pleural, peritoneal, or pericardial,) the stage at which the mesothelioma was diagnosed
  • Type of cells that became cancerous
  • Whether the cancer has spread to other areas of the body
  • Overall health, including age, fitness, smoking status, and the presence of any other illnesses or diseases

Location of the Primary Tumor

An important variable in estimating life expectancy is the location of the original tumor. There are four types of mesothelioma based on location:

  • Pleural mesothelioma is most common and affects the pleural tissue lining the lungs.
  • Peritoneal mesothelioma is the next most common and originates in the lining in the abdominal cavity.
  • Pericardial mesothelioma, which affects the lining of the heart is rare.
  • Testicular mesothelioma, affecting the lining of the testes, is extremely rare.

Of these four, testicular mesothelioma has the longest average life expectancy, although this is based on a very small number of cases. Pericardial mesothelioma has an average life expectancy somewhere between that of pleural and peritoneal, but again this is based on small numbers, which means it may not be very accurate.

Between the two more common types of mesothelioma, those cases that originate in the pleura generally have a longer life expectancy, but not by much. Peritoneal mesothelioma has a shorter life expectancy, but both of these are deadly and aggressive cancers and most patients cannot expect to have very long life expectancy estimates after a diagnosis. This difference is shifting with a new and more effective treatment for peritoneal mesothelioma that involves injecting heated chemotherapy drugs directly into the abdomen.

Median Life Expectancy by Stage

Even more important than primary tumor location or type of mesothelioma in determining a life expectancy is the state of the cancer. When a patient gets a diagnosis of mesothelioma, or any type of cancer, it comes with a stage designation that describes the extent of the cancer to the patient and other doctors. The earlier the stage, the longer the life expectancy will be, although other factors must also be taken into account.

Mesothelioma is typically staged from one to four.

  • Stage I
    Stage I is an early diagnosis, and rare for mesothelioma. It means that the original tumor is still in one place, although it may have penetrated into the tissue surrounding the pleura. Based on averages from previous cases, the life expectancy in stage I is 21 months.
  • Stage II
    By stage II the tumor has invaded tissues like the lung and diaphragm. The average life expectancy is 19 months.
  • Stage III
    In stage III mesothelioma has spread farther, possibly into the lymph nodes. Patients with stage III mesothelioma have an average life expectancy of 16 months.
  • Stage IV
    By stage IV the cancer has spread into lymph nodes and possibly into more distant sites in the body. Life expectancy at this stage is just 12 months.

Cell Type and Life Expectancy

Another important factor in determining mesothelioma life expectancy is the cell type. There are three main categories of cell type: epithelioid, sarcomatoid, and biphasic. Most cases of mesothelioma are diagnosed as epithelioid, which has a longer life expectancy than the other two. Epithelial cells cling to each other strongly. They branch out more slowly and therefore this type of cancer metastasizes more slowly, which gives patients a longer estimate for life expectancy.

Sarcomatoid mesothelioma is cancer made up of mostly sarcomatoid cells, which are more loosely attached to each other. These cells are better able to separate from each other and spread to other areas. This kind of mesothelioma metastasizes more rapidly and has a lower life expectancy. Biphasic mesothelioma contains a mixture of epithelioid and sarcomatoid cells and comes with a life expectancy somewhere between the two. The more sarcomatoid cells there are in the tumor, the lower the life expectancy.

Lifestyle Factors

Using mesothelioma type, stage, and cell type can only tell experts so much about how long a patient will live after a diagnosis. There are also many individual factors that can impact survival time. Some are things the patient can control, like smoking, while others are not, such as age. Younger patients and non-smokers have a better life expectancy after a mesothelioma diagnosis.

A measure called performance status can be used to sum up the protective and negative effects of individual lifestyle factors. It describes the overall health, fitness, and abilities of a patient. It is rated with a grade from zero to five. A performance status of zero means a patient is fully active and not restricted by symptoms of cancer. The lower the performance status grade given at the time of diagnosis is, the longer the life expectancy for a patient with mesothelioma. Lifestyle factors affect this. The grade is likely to be lower in patients who are at a healthy weight, who don’t smoke, who eat well and get enough sleep, who cope with stress well, and who get regular exercise.

Maximizing Mesothelioma Life Expectancy

One of the most important things that a person who has been diagnosed with mesothelioma can do to help themselves and to maximize their life expectancy is to seek medical treatment from a qualified mesothelioma specialist. These highly-trained physicians have extensive exposure to this rare disease, as well as cutting-edge knowledge of all of the latest and most successful treatment options. Any lifestyle changes that can be positively changed, such as quitting smoking, can make a small impact.

Survival Rates

Doctors use a statistic called survival rate as another way to estimate life expectancy. Medical researchers and physicians measure a five-year survival rate, which is the percentage of patients that live five years or more after receiving a cancer diagnosis.

A prognosis can be made more accurate by looking at five-year survival rates because they take into account large populations of cancer patients. For mesothelioma survival rates, only mesothelioma patients are measured. Although these numbers are useful, and even when used in conjunction with a patient’s individual characteristics, a prognosis is still only an estimate.

Survival rates for mesothelioma are generally low compared to many other types of cancers. Generally, for all types of mesothelioma, patients diagnosed at age 45 or older have a five-year survival rate of only 20 percent. For younger patients the survival rate goes up to 37 percent. Survival rates and life expectancy for mesothelioma have also been measured by stage.

For stage I mesothelioma, the median survival rate is 21 months, for stage II the life expectancy drops to 19 months. For patients diagnosed at stage III, a median life expectancy is only 16 months, and for stage IV patients it is only 12 months, or one year. These are median numbers only and individual factors influence how long a patient will survive after a diagnosis.

Treatment and Survival Rate

When looking at bulk statistics and survival rates, there are clear patterns in how treatment impacts the survival of patients. The more aggressive the treatment and the more varied the treatment approach—using more than one treatment technique—the better the survival rates are.

Among patients with pleural mesothelioma, those that received only chemotherapy for treatment, survival rates were around 20 percent after two years and four percent after five years. When surgical treatments were added to chemotherapy, survival rates went up significantly. For instance, patients who underwent a pleurectomy, the survival rates for two and five years went up to 40 and ten percent. For those who underwent an extrapleural pneumonectomy, a more aggressive surgery, the survival rates for two and five years were 37 and 12 percent.

Living with a Difficult Prognosis

It can be difficult to accept, but most patients will get a poor prognosis after being diagnosed with mesothelioma. Receiving that prognosis can come as a shock. The best thing to do when getting this news is to gather the support of loved ones. Being around and being supported by people who care will be the most important way of coping with a difficult diagnosis and prognosis.

If you or a loved one has been diagnosed with mesothelioma and given a poor prognosis, you will have important choices to make. Even if you choose to be aggressive with treatment, your prognosis is still likely to be disappointing. And yet the choices you make now can make a difference in how long you live and how good your quality of life will be. Get informed and rely on loved ones to help make the right decisions.

It also helps to spend time with other people who know what you are experiencing. Your friends and family care and they love you, but they don’t necessarily understand what it is like to be given a terminal diagnosis. Consider joining a cancer support group, a mesothelioma support group, if you can find one. There are plenty of support groups you can meet with in person or online. These people will understand you and provide a source of solace you won’t find anywhere else.

As a final step in coming to grips with your prognosis, you may want to consider starting a lawsuit to seek justice for the illness you are now facing. Chances are there was someone or some company to blame for your cancer if you were exposed to asbestos. A lawsuit can give you a sense of justice and closure, but can also provide money for your medical care and to help your loved ones after you are gone.

Page edited by Dave Foster

Dave has been a mesothelioma Patient Advocate for over 10 years. He consistently attends all major national and international mesothelioma meetings. In doing so, he is able to stay on top of the latest treatments, clinical trials, and research results. He also personally meets with mesothelioma patients and their families and connects them with the best medical specialists and legal representatives available. Connect with Patient Advocate Dave Foster
  1. National Institutes of Health. National Cancer Institute. (2018, July 30). Malignant Mesothelioma Symptoms, Tests, Prognosis, and Stages (PDQ)-Patient Version.
    Retrieved from: https://www.cancer.gov/types/mesothelioma/patient/about-mesothelioma-pdq
  2. Biomed Central. On Health. (2017, March 21). Latest Mesothelioma Life Expectancy Stats and Survival Rates.
    Retrieved from: https://blogs.biomedcentral.com/on-health/2017/03/21/latest-mesothelioma-life-expectancy-stats-and-survival-rates/
  3. American Cancer Society. (2018, November 16). Survival Statistics for Mesothelioma.
    Retrieved from: https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/survival-statistics.html
  4. Shavelle, R., Vavra-Musser, K., Lee, J. & Brooks, J. (2017). Life Expectancy in Pleural and Peritoneal Mesothelioma. Lung Cancer Int., 2017, 2782590.
    Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292397/

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