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Mesothelioma Prognosis

If you or a loved one has been diagnosed with mesothelioma, you need all the information you can get to make the best decisions, including your prognosis. A prognosis is the overall outlook that doctors give for each individual patient.  Mesothelioma is aggressive, and the prognosis is often poor, but it helps you and your doctors make better choices about treatment.

What is the Prognosis for Mesothelioma?

Unfortunately, the outlook for most cases of mesothelioma is not good. There is no cure for this type of cancer. Understanding your prognosis may be frightening or disheartening, but it will give you an idea of the likelihood of recovery, survival time, and the best treatments to pursue.

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What is the Life Expectancy for Mesothelioma?

For patients, prognosis means getting an idea of how long they can expect to live with this disease. The life expectancy for a mesothelioma diagnosis can be anywhere from a couple of months to just under two years. The median actual survival time for all types and stages of mesothelioma is 12 months.

What Factors Affect Prognosis?

The outlook for mesothelioma is different for every patient based on individual contributing factors. Survival time is ONLY AN ESTIMATE, but it is based on large numbers of patients and individual factors, including:

  • Cancer stage – Earlier stages have a better prognosis.
  • Type of mesothelioma – Peritoneal mesothelioma has a better outlook than pleural.
  • Cancer cell type – Epithelial cells have a better prognosis that sarcomatoid.
  • Overall health – Patients otherwise healthy at the time of diagnosis may be eligible for more aggressive treatments and may survive longer.
  • Age – Younger patients get a better prognosis.
  • Type of treatment chosen – More aggressive and early treatments give patients a better chance at longer survival times.
  • Gender – Although the reasons are not known, women survive longer with mesothelioma.

What Are the Average Survival Rates for Mesothelioma?

Oncologists use a statistic called survival rate to estimate a prognosis for each individual patient. Five-year survival rate refers to the percentage of patients living five years or longer after an initial diagnosis.

Five-year survival rates are only estimates but are fairly accurate because they are based on large number of patients. Still, every case of mesothelioma is unique. The most accurate prognosis comes from this general statistic and a consideration of individual, personal factors.

Taking into account patients with pleural mesothelioma at any stage, the five-year survival rate is nine percent. This means that nine percent of diagnosed patients live more than five years.

Younger patients can receive different treatment modalities and have a better outlook. One large study, for instance, found that 37 percent of patients younger than 45 survived five or more years after a mesothelioma diagnosis. The survival rate for patients 45 or older at five years was significantly lower, just 20 percent.

What is the Prognosis by Type of Mesothelioma?

Prognosis also depends on the type of mesothelioma. Mesothelioma may be pleural, peritoneal, or pericardial depending on whether it begins in the tissue around the lungs, the abdomen, or the heart.

The five-year survival rates by type are:

  • Pleural – 9 percent
  • Peritoneal – 50 percent with heated chemotherapy treatment
  • Pericardial – nearly zero, only half of patients survive six months

There are also three main types of mesothelioma based on cell type: epithelial, sarcomatoid and mixed. The cell type affects prognosis:

  • Epithelial cells stick together more and don’t spread to other areas as readily as sarcomatoid cells. This type is easier to treat and has a better prognosis.
  • Sarcomatoid cells  spread more readily. This type of mesothelioma comes with a worse prognosis.
  • Biphasic tumors contain a mix of both types of cells. The prognosis depends on which cell type predominates.

What is the Prognosis by Stage?

Staging is the most crucial factor in determining prognosis. Cancer is staged to describe the extent of the tumor, meaning how large it is and what structures it invades around the main tumor. It also describes any metastasis, spread of the cancer to distant areas of the body.

The American Cancer Society determined the median five-year survival rates for mesothelioma by stage. This was based on patients treated between 1995 and 2009. Patients have a better or worse outlook depending on individual factors.

The median survival times for patients given a diagnosis at each stage of mesothelioma are:

  • Stage I – 21 months
  • Stage II – 19 months
  • Stage III – 16 months
  • Stage IV – 12 months

How to Improve a Prognosis

After a diagnosis of mesothelioma, there are some steps you can take to try to improve your outlook. One of the most important steps that you can take is to get treatment from a mesothelioma specialist team.

  • Start Treatment Immediately. Work with your specialists to put together a treatment plan as soon as possible and start it right away. The more aggressive the treatment the better the prognosis.
  • Combine Therapies. Some patients cannot have surgery, but they can be given chemotherapy and radiation therapy to shrink tumors or slow the growth rate. For those who can have surgery, the procedure to remove as much of the tumors as possible is often followed by chemotherapy and radiation to eliminate more of the cancerous tissue.
  • Consider Aggressive Treatment. Some of the surgical procedures that give pleural mesothelioma patients the best outlook are aggressive. They involve removing a lot of tissue, and in the case of one procedure, an entire lung.
  • Choose HIPEC for Peritoneal Mesothelioma. Patients with peritoneal mesothelioma who choose a treatment called heated intraperitoneal chemotherapy, or HIPEC, have some of the best survival rates. The treatment involves circulating heated chemotherapy drugs through the abdominal cavity, as opposed to administering the drugs intravenously.
  • Join a Clinical Trial. Another approach to extending the life expectancy of a patient after a mesothelioma diagnosis is to try experimental therapies. Trials determine the safety and the efficacy of new treatments. Patients with terminal conditions are usually chosen to be a part of the trials. There are risks associated with clinical trials, but they can also lead to positive results.
  • Try Alternative and Complimentary Medicine. While treatment by specialists is most important, other factors can potentially improve your prognosis and certainly help you feel more comfortable. Make healthy lifestyle choices such as quitting smoking, exercising more, and eating well. Try alternative therapies to complement traditional treatment, such as acupuncture or aromatherapy.

Living with a Negative Prognosis

A poor prognosis is difficult, especially while you are also feeling unwell and trying to make big treatment choices. With support from loved ones, coming to terms with this is easier.

Rely on Friends and Family
Most importantly, you need strong social support. Keep your family and friends close and let them help you. Let them lend a shoulder to cry on, someone to shout at, or just someone to be there when you feel you can’t be alone. If you have the people you love around you, the prognosis will be much easier to live with.

Connect with Other Asbestos Victims
As much as family support systems may be there for you and willing to help, they can’t fully understand your situation. It helps to have connections with other people struggling with cancer and mesothelioma.

Look for a support group that you can meet with, online or in person, to talk about your feelings and experiences. This can help you to feel better about accepting your mesothelioma diagnosis.

Finally, consider seeking justice for the harm caused by asbestos exposure. This can bring some peace of mind during this difficult time. Filing a lawsuit or taking part in an asbestos trust fund can also provide you and your family with much-needed compensation. An experienced mesothelioma lawyer can help you take the next step to get justice and compensation.

Page Edited by Dave Foster

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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

Page Medically Reviewed and Edited by
Luis Argote-Greene, MD

Luis Marcelo Argote-Greene, MD
Luis Argote-Greene is an internationally recognized thoracic surgeon. He has trained and worked with some of the most prominently known thoracic surgeons in the United States and Mexico, including pioneering mesothelioma surgeon Dr. David Sugarbaker. He is professionally affiliated with University Hospitals (UH). His areas of interest and expertise are mesothelioma, mediastinal tumors, thoracic malignancies, lung cancer, lung transplantation, esophageal cancer, experimental surgery, and lung volume reduction. Dr. Argote-Greene has also done pioneering work with video-assisted thoracoscopic surgery (VATS), as well as robotic assisted minimally invasive surgery. He has taught the procedures to other surgeons both nationally and internationally.
Sources
  1. American Cancer Society. (2018, November 16). Key Statistics About Malignant Mesothelioma.
    Retrieved from: https://www.cancer.org/cancer/malignant-mesothelioma/about/key-statistics.html
  2. 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
  3. Leuzzi, G., Rea, F., Spaggiari, L., Marulli, G., Sperduti, I., Alessandrini, G., Casiraghi, M., Bovolato, P., Pariscenti, G., Alloisio, M., Infante, M., Pagan, V., Fontana, P., Oliaro, A., Ruffini, E., Ratto, G.B., Leoncini, G., Sacco, R., Mucilli, F., & Facciolo, F. (2015). Prognostic Score of Long-Term Survival After Surgery for Malignant Pleural Mesothelioma: A Multicenter Analysis. Ann. Thorac. Surg., 100(3), 890-7.
    Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/26163973

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