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Mesothelioma Prognosis

What to expect next is one of the first and most important things a medical team will provide a patient newly diagnosed with mesothelioma. An understanding of prognosis, even if disappointing or frightening, is important for making decisions about the future. Prognosis depends on a number of different factors, including the stage the cancer has progressed to, your age, gender and overall health, and the cell type of the mesothelioma.

For most people the prognosis for mesothelioma is not positive. This is an aggressive type of cancer and it tends to spread quickly to other tissues. Diagnosis is often delayed because symptoms are similar to those of other conditions and don’t emerge until decades after asbestos exposure first began. If you have been diagnosed with mesothelioma, make sure you take steps right away to develop a treatment plan and to give yourself the best possible outcome.

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Prognosis is Different for Everyone

The prognosis for a mesothelioma diagnosis is an estimate of life expectancy. It is most often poor, but there are always individual differences based on a number of factors:

  • The stage of the cancer,
  • The type of mesothelioma,
  • The cell type found in the tumor,
  • Overall health, and
  • Age of the patient.

In most cases patients should not be surprised to get a prognosis that is disappointing in spite of individual differences. Mesothelioma is aggressive and difficult to treat.

Average Survival Rates

Doctors use a statistic called survival rate to determine the prognosis for an individual patient. It is just one factor that helps determine an accurate prognosis for each individual. Five-year survival rate refers to the percentage of patients that live five years or longer after an initial diagnosis.

The survival rate is a useful average because it is based on large numbers of patients.  Then, considering individual factors, the general prognosis can be made more specific. It is important to remember that survival rate is an average and that every individual’s expected survival time will be different.

Overall, survival rates are not very high for mesothelioma. Younger patients 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. For those over 45 the survival rate at five years was significantly lower, at only 20 percent.

The Challenges of Diagnosing Mesothelioma

Mesothelioma is difficult to diagnose. For many patients this means a delay or misdiagnosis, which add to the overall poor prognosis. By the time an accurate diagnosis is made, many patients are already in the advanced stages of mesothelioma and treatment has been delayed too long to be life-saving or curative.

One reason mesothelioma is so challenging to diagnose is the long latency period. It can take decades for symptoms to be noticeable after being exposed to asbestos. Also, the symptoms are very similar to less serious diseases that are more common. Symptoms like difficult and painful breathing can seem like pneumonia or chronic bronchitis. Even when cancer is diagnosed, it may initially be mistaken for lung cancer, which is treated differently.

Prognosis by Type

Type of mesothelioma includes the both the location of the primary tumor and also the types of cells affected. Both are important factors in estimating a prognosis.

Patients who have been diagnosed with peritoneal mesothelioma, the cancer of the lining of the abdominal cavity, generally have a longer survival rate than do those with pleural mesothelioma.

Pericardial mesothelioma, which is in the tissue around the heart, has a worse prognosis because it is a difficult area to treat.

The identification of mesothelioma cell type also impacts treatment and prognosis:

  • Epithelial cells tend to adhere and don’t spread to other areas as readily as sarcomatoid cells do. This type is easier to treat and has better outcomes.
  • Sarcomatoid cells  spread more readily. This type of mesothelioma is always given a worse prognosis.
  • Biphasic describes tumors with a mix of both types of cells. The prognosis depends on which cell type predominates.

Staging and Prognosis

The staging of mesothelioma describes how far the cancer has spread from the original tumor. It significantly impacts prognosis. Stage I mesothelioma has a better prognosis than stage II, and so on. Doctors stage mesothelioma by examining the primary tumor, the lymph nodes, and other tissues to which the cancer may have spread.

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

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

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

Other Factors That Affect Prognosis

Research into mesothelioma indicates that it isn’t just cell type, stage, and cancer type that determine prognosis and survival time. Age, health, and the extent of asbestos exposure also play an important roles in outlook. Lifestyle choices that impact health can be particularly important, especially smoking. One of the best things a mesothelioma patient can do for a better outcome is to quit smoking.

Treatment choices also affect prognosis. Patients who are eligible for and choose surgery are more likely to survive longer and have an overall better prognosis. More aggressive treatments, such as surgery to remove an entire lung, come with unique and serious risks but can also extend a patient’s life to a greater extent than more conservative treatments.

Be Proactive to Improve Prognosis

By far the best way to get a better prognosis for mesothelioma is to get an early diagnosis and to begin treatment right away. Unfortunately many victims do not realize they were exposed to asbestos and get late diagnoses. If you even suspect you may have been exposed, take steps now to learn more, get screened, and monitor symptoms.

If you have symptoms that could be related to mesothelioma, see your doctor right away. Explain that you were or may have been exposed to asbestos and insist on cancer screenings. If your doctor doesn’t take you seriously, or you believe you have been misdiagnosed, seek a second opinion.

How to Improve a Prognosis after Diagnosis

If you have been diagnosed with mesothelioma, there are some steps you can take to improve your overall chances of long-term survival and to improve your prognosis. One of the most important steps that you can take is to put your treatment into the hands of a top-rated mesothelioma specialist and multidisciplinary team with experience helping mesothelioma patients.

  • Start Treatment Immediately. Putting together a treatment plan as soon as possible and putting it into action is crucial in improving a prognosis. There are many different treatment options and you have a choice as to whether or not you want to be aggressive in attacking the cancer, but the more aggressive the treatment the greater the chance of improving life expectancy.
  • Combine Therapies. Typical treatments for mesothelioma that can extend the life expectancy include chemotherapy, surgery, and radiation. Some patients cannot have surgery, but they can be given chemotherapy and radiation therapy to shrink tumors and slow the rate at which they spread. For those who can have surgery to debulk, or remove as much tumor tissue as possible, it is often followed by chemotherapy and radiation to eliminate even more of the cancerous tissue.
  • Join a Clinical Trial. Another approach to extending the life expectancy of a patient after a mesothelioma diagnosis is to try new therapies. Get involved in a clinical trial for a new therapy or medication. Trials determine the safety and the efficacy of new treatments and 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 unexpected positive results.
  • Try Alternative and Complimentary Medicine. While treatment and working with 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, and maintaining a healthy weight. Try alternative therapies to complement traditional treatment, such as acupuncture or aromatherapy.

Living with a Negative Prognosis

A poor prognosis is upsetting and tough to deal with while you are also feeling unwell and trying to make treatment choices. With good support, coming to terms with this is easier.

Rely on Friends and Family
There are some steps you can take to help cope with your mesothelioma prognosis. The first and most important thing you need is to have 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 that support system may be there for you and willing to help you, they can’t fully understand what you are going through. In addition to having these loved ones in your life, it also 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 shared feelings and experiences. This can go a long way toward helping you to feel better about accepting your mesothelioma diagnosis.

Finally, consider seeking justice for the harm caused to you. This can bring some peace of mind in a difficult situation. Most people who develop mesothelioma were harmed without ever being aware of it, and a company is typically liable. Getting justice and an admission of liability makes many patients feel just a little bit better about what they’re going through. Filing a lawsuit, joining an existing one, 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 money for your loved ones.

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
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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