Mesothelioma Prognosis

Download your free mesothelioma guide and get the answers you need to make smart decisions now.

Get Your Free Mesothelioma Guide

The prognosis (likely course of the disease) for mesothelioma patients is, in general, poor. Currently, mesothelioma is an incurable form of cancer. Its rarity (only 3,000 new cases each year in America) combined with its delayed onset of symptoms, make it extremely difficult to treat in time before the cancer spreads to distant parts of the body.

Mesothelioma Prognosis Overview

There are many options to improve a patient’s prognosis, including aggressive surgeries, multimodal treatments, and promising new therapies. Many patients who were initially given a poor prognosis have beat it, and gone on to live several more years with their diagnosis.

It’s important for patients to have a good understanding of what to expect after they’ve been diagnosed with mesothelioma.

Here’s what patients should know about a mesothelioma prognosis:

  • The general prognosis for mesothelioma patients is poor, with a life expectancy of only 12-21 months
  • A prognosis is a likely estimate, not a fact
  • Doctors use prognostic indicators such as survival statistics, previous cases, and the patient’s health history
  • Several treatments will improve a patient’s prognosis
  • Patients can seek a second opinion regarding their diagnosis, which can result in a different prognosis
  • Many patients have beaten their prognosis through personalized treatment plans from mesothelioma specialists

Mesothelioma patients should also understand that their doctors will adjust their prognosis as their disease evolves. When treatments control the spread of mesothelioma, doctors may say that the patient’s prognosis has improved.

What is the Mesothelioma Prognosis?

Prognosis is a term doctor’s use to describe the likely outcome of a disease. A good prognosis means the patient will likely beat the disease. A poor prognosis means the disease will likely be fatal. Because there is no one cure for mesothelioma, doctors say that the prognosis is poor.

It’s critical for all mesothelioma patients to know that a prognosis is only an estimate based on several outside factors. A prognosis is a not a fact, and it is not a certainty. A prognosis doesn’t take into consideration what will happen to a patient after they receive treatment, which is the only way to extend a patient’s life.

A true prognosis for mesothelioma should only be given by a doctor specialized in this rare cancer type. These doctors know and understand mesothelioma treatment and can predict how the disease will determine your life expectancy. Mesothelioma specialists can also help you know, realistically, what to expect as your disease progresses.

Prognosis by Mesothelioma Location

Mesothelioma can form in three primary areas: the lungs, abdomen or heart. Where the mesothelioma forms determine how it progresses. Certain locations affect particular organs, which also determines the disease’s proximity to any lymph nodes (the body’s immune system filters).

Each type of mesothelioma has its own prognosis, life expectancy, and survival rates. Treatments for each type are entirely different, and greatly determine the likelihood of beating the disease.

Pleural Mesothelioma Prognosis

Pleural mesothelioma has a poor prognosis—worse than peritoneal mesothelioma. Because pleural mesothelioma affects the chest, it compromises the respiratory, circulatory and ultimately the lymphatic systems. Pleural mesothelioma patients often die due to complications caused by mesothelioma, such as pneumonia or congestive heart failure.

As of now, most pleural mesothelioma patients do not survive past two years after their diagnosis. However, multimodal treatment, including a combination of surgery, chemotherapy and radiation can greatly improve the disease’s course.

Approximately 10% of pleural mesothelioma patients have survived past 10 years. Some have been disease-free for over 20 years and are declared mesothelioma survivors.

Peritoneal Mesothelioma Prognosis

Peritoneal mesothelioma has the best prognosis of all three, but it is still poor. Like all mesothelioma locations, peritoneal mesothelioma patients can expect to live 12 months after their diagnosis. However, the outlook is generally better because the types of treatments available for peritoneal mesothelioma have higher success rates.

The abdominal cavity is easier to operate on and remove tumors from than the chest cavity. The procedure for removing tumors from the peritoneum (abdominal lining) is called cytoreduction. Peritoneal mesothelioma specialists follow up cytoreduction (tumor debulking) with heated intraperitoneal chemotherapy (HIPEC). HIPEC is administered directly into the abdominal cavity and kills remaining cancer cells left behind after surgery.

Statistics show that 50% of peritoneal mesothelioma patients who undergo cytoreduction with HIPEC live five years or longer with their disease.

Pericardial Mesothelioma Prognosis

Pericardial mesothelioma has the poorest prognosis of all three locations because it affects the heart, which presents extremely high health risks.

For patients who receive a pericardial mesothelioma diagnosis while still alive, their average life expectancy is six months.

In many cases, doctors cannot operate on pericardial mesothelioma patients because the disease has spread too far or the risk of fatal complications is too high. By the time doctors reach a pericardial mesothelioma diagnosis, most patients are too sick to withstand the stress of surgery.

However, if detected early enough, doctors can perform a pericardectomy, which removes the diseased heart lining. This surgical procedure along with chemotherapy can improve a pericardial mesothelioma patient’s prognosis.

What Determines a Prognosis?

While it can be good for mesothelioma patients to inform themselves of survival rates and median life expectancy statistics, it’s important to not put all your stock into these numbers. A variety of factors determine an individual patient’s prognosis.

Mesothelioma advocates continuously reinforce the varying nature of the disease, and that it’s not one-size-fits-all cancer with catchall treatments.

Instead, mesothelioma specialists look at many factors when giving their patients an accurate and realistic prognosis.

The top mesothelioma doctors treat their patients as individuals and will look at things like:

  • Mesothelioma Location: Doctors typically formulate a general prognosis first based on where the mesothelioma has formed. Of the three primary locations, pericardial has the worst prognosis while peritoneal has the best prognosis, with pleural falling in the middle.
  • Mesothelioma Stage: At this time, only pleural mesothelioma has an official staging system. In staging, doctors use imaging tests and other tools to determine how far the mesothelioma has spread. In general, the farther it has spread to distant sites, the worse the mesothelioma prognosis.
  • Cell Type: Thanks to researchers’ continued dedication to mesothelioma, we now know that there are three categories of mesothelioma cell types (different cell types have different behaviors). With this information, doctors can determine how rapidly the mesothelioma will spread.
    • Epithelioid cell type spreads the slowest
    • Sarcomatoid cell type spreads most aggressively
    • Biphasic tumors are a combination of the two and may fall in between
    • Patient Health: A patient’s overall health level is also a vital consideration in prognosis. Aging patients are usually in poorer health compared to younger patients, which makes them less likely to respond well to treatment. Doctors also consider pre-existing health conditions and how bad the patient’s symptoms are.
    • Treatment Options: The above factors help doctors determine what treatment options are available. The more treatment options a patient has, the better their prognosis will likely be. This is especially true when surgical procedures are in the picture. Removing tumors surgically almost always improves a patient’s prognosis because it can limit and control the spread of mesothelioma cells.

    The Role of Patient Support in Mesothelioma Survival

    Experienced oncologists have dealt with thousands of patient cases. They may often draw similarities between cases because patients have presented the same location, stage, cell types and have had similar overall demographics and health levels.

    Experienced oncologists will also report that often the difference between a poor prognosis and beating the odds comes down to a patient’s own mental, emotional or spiritual state of being.

    Seeking support, such as connecting with a survivor or undergoing counseling, can make a major difference in the patient’s willingness to survive. Ultimately, it is the patient who is fighting the disease, not the doctor or the treatments.

    Many mesothelioma survivors will attest to this belief, which is why they’ve gone on to become fierce advocates for current and future patients.

    Ensuring that you or your loved ones have the best emotional support possible is a vital factor in improving prognosis.

    How Can I Improve My Prognosis?

    All patients should ask their team of healthcare providers this question: “how can I improve my mesothelioma prognosis?”

    Prognosis Update

    Though doctors are the ones responsible for administering treatments, there is a lot that patients themselves can do to ensure the effectiveness of their treatments.

    Some of the ways patients can take control of their own health and improve their prognosis include:

    • Commit to a Healthy Lifestyle: The reality is that a healthy patient will respond better to treatments than a patient in poor health. Healthy patients are better equipped to withstand the harsh side effects of aggressive chemotherapy drugs, or any potential surgical complications.
    • Healthy Living: Eat healthily, and continue moderate exercise and eliminate all harmful substances such as drugs, cigarettes, and alcohol.
    • Communicate With Your Specialists: It’s essential that patients build strong lines of communication with their healthcare team. Keep your doctors abreast of any changes in symptoms, signs or medication side effects. Your doctors will know how to intervene and adjust your treatment plan accordingly.
    • Pursue Complementary Therapies: Many doctors recommend pursuing additional therapies like acupuncture, physical therapy or massage. While there is no evidence that these therapies will directly improve survival, they can help ease symptoms.

    Improving quality of life increases mental and emotional wellbeing, which makes patients better equipped to fight their disease.

    • Participate in Clinical Trials: Many patients with otherwise limited treatment options have benefited tremendously from the new therapies being tested in clinical trials. All patients should ask their specialists about participating in clinical trials. Many of these novel treatments, such as immunotherapy, have had life-extending results.

    By following these steps, patients can take charge of their health. Work with your healthcare team to learn more about what you can do to improve your prognosis before and after treatments.

    Getting a Second Opinion

    Mesothelioma patients are entirely within their right to visit another specialist and obtain a second opinion. Medical care today is advanced but not foolproof.

    Patients should feel empowered to seek out additional advice and information if they are not satisfied with the prognosis they’ve received.

    There are many cases of patients seeking a second opinion and it being a game-changing decision. A second opinion can not only provide you with new information about your condition, but it can also give you more treatment options you otherwise wouldn’t have known about.

    What is Mesothelioma Life Expectancy vs. Survival Rate?

    It’s normal for mesothelioma patients to feel confused or overwhelmed by the sheer amount of statistics and numbers out there around life expectancy and survival rates. But there is a difference between these two terms, and knowing these differences can help set your expectations.

    Life Expectancy

    Doctors give each patient a life expectancy, meaning how long they can expect to survive with their disease. Life expectancy can change depending on what types of treatments the patient undergoes and the success rates of those treatments.

    Life expectancy is typically given in a range of months such as 18-21 months.

    You’ll also likely come across the term “median life expectancy”. Doctors take the halfway point of each life expectancy of patients with the same diagnosis to determine the median life expectancy. In a median life expectancy, half of the patients fell above it, while half fell below historically.

    Survival Rate

    The survival rate is different from life expectancy. To determine survival rate, researchers measure how long people lived with their diagnosis over a certain timeframe. That’s why you’ll see survival rates given in years.

    For example, the five-year survival rate for mesothelioma, in general, is under 10%. This means that fewer than 10% of patients diagnosed with any mesothelioma survive five years or longer.

    Most of the survival rates you see are usually based on total past cases. They often include cases from decades ago when treatments weren’t as advanced. As more cases of mesothelioma come forward, we’ll likely see an adjustment to survival rates that will reflect a more accurate picture.

    What is Mesothelioma Remission?

    Remission is a medical term that describes an inactive disease state. In mesothelioma, remission means that though the cancer is still present, it has stopped spreading and is now either fully or partially under control.

    When a patient is in full remission, it means that the treatments like surgery, chemo or radiation therapies have removed all visible and detectable signs of mesothelioma.

    It’s important to know that remission is not considered a cure—the nature of cancer is that there’s always a chance it will come back (recur).

    Partial remission is when the patient responds well enough to treatments that the tumors have shrunk significantly in size and are no longer spreading. Though there are still signs of cancer, the patient’s condition can be further managed with ongoing therapies.

    Many patients today are fully capable of achieving partial remission. Though there’s always a chance that mesothelioma will recur, specialists anticipate this and can intervene with additional therapies to manage cancer and control its spread.

    Get the Best Treatment Possible

    It can’t be overstated the importance of a personalized treatment plan for improving the prognosis of mesothelioma patients. While doctors want to provide realistic expectations to their patients, they also know first-hand how to improve a prognosis. Taking an active role in your fight against mesothelioma will give you the best chance at life-extension.

    Working with a mesothelioma specialist, undergoing multimodal treatment, committing to taking care of your health and participating in clinical trials are all standard, yet crucial elements of an improved prognosis. Many survivors are living proof of this philosophy.

    Mesothelioma research is advancing rapidly, and what was once a death sentence is not always the case anymore. Many of the country’s top mesothelioma specialists have shifted their attitudes toward mesothelioma. Today, doctors are much more inclined to approach mesothelioma as a chronic disease requiring ongoing management and control.

    Get in touch with Mesothelioma Help Now to speak to a Patient Advocate about support and legal and financial assistance.

View Author and Sources
Author

Sources
  1. Cancer Research UK, “Mesothelioma: Survival.” Retrieved from: http://www.cancerresearchuk.org/about-cancer/mesothelioma/survival. Accessed on November 15, 2017.
  2. American Cancer Society, “Survival Statistics for Mesothelioma.” Retrieved from: https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/survival-statistics.html. Accessed on November 15, 2017.
  3. US National Library of Medicine National Institutes of Health, “Peritoneal Mesothelioma: A Review.” Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994863/. Accessed on November 15, 2017.
  4. Journal of Gastrointestinal Oncology, “Diagnosis and treatment of patients with malignant peritoneal mesothelioma.” Retrieved from: http://jgo.amegroups.com/article/view/5959/5763. Accessed on November 15, 2017.
  5. Medscape, “Mesothelioma Treatment & Management.” Retrieved from: https://emedicine.medscape.com/article/280367-treatment. Accessed on November 15, 2017.

Last modified: February 5, 2018