Pleural Mesothelioma Prognosis

Quick Summary

When discussing outcomes for patients diagnosed with pleural mesothelioma, the term prognosis is used to describe the likely progression of the disease for that patient. A prognosis is a forecast that is made by your doctor, charting the predicted course of your cancer.

Your prognosis is formed from the data of other patients with the same stage and extent of cancer as well as similar patient profiles. The American Thoracic Society has stated that the median survival time for mesothelioma is less than a year from when symptoms first manifest.

That being said, a prognosis is an educated prediction, not a guarantee. Prognoses can change and there are many ways you can improve yours. If you take certain steps, it’s possible to extend your lifespan and improve your quality of life post-diagnosis.

As with any form of cancer, the earlier pleural mesothelioma is detected, the better the prognosis will be. When pleural mesothelioma is detected early and aggressive multimodal treatment is undertaken, approximately 50% of patients will see an increase in predicted life expectancy to two years and 20% will see an improvement to five years. In patients with advanced mesothelioma, just 5% will have a life expectancy of five years.

How Does Early Detection Improve Prognosis?

With early detection, cancer will often be localized—it may not have spread to other parts of the body yet. Localized cancer is classed as stage 1 cancer. This means it’s easier for doctors to remove the tumor via surgery.

If the mesothelioma has not spread beyond the pleura, doctors may recommend a pleurectomy with decortication (P/d) over an extrapleural pneumonectomy (EPP). The P/D surgery does not involve the complete removal of a lung and offers more comfort and a higher quality of life for patients than the EPP procedure.

In general, treatment options are greater for patients with early-stage pleural mesothelioma. Treatment is also easier and more successful in these early stages.

Early detection plays a huge role in how a patient’s prognosis will turn out. Because symptoms of mesothelioma often do not appear until many years after asbestos exposure, it’s critical to take an active role. This is why those who have been exposed to asbestos are encouraged to be screened as soon as possible. Pleural mesothelioma is screened for in several ways, including imaging scans, blood tests, and biopsies.

How Is a Mesothelioma Prognosis Determined?

A mesothelioma prognosis is based on individual characteristics, including the following major considerations:

  • The Patient’s Age: Older patients may have a poorer prognosis due to their inability to qualify for aggressive treatments and surgeries. Older patients are more likely to have additional health complications that may affect their treatment options.
  • Mesothelioma Stage: Mesothelioma progression is divided into 4 stages. Stages 1 and 2 are often referred to as “early stage” mesothelioma, while stages 3 and 4 are usually considered “late stage”. The stage refers to how far cancer has spread from its origin (the pleura). When cancer spreads away from the location of the original tumor it’s called metastasis.
  • Mesothelioma Cell Type: There are 3 types of mesothelioma cells: epithelioid, sarcomatoid and biphasic, which includes both epithelioid and sarcomatoid cells. The cell type present affects a patient’s prognosis because the types vary in their resistance to treatment.
  • Patient Health: Patient’s general health can impact the number of treatments they are eligible for. Habits such as smoking can limit treatment options, as can pre-existing health conditions or illnesses.

Prognosis by Mesothelioma Type

Mesothelioma can occur in the lungs (pleural), the abdomen (peritoneal) or the heart (pericardial).

The location of mesothelioma a patient has can also affect prognosis. The prognosis for pleural mesothelioma is typically less positive than it is for peritoneal mesothelioma but better than pericardial mesothelioma, which has the poorest prognosis overall.

The cell types found in the mesothelioma tumor present another factor that plays a role in prognosis. The cell type is confirmed after a biopsy is performed.

The main mesothelioma cell types are:

  • Epithelioid Mesothelioma: Patients who have epithelioid mesothelioma make up the majority of all mesothelioma cases. This cell type offers the best prognosis out of the 3 types and is more likely to respond positively to therapy.
  • Sarcomatoid Mesothelioma: Sarcomatoid mesothelioma is somewhat rare, comprising only 10% of all cases. Determining whether this cell type is affected can also only be confirmed via a biopsy, especially because sarcomatoid mesothelioma cells resemble healthy tissue. Sarcomatoid mesothelioma is most commonly linked to the pleural location of the disease. Unfortunately, this cell type is the least likely to respond well to treatment and presents the poorest prognosis out of the 3 cell types.
  • Biphasic Mesothelioma: Biphasic mesothelioma actually involves a combination of both the epithelial and sarcomatoid cell types. The prognosis for biphasic mesothelioma is usually more promising than sarcomatoid mesothelioma, yet not as positive as with epithelioid mesothelioma. However, how well biphasic mesothelioma responds to treatment depends on the ratio of epithelioid to sarcomatoid cells in the biphasic tumor.

Mesothelioma Life Expectancy Factors

Life expectancy for pleural mesothelioma is a common method for establishing prognosis. Survival rate expectations are formed by looking at the life expectancy and prognoses of previous patients. Because outcomes can vary, there is no way of predicting with complete accuracy the life expectancy of a given patient.

Life Expectancy Factors Update

Factors such as a patient’s age at diagnosis, habits, and response to treatment can impact their path. Survival times will be more promising for patients with earlier stages of mesothelioma when the cancer hasn’t yet spread to other parts of the body. However, the numbers can help your doctor form an educated assessment and allow you to prepare accordingly.


This information was presented by the American Cancer Society, citing an international study in which data from 1995 to 2009 was used. The study observed patients with pleural mesothelioma who received surgical treatment. Newer studies have also shown higher survival rates.

Stage of MesotheliomaMedian Survival Time
121 Months
219 Months
316 Months
41 Year

Improving Life Expectancy

You can take steps to improve the chances of surviving longer than your prognosis predicts. You can also try to reduce symptoms, increase your comfort and quality of life and prevent your prognosis from taking over every aspect of your day-to-day life.

Some positive improvements you can make include:

Maintain a Healthy Diet

Continue or start eating a wholesome, nutritious diet. You can work with your doctor to create a specific nutrition plan or simply make adjustments to your diet to ensure you’re getting the nutrients you need. Eating the right food can improve your energy levels, help you avoid fatigue and maintain strength and immunity.

Quit Smoking

Smoking can limit your treatment options and decrease life expectancy. Smokers often receive a poorer prognosis than non-smokers, and it’s never too late to see improvements from quitting. Smoking will weaken lung tissue, cause respiratory issues and lead to mucus buildup. It can also put you at greater risk for a variety of other health complications.

Get Plenty of Rest

Make sure you are well rested. Getting enough sleep will help you avoid colds and viruses, keep you energized and help you reap the benefits of exercise and activity.

Get Enough Exercise

While you’ll want to avoid pushing yourself to your limits in exercise, incorporating a healthy amount of activity into your lifestyle will likely help you feel good. Light exercise can help you combat fatigue, help bone density and muscle health and help you sleep. Staying active is also a good way to improve your mood through the release of endorphins, help you de-stress and allow you to sleep better.

Getting a Second Opinion on Your Prognosis

While it’s crucial to have a doctor you trust, it’s important to make sure you get a second opinion when receiving your prognosis. The best way to ensure the highest level of expertise is to consult a specialist in addition to a general oncologist. This way, you can avoid misinformation and feel more confident in your pleural mesothelioma prognosis.

Contact us today to speak with a Patient Advocate, who can connect you with highly regarded specialists. Don’t delay in getting the treatment you deserve.