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After receiving a mesothelioma diagnosis, for many the biggest question is: “How long will I survive?” Unfortunately, determining mesothelioma life expectancy is a complicated question that can vary widely between patients for a number of individual factors.
It can be easy to feel discouraged when looking at mesothelioma survival statistics across all patients, as they paint a rather bleak picture. But it’s important to remember mesothelioma will develop differently in each individual, and there is hope to extend survival.
What Is Life Expectancy?
It can be easy to confuse prognosis, survival rates, and life expectancy, since all of these terms relate to how long you can expect to live after your mesothelioma diagnosis. Life expectancy means the average amount of time a person is expected to survive. When hearing the term “average life expectancy,” patients should remember this means about half of mesothelioma patients survive longer or shorter periods of time.
Average mesothelioma life expectancy ranges from about one year to 24 months. Research shows around 40% of mesothelioma patients survive over one year after diagnosis, though overall only about 9% live longer than five years. Again, these averages take into account all mesothelioma cases, including those with each type and stage of the cancer. Patients need to discuss with their mesothelioma doctor the factors that will make up their own expected survival.
What Determines Your Mesothelioma Life Expectancy?
There are many factors that will influence your prognosis. One of the most important factors in determining your survival is the stage at which you are diagnosed. Stage 1 or stage 2 mesothelioma indicates little to no spreading, so it is much easier to target and remove tumors and cancerous cells with treatments like surgery and chemotherapy. On average, patients at these earlier stages have a life expectancy of 19 to 21 months or more.
As the cancer becomes more advanced and spreads to other parts of the body or the lymph nodes, it is much more difficult to treat. Median survival for patients diagnosed with stage 3 or stage 4 mesothelioma is about 12 to 16 months.
The type and cell type of mesothelioma you have also have a big influence on prognosis. For instance, peritoneal mesothelioma with the most common cell type (epithelioid) has the longest life expectancy at 54 months on average. Pleural mesothelioma with the same cell type only has a life expectancy of 19 months. Epithelioid cells respond the best to treatment, and patients with this cell type survive on average 18 – 24 months.
Sarcomatoid cells, on the other hand, are the rarest and also the most difficult to treat, thus leading to a worse prognosis. Patients diagnosed with biphasic mesothelioma, which is a mix of the other cell types, see more varied life expectancy, depending on which cell type is more dominant.
Regardless of cell type, peritoneal mesothelioma patients have seen better survival rates in more recent years compared to the other types. About 92% of peritoneal mesothelioma patients survive one year after diagnosis, while 73% of pleural mesothelioma patients survive one year. Though this isn’t a huge disparity, as time goes peritoneal patients tend to see longer survival. There isn’t much research available around the rarest type, pericardial mesothelioma. This form of mesothelioma develops in the lining of the heart, and often isn’t even diagnosed until posthumously.
Other factors that can impact your life expectancy include:
- Overall health
- Smoking history
How to Improve Life Expectancy
Early diagnosis is the best way to improve your life expectancy. When detected at earlier stages, patients have more curative treatment options. For many, the cancer isn’t diagnosed until the later stages, which may result in only palliative treatments being available. Unfortunately, it is difficult to diagnose mesothelioma early because of the long latency period after asbestos exposure and the nonspecific symptoms, which can lead to misdiagnosis. This is why it’s so important for more people to be aware of asbestos and the symptoms that could potentially indicate mesothelioma.
In addition to early detection, treatment is truly the best way to extend survival. Mesothelioma life expectancy without treatment is very poor. Patients who can tolerate aggressive treatment options stand the best change of long-term survival. Peritoneal mesothelioma, in particular, has seen improved life expectancies in more recent years thanks to improved treatment options. Researchers have found that surgery coupled with a heated chemotherapy wash could result in survival rates as high as 67% of patients surviving 5 years or more.
Pleural mesothelioma has also seen some improvements in extended survival with better treatment options. Patients are often treated with a multimodal method, or combination of treatments. Aggressive, curative surgery remains one of the most effective options, with patients seeing a median life expectancy of 36 or 38 months. Immunotherapy alone and in combination with surgery has also been an emerging option that has been able to extend survival for some patients.
Research That Could Impact Survival
Though mesothelioma is known for being difficult to diagnose and treat, researchers are making progress on both fronts. Clinical trials are the best opportunity for researchers to develop new treatments, as well as testing the efficacy of different treatment combinations.
There have been some breakthroughs with new diagnostic techniques in the last couple of years. Biomarkers, proteins in the blood, have shown potential in being able to detect mesothelioma early, and researchers have also been exploring various genetic mutations and fusions that could also help lead to earlier diagnosis. Researchers have even developed a breath test that can detect someone experiencing mesothelioma symptoms at a nearly 90% success rate.
Doctors have also seen a lot of promise in clinical trials around emerging treatments. As mentioned earlier, immunotherapy, like the drug Keytruda®, has shown potential for a better life expectancy for a number of cancers, including mesothelioma. Researchers have also been testing these emerging treatments along more standard mesothelioma treatments, like surgery and chemotherapy. One clinical trial with promising results focused on applying immunotherapy before surgery to remove tumors. The trial is still ongoing, but is just one of many clinical trials in progress today that could help change the standard of care for mesothelioma.
Long-Term Survivorship Is Possible
Though all these statistics can seem frightening, there is hope. Some have survived well past even their best prognosis. Heather Von St. James is a 12-year survivor of malignant pleural mesothelioma, though she had a life expectancy of just 15 months when she was first diagnosed. After seeking aggressive treatment in Boston, Heather has been able to survive well beyond initial expectations, and continues to advocate for mesothelioma and an asbestos ban so others don’t have to face a similar situation.
Mesothelioma patient Mavis Nye was also able to go into remission, thanks to being part of an immunotherapy clinical trial. After going through chemotherapy for so long after her diagnosis in 2009, the treatment stopped being effective. Mavis was growing weaker until she was able to find the clinical trial as a sort of last hope. Since beginning the trial in 2016, Mavis has been in remission and now works to raise awareness for the disease.
Despite the sometimes scary statistics, these women are just two examples that survivorship is possible. Hopefully as research continues and doctors find more effective treatments, more mesothelioma patients will be able to achieve long-term survival.