Mesothelioma Prognosis

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This page was medically reviewed by James Stevenson, M.D. on February 6, 2019. For information on our content creation and review process read our editorial guidelines. If you notice an error or have comments or questions on our content please contact us.

James Stevenson, M.D. Thoracic Medical Oncologist

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A mesothelioma prognosis is the overall outlook for a specific patient and can be estimated by a doctor. Some mesothelioma patients live less than a year, but many live 18 to 31 months. Treatment can improve prognosis. Patient health, tumor type, nutrition and other factors can also affect prognosis.

01. Overview

What Is Mesothelioma Prognosis?

Mesothelioma prognosis refers to an estimate of how an individual’s disease is expected to progress and develop, along with the likelihood of survival. Prognosis for mesothelioma has been poor historically, but newer treatment options have extended survival. Currently, malignant mesothelioma patients have an average life expectancy of 18 to 31 months.

Mesothelioma 5-Year Survival Rates

Mesothelioma 5-year survival graph

Because malignant mesothelioma is an aggressive cancer with a long latency period, it often remains undetected until an advanced stage. Other factors such as location of tumors, cell type and a patient’s age also impact prognosis.

Although there is no cure for mesothelioma, the prognosis has been improving in recent years. This is due to the development of experimental treatments, new diagnostic methods and other advancements in clinical trials.

In addition to prognosis, patients may hear other terms related to survival, including life expectancy and survival rate. Together, these survival statistics can help patients better understand their individual cases.

02. Prognosis by Type

Prognosis by Mesothelioma Type

The type of mesothelioma, or where the cancer develops, affects the prognosis of the disease.

Pleural Mesothelioma Prognosis

Pleural mesothelioma affects the linings of the lungs. Generally, pleural mesothelioma patients who receive some form of treatment live about 18 months after diagnosis. Some treatments have been linked to longer survival times, such as surgery combined with chemotherapy.

Peritoneal Mesothelioma Prognosis

Peritoneal mesothelioma affects the linings of the abdomen. Peritoneal mesothelioma patients survive about two to six years, depending on a number of factors. Patients who undergo surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) have been able to improve prognosis, with a 5-year survival rate as high as 87% in qualified patients.

Prognosis for Rare Mesothelioma Types

Pericardial mesothelioma is seen in the linings of the heart and is a rare form of the disease. This type has the least favorable prognosis, about six months, with many cases diagnosed posthumously.

Testicular mesothelioma occurs in the lining of the testes, the tunica vaginalis. It is one of the two rarest forms of the disease. Prognosis for testicular mesothelioma is about six years.

03. Prognosis by Stage

Mesothelioma Prognosis by Stage

Stage is the most important factor in understanding a patient’s prognosis. Patients diagnosed at an early stage of mesothelioma will have more treatment options and a better prognosis than those diagnosed at a later stage. Once mesothelioma metastasizes (spreads) and reaches a later stage, treatments such as surgery may not be viable.

Stage 1 Mesothelioma Prognosis

Stage 1 mesothelioma patients have an average life expectancy of 21 months or longer.

Stage 2 Mesothelioma Prognosis

Stage 2 mesothelioma patients have an average life expectancy of 19 months or longer.

Stage 3 Mesothelioma Prognosis

Stage 3 mesothelioma patients have an average life expectancy of 16 months or longer.

Stage 4 Mesothelioma Prognosis

Stage 4 mesothelioma patients have an average life expectancy of 12 months or longer.

04. Other Prognosis Factors

Other Factors Affecting Mesothelioma Prognosis

There are several factors doctors consider when determining a prognosis for mesothelioma patients. These factors can help physicians provide patients with a prognosis. However, the disease progression will still differ on a case-by-case basis.

Cell Type

The types of cells that make up a mesothelioma tumor also influence prognosis. Of the three primary mesothelioma cell types, epithelioid mesothelioma has the best prognosis. Epithelioid cells spread slower and are more responsive to treatment than other cell types.

Sarcomatoid mesothelioma has the least favorable prognosis of the cell types. Sarcomatoid cells behave aggressively and are not as responsive to treatments.

Biphasic mesothelioma varies based on which cell type is dominant. In some cases, patients may be diagnosed with other rare cell types, which have prognoses that vary from a few months to 10 years or longer.


Nutrition plays an important role in a patient’s cancer prognosis. Poor nutrition may negatively affect survival, while improved nutrition may extend survival.

Research indicates the risk of malnutrition increases with the progression of cancer. Malnutrition may lead to weight loss during cancer treatment. Weight loss before or during cancer treatment has been tied to worse overall survival.

However, patients who prioritize nutrition during mesothelioma treatment may improve their prognosis. A recent study followed lung cancer patients undergoing chemotherapy. Patients who gained more than 5% of their body weight during treatment lived about 60% longer than those who did not. Higher body mass index (BMI) before treatment is also associated with a better prognosis than lower BMI.

Patients may find these nutritional strategies helpful during cancer treatment:

  • Mixing patient-centric smoothies: At-home smoothies can incorporate the best food for mesothelioma patients. Recipes can accommodate the patient’s nutritional needs and food preferences. This may make it easier to get balanced nutrition.
  • Optimizing meals: Patients may find it easier to eat many small meals throughout the day. A mesothelioma treatment diet may be easier to maintain if patients eat on a set schedule or eat more when they are hungry.
  • Snacking with purpose: Patients may gain nutrition and energy from handy, high-calorie snacks. Foods including chocolate milk, fruit in heavy syrup, nuts and peanut butter can provide significant calories with little or no preparation.

Cancer patients should receive nutritional support as soon as they notice weight loss or decreased appetite. Mesothelioma patients discuss nutritional support with their oncology team. Their team can help patients find the best nutritional approach for their unique situation.

Patient Characteristics

Factors like age, gender, race and a patient’s overall health can also impact prognosis of mesothelioma. Research shows patients over 75 years old have a worse prognosis than those 50 years old or younger. This may also be attributed to the patients’ overall health. Older patients may have pre-existing conditions or may not be able to withstand the side effects of treatment. Research also shows women tend to have a more favorable prognosis than men.

05. Improving Prognosis

Improving a Mesothelioma Prognosis

In recent years, researchers have developed new diagnostic techniques and treatments for mesothelioma, which have helped improve prognosis. Early detection is the best way to improve mesothelioma prognosis.

  • Mesothelioma prognosis without treatment: 6 months
  • Mesothelioma prognosis with some form of treatment: 18 – 31 months

Mesothelioma Treatments That Improve Prognosis

After diagnosis, treatment is the best way to improve survival. For many patients, a combination treatment plan, also known as a multimodal treatment plan, will be recommended. Some treatments have proven to be more effective in improving prognosis than others. For example, surgery coupled with HIPEC has improved the prognosis for some patients with peritoneal mesothelioma. HIPEC is a special, heated form of chemotherapy. At least half of the patients who undergo this treatment survive five years or longer.

Mesothelioma Prognosis After Chemotherapy

Pleural mesothelioma patients treated with chemotherapy live about 14 months after diagnosis.

Chemotherapy may prove most beneficial for patients with inoperable tumors. Chemotherapy can also be helpful as part of a multimodal treatment plan.

Mesothelioma Prognosis After Immunotherapy

Pleural mesothelioma patients treated with the immunotherapy drugs Opdivo® and Yervoy® live about 18 months.

Immunotherapy may work best for patients with inoperable tumors or non-epithelial cell type. Patients may undergo treatment with multiple immunotherapies simultaneously.

Mesothelioma Prognosis After Radiation Therapy

Pleural mesothelioma patients undergoing radiation combined with other treatments live more than two years.

Radiation therapy often precedes or follows other cancer treatments. It is often incorporated into multimodal treatment plans.

Mesothelioma Prognosis After Surgery

Mesothelioma patients undergoing therapeutic surgery within a multimodal treatment plan live about two to six years.

Surgery within a multimodal plan has improved prognosis. Surgery alone has not proven effective in treating mesothelioma.

Mesothelioma Prognosis After Multimodal Treatment

Mesothelioma patients undergoing multimodal treatment live about two to six years.

Multimodal treatment combines more than one cancer therapy in one treatment program. Research shows this approach may be most effective in improving prognosis.

Mesothelioma Prognosis With Alternative Treatments

Mesothelioma patients undergoing alternative treatment may have a prognosis that is difficult to estimate.

Alternative treatments come in many forms and may improve prognosis. However, many alternative therapies have not been well studied in mesothelioma.

Other Options for Improving Prognosis

Some patients may seek additional ways to improve their prognosis, even after traditional therapies. Clinical trials may help some patients, especially those who experience cancer progression during regular treatment. Clinical trials can provide access to new treatments such as photodynamic therapy.

Although some prognostic factors cannot be changed, patients can follow a healthy lifestyle by maintaining a healthy diet and exercising regularly. Engaging in holistic practices such as meditation, massage and yoga can also help alleviate mental and physical stress. Such activity may positively impact a patient’s quality of life and ability to receive treatment.

As more treatment options have become available in recent years, malignant mesothelioma prognosis has improved. Some mesothelioma survivors have extended their survival years beyond the initial prognosis.

Mesothelioma Patients Who Beat Their Prognosis

When pleural mesothelioma patient Heather Von St. James was first diagnosed, she was given 15 months to live. After undergoing surgery, chemotherapy and radiation, Heather has survived more than a decade beyond her prognosis.

Learn MoreRead Heather’s Story

Peritoneal mesothelioma patient Jim Dykstra was diagnosed in 2013. He underwent surgery, radiation and chemotherapy. Jim continues to undergo treatment with immunotherapy and has survived more than six years.

Learn MoreRead Jim’s Story
06. Remission and Recurrence

Mesothelioma Remission and Recurrence

Despite a potentially poor prognosis, some mesothelioma patients have been able to achieve remission and long-term survival. There are two types of mesothelioma remission: partial remission and complete remission.

  • Partial remission indicates a decrease in the size of tumors or extent of mesothelioma in the body. Partial mesothelioma remission is associated with at least a 30% reduction in tumor size.
  • Complete remission indicates that the cancer has been completely removed or destroyed and is no longer seen on imaging scans such as CT scans. Complete mesothelioma remission is more likely with patients that had early detection and aggressive treatments.

It is important for patients to maintain frequent medical follow-ups and monitoring for recurrence, or the regrowth of tumors, after remission. Recurrence occurs in the majority of patients with mesothelioma.

Cell type and previous treatments can influence where and when recurrence develops. Researchers are focused on developing second-line treatments for patients with recurrent mesothelioma, including new combinations of immunotherapy.

Because mesothelioma recurrence is unpredictable, all mesothelioma patients should be aware of the risks and receive ongoing medical care throughout remission.

07. Prognostic Terms

Understanding Mesothelioma Prognostic Terms

It can be difficult to digest all the information that makes up a mesothelioma prognosis. Understanding a few key terms can make things easier, though.

Life Expectancy

Life expectancy is an estimate of the average amount of time a person in a given situation will live.

In mesothelioma, patients may understand life expectancy as an estimate of the amount of time they will live after diagnosis.

Survival Rate

Survival rate is the percentage of people in a certain group who are still alive at a specific point in time.

Mesothelioma studies often report survival rates as one- or two-year survival, showing the percentage of patients alive one or two years after diagnosis.

Death Rate

A cancer death rate reports the number of cancer deaths per 100,000 people in a single year.

Because mesothelioma is so rare, it would be difficult to find a true death rate for it. However, cancer organizations often report death rates for the country as a whole.

08. Common Questions

Common Questions About Mesothelioma Prognosis

How accurate is a mesothelioma prognosis?

A mesothelioma prognosis is only an estimate, using information such as cancer type, stage and other influencing factors. There are patients who have outlived their initial prognosis.

Can a mesothelioma prognosis be improved?

Patients may undergo treatments and potentially participate in clinical trials to improve their mesothelioma prognosis.

Is mesothelioma always fatal?

Mesothelioma is a deadly disease that currently does not have a cure. However, there are treatment options available that can improve prognosis, as well as mesothelioma survivors that have beat their prognosis.

Can mesothelioma go into remission?

Mesothelioma can go into complete or partial remission with appropriate treatment.

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