Mesothelioma Prognosis

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. On average, 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 of 67% or higher.

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 is seen in the linings of the testes and is the rarest of the four types. Prognosis for testicular mesothelioma patients is typically 20 – 23 months, though some have lived longer.

03. Other 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.

Stage

Stage is the most important factor in determining 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 patients have an average life expectancy of 21 months or longer.
• Stage 2 mesothelioma patients have an average life expectancy of 19 months.
• Stage 3 mesothelioma patients have an average life expectancy of 16 months.
• Stage 4 mesothelioma patients have an average life expectancy of 12 months after diagnosis.

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 spread 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.

Patient Characteristics

Factors like age, gender, race and a patient’s overall health can also impact prognosis of mesothelioma. Studies have shown 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.

04. 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.

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. At least half of the patients who undergo this treatment survive five years or longer.

Patients with tumors that can’t be removed through surgery may benefit from chemotherapy. Some studies have shown chemotherapy extended survival by several months or years in some cases. Immunotherapy treatments have also shown promise in treating mesothelioma, with some studies showing an average survival of two years or longer. Radiation therapy may also be used in a multimodal treatment plan.

Clinical trials can provide a final hope for improving prognosis in some patients. Clinical trials offer promising experimental treatments like immunotherapy, gene therapy and photodynamic therapy. These therapies have shown longer life expectancies in some cases.

Although some of these prognostic factors cannot be changed, patients should be sure to 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.

05. Remission and Recurrence

Mesothelioma Remission and Recurrence

Despite a generally 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.

06. Common Questions