What Is a Mesothelioma Prognosis?
A malignant mesothelioma prognosis describes the likely course a patient’s cancer will take.
The prognosis for mesothelioma is usually poor, with most patients living less than 2 years after their diagnosis. However, every case is unique, and many individuals outlive their prognosis.
Patients diagnosed early typically have a better prognosis because the cancer has not yet spread and is easier to treat.
Mesothelioma patients diagnosed when their cancer is advanced usually don’t qualify for surgery and have a shorter life expectancy as a result.
Treatment from experienced mesothelioma specialists is often the best way for patients to improve their prognosis. Unfortunately, the cost of mesothelioma treatment can quickly add up.
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Prognosis vs. Diagnosis
A prognosis tells the patient what to expect from their disease, while a mesothelioma diagnosis confirms an individual’s disease or cancer. Doctors must first diagnose a patient with mesothelioma before they can provide an accurate prognosis.
What Makes Up a Mesothelioma Prognosis?
A mesothelioma prognosis consists of two estimates: life expectancy and survival rate. While they may seem similar at first, they are two different estimations to help patients understand what to expect throughout the course of the disease.
Mesothelioma Life Expectancy
Mesothelioma life expectancy is the estimated amount of time, in months or years, a patient will live after their diagnosis. It varies greatly depending on the patient’s stage and type of mesothelioma, overall health, and other factors like their age and gender.
Mesothelioma patient life expectancy can range from roughly 4 months to over 5 years or more depending on an individual’s prognosis and eligibility for treatment.
Some patients have even lived for decades following their diagnosis thanks to life-extending treatments.
Mesothelioma Survival Rate
Survival rate is the percentage of mesothelioma patients who have outlived a certain length of time. Mesothelioma specialists often look at mesothelioma survival rates to help predict an individual patient’s life expectancy.
The 1-year median survival rate for mesothelioma is 73%, meaning 73% of people with mesothelioma live at least 1 year after diagnosis.
What is the survival rate for mesothelioma?
It used to be the average survival rate for mesothelioma was 6-18 months. Recently in the last few years, with the new drug Alimta chemotherapy regimen, we are seeing survival rates well beyond 36 months. The average survival rate also varies depending on the cell type of mesothelioma and the other underlying health conditions of the patient. Care is focused more towards treatment and not cure. Treatment varies depending on what type of mesothelioma they have. Other comorbidities they have such as heart disease or diabetes. The quality of life suffers during these phases depending on their reaction to chemotherapy and the side effects they may experience during chemotherapy.
Pleural Mesothelioma Prognosis
The prognosis for malignant pleural mesothelioma, which originates in the lining of the lungs (pleura), is one of the least favorable because it’s usually diagnosed when the cancer is already advanced.
Unfortunately, curative treatment is not possible when it is diagnosed in advanced stages.
That said, the prognosis for pleural mesothelioma may vary depending on the stage at diagnosis. Patients with early-stage mesothelioma typically have a better prognosis.
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Stage 1 Mesothelioma
Patients with stage 1 pleural mesothelioma have a life expectancy of 21 months and 5-year survival rate of 16%. Patients diagnosed during this first stage are the most likely to be eligible for curative treatments and, as a result, have the best prognosis.
Stage 2 Mesothelioma
Stage 2 mesothelioma patients have a life expectancy of 19 months and 5-year survival rate of 13%. At this stage, prognosis is still generally favorable because the cancer can usually be surgically treated.
Stage 3 Mesothelioma
Mesothelioma patients in stage 3 have a median life expectancy of 16 months and 5-year survival rate of 11%. Stage 3 mesothelioma is usually too advanced for mesothelioma oncologists (cancer doctors) to safely and effectively remove through surgery, resulting in a poor prognosis.
Stage 4 Mesothelioma
On average, patients with stage 4 mesothelioma live 12 months after diagnosis. Stage 4 mesothelioma is the most advanced stage, when the cancer has spread to distant parts of the body and oncologists can no longer surgically remove it.
For stage 4 pleural mesothelioma, the 5-year survival rate is 4%.
Peritoneal Mesothelioma Prognosis
Peritoneal mesothelioma affects the lining of the abdomen (peritoneum). Compared to pleural mesothelioma, peritoneal mesothelioma progresses fairly slowly and responds better to treatment.
For these reasons, peritoneal mesothelioma generally has a better prognosis than its pleural counterpart. The average life expectancy for patients with peritoneal mesothelioma is 63.2 months. Peritoneal mesothelioma has a 5-year survival rate of 47%.
Peritoneal mesothelioma patients who undergo cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) can increase their survival by up to 90 months.
Sadly, most patients who don’t qualify or opt for treatment live less than 6 months from the time of their diagnosis.
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Prognosis of Rare Mesothelioma Types
Pericardial and testicular mesothelioma are more rare types of mesothelioma that account for less than 1% of cases.
Each of these have a unique prognosis that, like pleural and peritoneal mesothelioma, varies depending on whether it is diagnosed in early stages or advanced stages.
Pericardial Mesothelioma Prognosis
Because pericardial mesothelioma develops close to the delicate heart, prognosis for the disease is poor.
The average life expectancy for pericardial mesothelioma is 2-6 months from diagnosis, while the 5-year survival rate is about 9%.
Testicular Mesothelioma Prognosis
Testicular mesothelioma prognosis is generally good if detected in its early stages. Before it spreads to other parts of the body, the cancer is often responsive to treatment through surgery.
Patients with testicular mesothelioma often live 26-36 months after diagnosis and have a 5-year survival rate of 49%.
Factors That Affect Mesothelioma Prognosis
Other than early detection, there are some other factors that influence a mesothelioma prognosis.
These factors include:
- Age: Younger patients tend to have a better prognosis.
- Cell Type: Epithelioid mesothelioma cells spread slowly and respond better to treatment than sarcomatoid or biphasic cells. Because they are more responsive to treatment, patients with an epithelioid cell type often have a better prognosis.
- Gender: Female mesothelioma patients have a better prognosis because, statistically, their bodies respond better to treatments than men.
- Lifestyle: Patients who quit tobacco use, maintain a healthy diet, and stay physically active have a better chance of recovering quickly after mesothelioma treatment. They also may reduce stress and depression, improving their quality of life.
- Mesothelioma Type: Some types of mesothelioma, like peritoneal mesothelioma, tend to progress more slowly than types like pleural mesothelioma.
- Overall Health: Patients with other diseases or who suffer from overall poor health have lower life expectancies.
Improving Prognosis Through Treatment
The best way to improve a mesothelioma prognosis is by catching the cancer early and undergoing life-extending mesothelioma treatments performed by an experienced mesothelioma doctor.
Without treatment, mesothelioma patients survive 4-12 months on average.
Surgery
Although invasive, surgery is the best option for improving a mesothelioma patient’s prognosis, especially when combined with other treatments in a multimodal approach.
Life-extending surgeries for mesothelioma include:
- Extrapleural Pneumonectomy (EPP): Removes cancerous tumors, the lung closest to the tumors, the lining around the heart, and part of the diaphragm
- Pleurectomy with Decortication (P/D): Removes cancerous tumors and the lining around the lungs (pleura) but spares both lungs, making it a less invasive option than an EPP
- Cytoreduction with HIPEC: Involves removing all visible tumors and the lining around the abdomen (peritoneum) and treating the abdominal cavity with heated chemotherapy to kill any remaining cancer cells
Chemotherapy
Chemotherapy helps eliminate cancerous cells and stop their growth. This form of treatment may improve patient prognosis either by itself or by increasing the effectiveness of surgery.
Mesothelioma patients who receive chemotherapy alone have an average life expectancy of 12-18 months.
Immunotherapy
With mesothelioma immunotherapy, patients are prescribed immune-boosting drugs, which help the patient’s immune system target and combat cancer cells when they emerge.
In a clinical trial, a combination of the immunotherapy drug atezolizumab and the chemotherapy drug bevacizumab proved effective in treating advanced malignant peritoneal mesothelioma.
The combination more than doubled the length of time before patients progressed to the next stage of treatment (17.6 months versus 8.3 months), compared to standard chemotherapy care.
Radiation
Radiation therapy uses powerful X-ray machines to target and kill mesothelioma cells in a specific location.
Radiation therapy is not a curative treatment on its own due to the risk of severe side effects. However, it may improve mesothelioma prognosis and quality of life if combined with other therapies.
“Radiation can, in conjunction with chemotherapy, help the cells from dividing and multiplying. It can make shortness of breath better. It can make your pain control better by shrinking the size of the tumor.”
– Amy Fair, Registered Nurse
Access Treatment from a Mesothelioma Specialist
A cancer diagnosis is not easy news to receive. No matter your prognosis, receiving curative treatment gives you the best chance of potentially living past your prognosis.
That said, mesothelioma treatment can be expensive and daunting, leading to unneeded stress for patients and their families.
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Mesothelioma Prognosis FAQ
Can mesothelioma go into remission?
Yes. Mesothelioma remission is rare but has been documented in cases with advanced treatment.
It’s possible for patients with mesothelioma to go into remission for several months or years after aggressive, early treatment. This means that doctors can no longer detect any cancer cells in the body.
However, in many mesothelioma cases, the cancer returns, which is known as recurrence. Recent average 5-year survival rates for mesothelioma are less than 10%, which is lower than most cancers.
The effectiveness of treatment depends on a number of factors, including the stage of the cancer and the patient’s age and gender. Researchers studying cases of remission hope to learn more about what factors lead to successful treatment.
What is mesothelioma recurrence?
Mesothelioma recurrence is when a patient’s cancer begins to spread and grow again after remission.
Patients with mesothelioma recurrence generally have a poor prognosis and short life expectancy.
Is mesothelioma always fatal?
Not always. Depending on when mesothelioma is caught and diagnosed, a patient’s prognosis can range from a few months to five years or more.
If the cancer is discovered early, it can be treated and often slowed down significantly. Some procedures include surgery to remove the mesothelium and chemotherapy to kill cancer cells.
For example, mesothelioma survivor Julie G. was given just 6-12 months to live after being diagnosed with peritoneal mesothelioma in 2006. Thanks to multimodal treatment, Julie is still living today.
