What Is the Prognosis for Mesothelioma?
Prognosis refers to the likely course or progression of a disease. In general, mesothelioma has a poor prognosis. However, the prognosis of any disease is merely a forecasting tool and not an exact science. There are emerging treatments and therapies that may offer mesothelioma patients hope and improved quality of life.
Mesothelioma is a cancer of the mesothelium, a thin layer of tissue that surrounds the lungs and chest cavity, abdomen, and the heart. There are three types: pleural (lungs), peritoneal (abdomen), and pericardial (heart). The disease develops as a result of asbestos exposure and can take years or even decades to develop. Symptoms are not always obvious, which means mesothelioma is often diagnosed in the later stages when the cancer has spread (metastasized) to other parts of the body. Late-stage diagnosis can lead to a bad prognosis, so it’s essential for patients to visit a doctor immediately if they notice any signs or symptoms associated with the disease. As with many cancers, early detection and treatment lead to a better mesothelioma prognosis.
What Is the Life Expectancy for Mesothelioma?
To date, the medical community doesn’t have a definitive answer for how long patients can live with mesothelioma. Patients with mesothelioma generally live less than a year, but life expectancy depends on the individual. Every mesothelioma diagnosis is different.
Patients or family members researching mesothelioma survival statistics may find the results overwhelming or disappointing. However, these numbers don’t always provide an accurate snapshot of life expectancy with mesothelioma. Statistics merely represent past outcomes for specific patients. They may not include factors like the type of mesothelioma, stage, or general health of the individual. There are new therapies that offer curative treatment for those diagnosed early, as well as options to improve the quality of life for late-stage mesothelioma patients.
Mesothelioma is rare, so it’s crucial to find a doctor who specializes in treating this particular cancer. Each patient requires individual care and treatment options.
What Affects a Patient’s Mesothelioma Prognosis?
Several factors can affect a mesothelioma prognosis. A doctor can explain how each one affects individual patients.
Mesothelioma Type and Location
Mesothelioma tumors develop in the mesothelium: the lining of the lungs, abdomen, or, in rare cases, the heart or testicles. Patients with peritoneal mesothelioma, which develops in the abdominal cavity, often have a better prognosis than those with other types of mesothelioma, like pleural, which affects the lungs and chest cavity. Of the three types, those diagnosed with pericardial mesothelioma tend to have the worst prognosis. This type of mesothelioma is usually discovered during surgery for other conditions or after the patient has died
Mesothelioma Tumor Cell Type
The types of cells that make up mesothelioma tumors also play a significant role in a patient’s prognosis. There are two main types of mesothelioma cells: epithelioid and sarcomatoid. Some tumors contain both and are considered biphasic tumors. Studying the microscopic tissue within tumor cells, otherwise known as histology, helps doctors determine a prognosis and create a targeted treatment plan. For example, patients with epithelioid tumors have an average survival rate of 18–24 months, compared to 4–6 months for patients with sarcomatoid tumors. Patients with biphasic tumors fall somewhere in the middle, with a median survival rate of 10–15 months. Why? Epithelioid cells don’t metastasize as quickly as sarcomatoid cells and respond better to treatment.
There are four stages of mesothelioma. Patients who are diagnosed in the early stages, before the cancer has spread, usually have a better prognosis.
Unfortunately, because mesothelioma takes decades to develop and resembles the symptoms of other common diseases, it often isn’t discovered until the later stages when the cancer has reached the lymphatic system and spread to different parts of the body. Similar to other cancers, mesothelioma responds better to first-line therapy, like surgery, chemotherapy, and radiation, in stages 1 or 2. Once it has spread, the prognosis worsens, and patients may have to rely on palliative care to alleviate symptoms, versus more curative treatments to eradicate the cancer.
Those who try a multimodal treatment program that includes surgery, chemotherapy, radiation, and potentially other therapies usually have a better prognosis than patients with late-stage mesothelioma who have access to fewer treatment options or patients who decline to pursue a combination of treatments. Additionally, some people may be eligible for specific clinical trials or experimental therapies that have the potential to improve prognosis.
The healthier a patient is, the better their prognosis. A robust immune system often means the body is more receptive to cancer treatments. Mesothelioma patients who engage in unhealthy behaviors — like smoking, eating a poor diet, or living a sedentary lifestyle — are likely to have a worse prognosis than those who refrain from smoking, eat well, and exercise regularly.
According to researchers, genetics may also play a role in a patient’s prognosis. Several studies from 2011 showed a link between a genetic mutation called BAP1 and the development of mesothelioma. Nearly 70 percent of mesothelioma patients have this mutation. Clinical trials at the University of Hawaii are now targeting the BAP1 gene to determine how to prevent and treat mesothelioma.
- Younger patients often have higher survival rates than older patients, most likely because their bodies can withstand more intensive treatments, like chemotherapy and surgery. Those who are older and those with other, pre-existing conditions may struggle with aggressive therapies. Younger patients also tend to recover from treatment more quickly.
- The majority of mesothelioma patients are men. However, women who are diagnosed with this disease have a better prognosis than their male counterparts. According to a study from The Society of Thoracic Surgeons, women showed a survival rate of 13.4 percent, compared to only 4.5 percent for men. Researchers can’t pinpoint the exact reason, but some believe hormones factor into the survival equation. Women were also more likely to see a doctor as soon as they noticed symptoms, while men waited longer.
How to Improve a Mesothelioma Prognosis
Treatment options for patients depend on the type of mesothelioma they have and how far the cancer has spread. Some curative treatment options can improve a mesothelioma prognosis significantly.
Early-stage mesothelioma that hasn’t spread is easier to treat than advanced-stage tumors. For early-stage patients, doctors recommend a multimodal treatment approach, which includes surgery followed by radiation, chemotherapy, or both.
As mesothelioma spreads, there are fewer treatment options available, leading to a worse prognosis. The majority of mesothelioma patients are diagnosed at stage 3, often ruling out curative surgery. Cases of stage 4 mesothelioma have likely entered the lymphatic system and spread throughout large portions of the body. Some traditional treatment options are still available but are instead used to relieve pain and make patients more comfortable.