A mesothelioma prognosis is the average outlook for the disease. Because mesothelioma is aggressive and has no cure, the prognosis for most patients is very poor. However, a prognosis may not be set in stone. With early detection and the help of mesothelioma specialists, it may be possible to extend some patients’ lives.
Understanding a Mesothelioma Prognosis
Shortly after a mesothelioma diagnosis is made, a doctor can give their patient a prognosis for the disease. A prognosis is the expected course the disease will take or its “outlook.
When patients are first diagnosed with mesothelioma, they may wonder what their chances for recovery are. Unfortunately, mesothelioma is a fatal disease. It also does not have a very high 5-year survival rate. Full recoveries are exceptionally rare. Since there is no cure for mesothelioma, a doctor’s prognosis is often based on how long patients can expect to live with the disease.
Most people who have mesothelioma are given a poor prognosis. According to recent data presented at the 8th International Symposium on Malignant Pleural Mesothelioma, less than 5% of people diagnosed with mesothelioma will live beyond 5 years after diagnosis.
Keep in mind that because mesothelioma is such a rare disease, there is a limited number of patient cases. Therefore, a prognosis is not always reliable. Also, survival rates are improving as treatments, drugs, and specialized care advance.
While there is no cure for mesothelioma, a prognosis can vary and change over time. There have been many reports of patients living well beyond their initial prognosis.
Common Prognosis Factors
To provide an accurate prognosis, doctors take note of the factors in your specific case and compare them to other cases of mesothelioma.
Many different factors determine a patient’s prognosis, including:
Location and Type
Mesothelioma is classified based on where it is found in the body.
The 3 main types of mesothelioma are:
- Pleural Mesothelioma: Pleural mesothelioma is the most common form of mesothelioma and occurs in the lining of the lung(s). Patients with pleural mesothelioma often have a poor prognosis. After the cancer spreads, it can attack major organs in the chest and the lymphatic system.
- Peritoneal Mesothelioma: Peritoneal mesothelioma occurs in the lining of the abdomen. Collections of data show that this form of mesothelioma can be treated more effectively than pleural mesothelioma because doctors can remove cancer from the abdomen more easily.
- Pericardial Mesothelioma: Pericardial mesothelioma occurs in the lining around the heart. Unfortunately, this type is incredibly difficult to treat with surgery. Early detection, however, gives some pericardial mesothelioma patients more options.
Mesothelioma grows in tumors throughout the body. These tumors are made up of different cancer cells.
There are 3 cell types, and each impacts prognosis differently:
- Epithelial Cells: Epithelial cells are the most common mesothelioma cell type. They are found in 60-70% of all mesothelioma cases. This is the least aggressive cell type, so it responds best to treatment.
- Sarcomatoid Cells: Sarcomatoid cells are found in 10-20% of cases. This is the most aggressive cell type and the least responsive to treatment because they grow in a randomized fashion throughout the affected area.
- Biphasic Tumors: When a tumor contains both epithelioid and sarcomatoid cell types inside of it, it is known as a biphasic tumor. It is also known as “mixed type.” This type accounts for 20-30% of cases. Treatments will vary depending on the ratio of the cell types.
- Desmoplastic Cells: This is the rarest mesothelioma cell type, accounting for 5-10% of all cases. It has a very poor prognosis, as the tumors tend to grow directly into the lungs or chest wall.
Stage of the Disease
The earlier mesothelioma is diagnosed and treated, the better the prognosis. If doctors can catch the cancer before it spreads to other areas, it may be possible to extend a patient’s life.
Unfortunately, this is easier said than done.
Because the symptoms of mesothelioma are similar to less serious illnesses like the flu, a patient may be misdiagnosed. Misdiagnoses can happen often in the earlier stages of mesothelioma when the symptoms are mild.
Unfortunately, a majority of mesothelioma patients are not correctly diagnosed until the later stages of the disease when the symptoms are more distinguished.
The 4 stages are:
- Stage 1: In the earliest stage of mesothelioma, the cancer remains contained to the pleura. Patients have a much better chance of living longer if they are diagnosed in this stage.
- Stage 2: By this stage, the cancer has already started to spread to nearby areas such as chest wall, lungs, and sometimes the lymph nodes. Some treatments can be effective during this stage because the cancer has not spread to other, more distant parts of the body.
- Stage 3: When detected in this stage, mesothelioma tumors have spread and can be found in the ribs, heart, and lymph nodes. Stage 3 is very advanced, but in some cases, invasive treatments like surgery may be able to help reduce or remove cancerous masses.
- Stage 4: This last stage has the worst prognosis since the cancer has spread significantly. It can be found in the lymph nodes, brain, liver, or spine. Surgery is usually no longer an option by this point. However, some treatments are available to reduce pain and other symptoms.
Only pleural mesothelioma has official stages. Because they are less common, pericardial and peritoneal mesothelioma are classified as “early” or “advanced” depending on the spread of the cancer.
Mesothelioma patients and their loved ones will likely hear this word a lot. “Metastasis” refers to how much the cancer has spread into other parts of the body.
Because mesothelioma has a long latency period, it may have already metastasized by the time doctors make a diagnosis. This makes the cancer much harder to treat. Generally speaking, most mesothelioma patients are not diagnosed until the later stages of the disease.
Other Mesothelioma Prognosis Factors
Several other factors can influence or alter a prognosis. Some of these increase or decrease a patient’s chance of surviving beyond a few months or years.
Other factors that affect a mesothelioma prognosis include:
- Patient Age and Health: On average, younger mesothelioma patients who do not smoke will live longer. Older patients, or those with other health problems, may not respond as well to treatment.
- Remission: Unfortunately, most patients never go into remission, but the cancer may be slow to return if it is successfully removed through surgery. Many have lived longer than originally expected due to early and effective treatment.
- Alternative Care: Some patients have lived longer by combining medical treatments with alternative care. This includes following a modified and nutritious diet and practicing stress-reduction techniques.
- Clinical Trials: Through clinical trials, doctors continue to develop new treatment methods to extend patients’ lives. Typically, these trials test new drugs, surgeries, or treatment plans that might help certain mesothelioma patients.