When someone is diagnosed with lung cancer caused by asbestos, the doctor usually gives them a prognosis – an expected outcome and a time frame for that outcome. A prognosis is an indicator of the person’s potential to recover from the cancer, and it gives an estimation of how long the patient can expect to live.
Patients with asbestos-related lung cancer face a similar prognosis as patients with non-asbestos-related lung cancer. In one Japanese study, the average prognosis for asbestos-related lung cancer was 16.2 months, while the average prognosis for non-asbestos related lung cancer was 17.2 months. Of the patients with asbestos-related lung cancer, 25 percent achieved a five-year survival rate with treatment. Exposure to asbestos was not found to substantially increase or reduce a lung cancer patient’s prognosis.
As with other asbestos-related diseases such as mesothelioma, early diagnosis can help lung cancer patients achieve a better prognosis. Asbestos-related diseases develop slowly and are often diagnosed in their later stages, preventing many patients from achieving treatment at the most crucial point of disease progression. Patients who have been exposed to asbestos but have not yet been diagnosed with lung cancer should consider regular lung cancer screenings to catch any cancerous growths before they become advanced and negatively impact the patient’s prognosis.
Stage of the cancer
Metastatic spread of the cancer
Size of the cancer
Patient’s age and overall health
Patient’s history of smoking
However, your prognosis is not a fixed number. You may be able to improve your life expectancy through treatment. Surgery, chemotherapy , radiation therapy and alternative therapies all can play a role in someone living longer with asbestos cancer.
Several factors affect the prognosis of someone with asbestos lung cancer. Some are positive, meaning they will tend to increase the length of your life, while other negative. The type of cancer and the stage of the cancer are two of the most significant factors. So is your history of asbestos exposure. Among the other factors are age, gender and history of smoking.
|Positive Prognostic Factors:||Poor Prognostic Factors:|
|Non-smoker||Old Age (65 years +)|
|Under age 65||Male Gender|
|Female||Stage III or IV cancer|
|High hemoglobin levels||Cancerous spread to other organs|
|Normal lactate dehydrogenase levels|
Patients can have a combination of both poor and positive prognostic factors.
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The cancer’s stage is one of the primary assessment factors when assigning a patient’s prognosis. Overall, lung cancer patients who are diagnosed with an early stage cancer tend to have a better prognosis and longer survival rate. Up to 70 percent of patients diagnosed with stage I lung cancer tumors achieve five-year survival, while the numbers drop as low as 26 percent for patients with stage III lung cancer.
The following chart illustrates the five-year survival rates for each stage of non-small cell lung cancer (NSCLC). Note the significant decrease between each stage:
|Stage at Diagnosis||Five-Year Survival Rate (%)|
Similarly, the more advanced stages of small cell lung cancer (SCLC) are associated with a poorer prognosis.
Non-small cell lung cancer spreads less quickly than small cell lung cancer, making it easier to successfully treat. Additionally, NSCLC is often diagnosed in an earlier stage, when therapy is more effective. Because of this, approximately 17 percent of non-small cell lung cancer patients live five years or longer.
Adenocarcinoma tends to have a slightly better prognosis than other forms of NSCLC. A 2011 study reported that adenocarcinoma patients lived a median of 8.4 months while all other NSCLC patients lived a median of 8.1 months. While the difference is small, researchers have found similar results in other studies and believe the statistics are significant.
As the more aggressive type of lung cancer, small cell lung cancer has a poorer prognosis. Limited small cell cancer, which is confined to the lungs, is associated with a median survival rate of 16 to 22 months. Extensive small cell cancer, which has spread to other parts of the body, has a median survival time of nine to 11 months.
Asbestos exposure is not a significant prognostic factor for lung cancer patients. Patients with asbestos-related lung cancer have similar prognoses as patients with lung cancer caused by another carcinogen such as cigarette smoke.
While prognostic factors are identified through retrospective studies and scientific analysis, they can’t account for personal factors. Although these factors all play a statistical role in the development of a lung cancer patient’s prognosis, patients can exceed their prognosis without any significant explanation. Some lung cancer patients, such as Kathleen Houlihan, partially credit their survival to alternative medicine and cancer diets, while others have participated in clinical trials that gave them access to groundbreaking therapies.
Younger lung cancer patients often have a better prognosis than older patients. Unfortunately, because the latency period between asbestos exposure and onset of the cancer is so longer – often 30 years or longer – there are few young asbestos cancer patients.
One study showed that older patients are more likely to receive only supportive care (40.5 percent of patients 70 years or older) instead of potentially curative treatments (14.1 percent of patients under 70 years of age). The same study revealed that patients under 70 had a median survival of 38 weeks, while patients over 70 had a median survival of 25 weeks.
Because asbestos lung cancer is caused by work-related exposures and those exposures are mostly in blue-collar trades, more men than women contract the disease. In addition, men typically have a poorer prognosis than women. In one study of non-small cell lung cancer patients, women survived an average of 12.4 months, while the average survival of males was 8.8 months. In another study, women were more responsive than men to therapeutic Gefitinib, an anticancer drug.
While some prognostic factors such as age and gender cannot be changed, patients can take several other steps to improve their prognosis. One of the most impactful changes a patient can make is to quit smoking if they are currently a smoker. Some cancer centers offer smoking cessation programs, and the National Cancer Institute offers a free smoking quit line.
Patients can also consider enrolling in a clinical trial testing new therapies that may yield a better prognosis than existing lung cancer therapies.
Karen Selby joined Asbestos.com in 2009. She is a registered nurse with a background in oncology and thoracic surgery and was the director of a tissue bank before becoming a Patient Advocate at The Mesothelioma Center. Karen has assisted surgeons with thoracic surgeries such as lung resections, lung transplants, pneumonectomies, pleurectomies and wedge resections. She is also a member of the Academy of Oncology Nurse & Patient Navigators.
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