Mesothelioma Prognosis

What Is the Prognosis for Mesothelioma?

The prognosis for mesothelioma is often described as serious. Most people live between 12 and 18 months after diagnosis. However, each person’s outlook varies. Factors like your cancer type, stage at diagnosis, treatment choices and individual health all play important roles.

Mesothelioma Prognosis at a Glance

• About 15% of patients live 5 years or longer.
• Average survival is 12 to 18 months after diagnosis.

• Early-stage patients often live more than 2 years.
• New treatments approved in 2024 and 2025 offer hope.
• Surgery eligibility improves outcomes, but only about 20% of patients qualify.

People who get treatment usually live longer than those who don’t. With treatment, most people with mesothelioma live 1 to 2 years after receiving their diagnosis. Without it, they live 6 to 8 months. Treatment advances, including new immunotherapy drugs like Keytruda (pembrolizumab) combined with chemotherapy, have improved outcomes recently. Early diagnosis and aggressive care often lead to a better prognosis.

Kasie Coleman, diagnosed with peritoneal mesothelioma in 2010, tells us her cancer went into remission in 2012. She underwent several cycles of chemotherapy and HIPEC treatments. 

“Before you begin to fight, you must first arm yourself with the right tools,” Kasie shares. “Get your mind right. It’s extremely hard to develop a positive attitude when possibly facing death, but it’s possible. I decided that although the statistics were horrible, I was going to be the exception.”

Survivor Story

Tamron Little: What I Wish I Knew When I Received My Mesothelioma Diagnosis

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One thing that I wish I would have known when I was diagnosed that I know now is that you can survive and have a thriving life after mesothelioma.

All of the things that I was reading was giving me poor prognosis, so I wish I would have known that from the start because I could have handled it better than I did from the beginning.

Mesothelioma Prognosis by Type

The type of mesothelioma you have can significantly impact your prognosis. Some types respond better to treatment and have a better overall outlook. The origin of tumors defines the types of mesothelioma, according to the Centers for Disease Control and Prevention. 

Pleural Mesothelioma Prognosis

Pleural mesothelioma is the most common type of this cancer, forming in the lining of the lungs. It generally has the shortest average lifespan, around 12 to 18 months. Only about 12% of people with pleural mesothelioma live 5 years or more, but those diagnosed in early stages who undergo aggressive, lung-sparing surgery often live 2 years or longer.

A 2022 study in the journal Cancers reported patients with stage 1 or 2 pleural mesothelioma had a median survival of 32.1 months. Early detection combined with multimodal treatment, including surgery, chemo and immunotherapy, is key in improving outcomes.

Peritoneal Mesothelioma Prognosis

Peritoneal mesothelioma affects the lining of the abdomen. This type generally offers the best prognosis when treated aggressively. Patients who undergo surgery combined with heated chemo applied inside the abdomen or HIPEC, live around 4 to 5 years on average. About 47% to 52% survive at least 5 years after diagnosis.

The combination of surgery and heated chemo helps control the cancer better than other treatments alone. Peritoneal mesothelioma patients often experience longer survival and better quality of life when treated at specialized centers. For example, survivor Tamron Little has lived more than 18 years since her diagnosis and aggressive surgery. She now advocates for patients facing similar diagnoses.

Pericardial Mesothelioma Prognosis

Pericardial mesothelioma is very rare, affecting the lining around the heart. It has the poorest outlook, with most patients surviving only 2 to 6 months after diagnosis. Treatment options are limited, but chemo or surgery can sometimes extend survival. Few patients live beyond a year, making this the most challenging mesothelioma type. Because of its rarity, detailed prognosis data is limited.

Testicular Mesothelioma Prognosis

Testicular mesothelioma is also rare but tends to have a better outlook than other types. Patients who undergo surgery have a median survival of about 4 years. Around 50% reach the 5-year mark. Some have lived more than 10 years. Surgery often successfully controls this cancer type when caught early.

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Mesothelioma Prognosis by Stage (I–IV)

Staging is one of the most critical factors in mesothelioma prognosis. Generally, the earlier the stage at diagnosis, the better the outlook. Early-stage diagnosis combined with aggressive, lung-sparing surgery leads to these better outcomes. While the prognosis for stage 4 is poorest, some stage 4 patients defy odds and live longer with palliative care and targeted treatments.

Mesothelioma Prognosis by Stage

• Stage 1: This stage offers the best prognosis because cancer is localized. Patients often live about 19 to 22 months with surgery. Around 39% survive 2 years, and about 11% survive 5 years. 
• Stage 2: Prognosis remains relatively favorable at this stage with multimodal therapy. Life expectancy is similar to stage 1 at about 19 months. Around 39% survive 2 years. 
• Stage 3: Life expectancy is about 18 months. Patients are less likely to be eligible for curative surgery as the cancer spreads further. The 2-year survival rate is around 41%, and the 5-year survival rate is about 13%.
• Stage 4: The least favorable stage, the life expectancy is about 13 to 15 months even with multimodal therapy. About 31% survive 2 years, and roughly 11% survive 5 years. 

It’s important to remember every patient is different, and outcomes can vary widely. People with advanced stage mesothelioma may live longer with successful treatment. Seeking expert care can ensure you receive personalized care optimized for you, potentially extending survival and improving quality of life.

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Sean Marchese, RN: How will personalized treatment help a mesothelioma patient’s prognosis?

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By making treatment options more personalized to a specific patient’s type of cancer, where the cancer is, how they’ve responded to treatment in the past. It means that doctors can go in and look and see what potential avenues they can explore that haven’t been explored before. It improves the prognosis of these patients because now there are options that they know will have a better chance of success before trying other types and failing.

Other Factors That Affect Mesothelioma Prognosis

In addition to stage and mesothelioma type, other factors affecting mesothelioma prognosis include age, gender and overall health. Younger people and women tend to have better outcomes. Those with co-existing health conditions or otherwise poor health tend to have poorer outlooks. 

While you can’t control factors like your tumor cell type, you can improve your personal prognosis with mesothelioma treatment. Pleural mesothelioma survivor Michael Cole shares his firsthand experience of treatment, sharing, “I believe that the aggressive treatment I had in the beginning was absolutely necessary to give me a chance to be here now. And I am grateful for the decision that we made.”

Insight From a Mesothelioma Specialist

I’ve treated many mesothelioma patients over the years, and the treatments for it can be tough. Many times, aggressive treatment is necessary to extend their lives and improve their quality of life.

Dr. Jacques Fontaine, board-certified thoracic surgeon

Cell Type

There are 2 main types of mesothelioma cells found in tumors. A third type is when a combination of these 2 types are present.

Mesothelioma Cell Types Can Affect Prognosis

• Epithelioid: This is the most common cell type and it responds best to treatment. People with epithelioid tumors tend to live longer because these cells grow more slowly and stay localized longer.
• Sarcomatoid: This type grows quickly and spreads early. It often responds poorly to standard treatment, though immunotherapy is helping improve prognoses. 
• Biphasic: This type is a mix of epithelioid and sarcomatoid cells. Outcomes often vary depending on which cell type outnumbers the other.

Knowing your mesothelioma cell type helps your doctor select the most effective treatment plan for you. This information helps your doctor better understand the complex combination of factors that may influence your outlook.

Patient and Demographic Factors

Certain patient characteristics can also affect how well someone with mesothelioma may respond to treatment. These factors can influence overall prognosis and survival.

Important Factors That Can Influence Prognosis and Survival

• Age: Patients under 50 often have better outcomes as they’re more likely to qualify for and tolerate aggressive treatments.
• Gender: Women tend to live longer than men with mesothelioma, though researchers are still studying the reasons for this difference.
• Overall health: People with active lifestyles and no chronic illnesses tend to tolerate treatment better.
• Race: Black patients show a higher 5-year survival rate (21.3%) compared to white patients (13.9%) in some studies, according to SEER.

Statistics offer broad patterns, but individual outcomes often surprise doctors. Susan Dickman proved that persistence and the right mesothelioma surgeon could overcome both her age and advanced diagnosis. Diagnosed at 72 with stage 4 peritoneal mesothelioma, Susan was initially told she wasn’t a surgery candidate, but she refused to accept palliative care as her only option. More than a decade since her tumor-removing surgery, Susan says she hasn’t had a recurrence and “Life is good.”

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What Are My Chances of Recovering From Mesothelioma?

While there is no cure for mesothelioma, remission does happen. In our 2025 survey, 11% of patients who told us their doctor said they’re in remission or cancer-free. All of those in remission had received treatment including surgery (23%) and a combination of chemo and surgery (76%). 

Mesothelioma type also affected remission rates. Of patients with peritoneal mesothelioma,  16% reported remission compared to 8% of those with pleural mesothelioma.

These findings show remission is possible with tailored treatment, underscoring the importance of expert mesothelioma care. Every patient’s journey is unique, and thanks to advances in therapies and approaches, there’s hope for those coping with a mesothelioma diagnosis. 

Dr. Andrea Wolf, who directs the New York Mesothelioma Program at Mount Sinai, helps many people with mesothelioma improve their prognosis. Dr. Wolf tells us, “I’m realistic. And there is good reason today to be optimistic. We can help these patients. We’ve proven that. They can live with mesothelioma if treated effectively.”

Mesothelioma Caregiver

Kim Snyder: What We Were Told About My Dad’s Mesothelioma Prognosis

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Before the surgery, there was just, like, if he did nothing, it was probably gonna be, like, six months maybe if he did nothing, maybe nine at the most.

With having the surgery, then they would have been able to extend it, you know, maybe, like, a year, eighteen months.

And, but, yeah, without doing anything, it would probably only been about six months or so.

How to Improve Your Mesothelioma Prognosis

While factors like demographics and cell type are beyond your control, you can take steps to improve your mesothelioma prognosis. Working with specialists to develop a custom plan that’s right for you and maintaining your overall health with healthy habits like diet and exercise can make a meaningful difference in survival and quality of life.

5 Tips for Improving Your Mesothelioma Prognosis

1. Ask about multimodal therapy: This type of mesothelioma treatment combines therapies to target cancer in different ways. People often see better results with a combination of treatments.
2. Consider palliative and supportive care: Palliative care helps people with mesothelioma manage symptoms like pain. Supportive care addresses your physical and mental health needs from side effect management to support groups and counseling. 
3. Find a mesothelioma specialist: A specialist has the expertise to develop the best treatment plan for you, offering the best chance of improving your mesothelioma prognosis.
4. Make healthier lifestyle choices: Gentle exercise and a balanced diet can help. They can reduce side effects and improve mesothelioma symptoms. 
5. Participate in a clinical trial: Clinical trials offer access to cutting edge therapies that may improve your outlook. 

Michael Cole tells us he was very active before his diagnosis, but it was challenging to exercise after surgery. He shares, “Exercise is very important to keeping our strength up and our bodies working correctly. In my experience, it can also be one of the hardest things to do. After my extrapleural pneumonectomy surgery they had me up walking within a very short period of time. It was hard, and I really didn’t want to do it, but they told me if I did not I would die. Not a bad motivator. Since then, my wife has helped motivate me to exercise, even when I do not want to.”

Asbestos.com Expert Takeaway

Expert Takeaways on Mesothelioma Prognosis

• Clinical trials aim to improve mesothelioma prognosis. A new study, for example, reports heated chemo after pleurectomy decortication surgery improved overall survival by 27% compared to just using only surgery.
• Average prognosis reflects general statistics. Predicting an individual’s treatment response is difficult. Overall health and lifestyles play a role. Your prognosis is personal.

“The prognosis for mesothelioma is not as grim as often portrayed. Many factors affect the journey, ranging from the patients to the options on treatments that patients chose. It’s important for patients to stay positive and to know that long-term survivors do exist.”

Dr. Catherine Perrault, medical officer and board-certified family physician with The Mesothelioma Center’s Medical Outreach Team

Common Questions About Mesothelioma Prognosis

We asked The Mesothelioma Center’s team of Patient Advocates what patients ask about mesothelioma prognosis when they call us. They’ve shared these questions along with their helpful answers.

How long can I live with mesothelioma?

Most people with mesothelioma live 12 to 24 months with treatment. Without treatment, survival often is measured in months, usually 6 to 8. Some patients live for many years, even more than a decade, especially when working with experienced mesothelioma specialists.

Can mesothelioma go into remission?

Yes, remission can happen. In our 2025 survey, 11% of mesothelioma patients reported their doctors told them they were in remission or cancer-free. All those patients had received treatment, showing that active care can lead to remission.

Can mesothelioma come back after treatment?

Mesothelioma can return after treatment. The cancer may be controlled but not completely cured. Regular follow-ups are essential to catch any signs of mesothelioma recurrence early.

How can a mesothelioma specialist improve my prognosis?

Mesothelioma specialists have experience treating this rare cancer. They can offer the latest therapies, tailor care plans to your needs, and help you access clinical trials. Working with a specialist often improves both prognosis and quality of life.