A mesothelioma prognosis is generally poor because most patients live about 12 months after diagnosis. The prognosis, or estimate of how cancer will affect the body, also depends on stage, type of malignant mesothelioma and general health of the patient.
Doctors describe the typical mesothelioma prognosis as an overall outlook, specific to each patient.
Prognosis is often measured in terms such as “good,” “favorable,” “bad” or “poor” based on how the cancer is expected to progress. It includes the prospect of recovery and helps determine what treatment options may be available.
When patients ask about their prognosis, what they usually want to know is how long they will live.
Most patients live about one year after being diagnosed with mesothelioma.
How long you live with mesothelioma largely depends on the stage you are diagnosed at and how well you respond to mesothelioma treatments.
People diagnosed early, in stage 1 or stage 2, often qualify for surgery, which offers the best chance at long-term survival. Approximately 20 percent of pleural mesothelioma patients are diagnosed early enough to qualify for surgery. Stage 1 patients who undergo surgery have a median life expectancy of 22.2 months.
But most patients are diagnosed late, at stage 3 or 4, and do not qualify for surgery. Stage 4 patients who undergo treatment have a median life expectancy of 14.9 months.
Although history and statistics play a part in determining your prognosis, every mesothelioma case is unique.
Some mesothelioma patients are beating the typical outlook more frequently thanks to advances in treatment and care. Survivors credit life span increases to multimodal treatment, improvements in their diet and complementary therapies.
A person’s life expectancy is affected by their mesothelioma prognosis. The term “life expectancy” refers to the average age a person or population is expected to live based upon their location and other demographics.
Mesothelioma can shorten a person’s life expectancy by several years or decades. It all depends on their age at diagnosis and how long they live with mesothelioma.
For example, a healthy 70-year-old man has a life expectancy of 14 years. If he is diagnosed with stage 4 mesothelioma, his life expectancy is reduced to two years.
Mesothelioma prognosis is primarily based on the cancer’s average survival rates, which measure how long most people live with mesothelioma.
Survival rate is defined as the percent of people who survive a disease for a specified period of time, usually five years.
The National Cancer Institute shows the five-year survival rate for mesothelioma was 9 percent between the years 2007 and 2013.
Following a diagnosis, it is important to receive a prognosis from a mesothelioma specialist. These doctors are highly trained and experienced in mesothelioma treatment and can more accurately predict how your diagnosis will affect your life span.
The four types of mesothelioma affect your body in different ways. The exact type plays an important role in determining whether your prognosis will be good or bad.
The prognosis for patients with pleural mesothelioma — the most common type — is not favorable. Research shows approximately 40 percent of patients survive for one year after diagnosis. Because the cancer forms in the lining of the lungs, tumors put pressure on the chest cavity, making it difficult to breath and potentially leading to pneumonia or congestive heart failure.
However, some patients who undergo multimodal treatment and complementary therapies survive several years after diagnosis. About 9 percent of pleural mesothelioma patients survive more than five years.
Patients with peritoneal mesothelioma have a far better prognosis than those diagnosed with the pleural type. New treatments for peritoneal, such as heated chemotherapy, have improved the chance at long-term survival. Around 50 percent of patients who undergo surgery with heated chemotherapy live longer than five years.
Prognosis for pericardial mesothelioma is generally poor because of the location where the cancer develops — the lining of the heart. Around half of patients survive six months. Rare cases of five-year survival have been reported and usually involve treatment including surgery and chemotherapy.
Although testicular mesothelioma is the rarest type, its prognosis is typically the best. Average survival is around two years and some patients live more than a decade.
The size of tumors and how far they have spread (metastasized) from their original location affect prognosis. Doctors typically discuss tumor size and the extent of a cancer’s spread in terms of stages, ranging from stage 1 to stage 4 in order of severity. Patients with stage 1 or stage 2 (early stages) will typically have a better prognosis than patients with stage 3 or stage 4 (advanced stages).
More prognosis data by stage is available for pleural mesothelioma than peritoneal. The reason for this is twofold. First, the pleural type is significantly more common, meaning there are more patients to gather data on. Second, there is no formally adopted staging system for peritoneal mesothelioma, which prevents researchers from collecting data on peritoneal survival by stage.
Patients diagnosed at stage 1 have the best prognosis. The cancer does not cause symptoms at this stage. Aggressive treatments are recommended to people in otherwise good health.
Stage 1A: The two-year survival rate is 46 percent and the five-year survival rate is 16 percent.
Stage 1B: The two-year survival rate is 41 percent and the five-year rate survival is 13 percent.
Median overall survival at stage 1 is 22.2 months with surgery.
Patients diagnosed at stage 2 have a better prognosis than late-stage patients. The cancer rarely causes symptoms at this stage, but patients may feel short of breath during exercise. Aggressive treatment plans are also recommended at this stage.
The two-year survival rate for pleural mesothelioma is 38 percent and the five-year survival rate is 10 percent.
Median overall survival at stage 2 is 20 months with surgery.
Prognosis becomes more unfavorable for patients diagnosed in stage 3. The cancer begins to cause symptoms at this stage including chest pain, difficulty breathing and weight loss. Some stage 3 patients qualify for aggressive treatment plans.
Stage 3A: The two-year survival rate is 30 percent and the five-year survival rate is 8 percent.
Stage 3B: The two-year survival rate is 26 percent and the five-year survival rate is 5 percent.
Median overall survival at stage 3 is 17.9 months with surgery.
The prognosis at stage 4 is generally poor. Symptoms slowly worsen at this stage and patients may develop a fever, night sweats and difficulty swallowing. Palliative treatments are recommended at this stage to control symptoms and extend survival as long as possible.
The two-year survival rate for pleural mesothelioma is 17 percent and the five-year survival rate is less than 1 percent.
Median overall survival at stage 4 is 14.9 months with treatment.
Aside from the type of mesothelioma and its stage, doctors individualize a prognosis based on a variety of factors. Most of these factors are outside of your control, including your age, gender and race.
You can hope to improve your prognosis with the latest treatments and by living a healthy lifestyle.
“I would tell anyone who gets diagnosed with this disease, don’t just take the first advice you get and give up. Look around and see what is out there.”
— Gene Hartline, diagnosed with pleural mesothelioma in 2016
The types of cells that make up your tumor — what doctors call histology — can impact your prognosis. Patients with epithelioid mesothelioma generally live longer than those with either sarcomatoid or biphasic (combination) subtypes, which are considered more aggressive and harder to treat. People with epithelioid tumors live an average of 200 days longer.
Your age can affect your prognosis. As we age, our immune system weakens and struggles to fight off cancer growth. Older bodies tend to not respond as well to cancer treatment as younger bodies. For example, older people experience more surgical complications than younger people.
Younger people have a better prognosis with mesothelioma than older people. More than half of patients diagnosed under age 50 live at least a year with mesothelioma, whereas under a third of patients diagnosed over age 75 live that long.
Gender has a significant impact on mesothelioma prognosis. Women with mesothelioma live longer than men do.
Researchers do not fully understand why women live longer. They suspect that hormones may play a role. They do know that women are more often diagnosed with peritoneal mesothelioma, which carries a better prognosis, than pleural mesothelioma.
Race plays a role in mesothelioma prognosis. In 2013, the five-year survival rate was 8.7 percent for whites and 10 percent for blacks.
Black women tend to live the longest with mesothelioma. In 2013, the five-year survival rate was 13.6 percent for white women and 30.1 percent for black women.
You can choose to be proactive and take steps to improve your prognosis. While you can’t change important prognostic factors, such as your age, mesothelioma type or cancer stage, you can improve your overall health. Try treatments to control the cancer, and take good care of yourself when side effects develop or symptoms worsen.
Mesothelioma is primarily treated with surgery and chemotherapy. Other treatments, including radiation therapy and immunotherapy, play a role in multimodal therapy or clinical trials. Most patients are diagnosed too late to qualify for surgery and only undergo chemotherapy.
People diagnosed in stage 1, 2 or 3 may qualify for aggressive surgery, which offers the greatest opportunity for long-term survival. Surgery can involve removal of an entire lung, part of the lung or only the removal of the lining of the lung, known as the pleura.
Many people wonder if a person can live with one lung, and the answer is yes. Surgery is regularly combined with chemotherapy and sometimes radiation therapy or immunotherapy.
Chemotherapy, radiation therapy and immunotherapy are available for patients at all stages.
The chemotherapy response rate is nearly 50 percent, meaning about half of mesothelioma patients experience tumor shrinkage or no new tumor growth for a period of time. A 2016 study published in the journal Clinical Epidemiology found that patients receiving chemotherapy lived an average of 12 months, while those who elected no treatment lived an average of four months.
Palliative care, which aims to control symptoms and improve quality of life, is also available at any stage.
Patients with peritoneal mesothelioma can improve their prognosis with a combination of surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). It involves adding chemotherapy drugs to a heated saline solution and pumping it directly into the patient’s abdomen. Research shows roughly half of patients who underwent this procedure survived more than five years.
Although recurrence is common, people diagnosed with mesothelioma are overcoming their initial prognoses. Whether it’s because of their particular type of mesothelioma, specialized treatments, genetics or simply changing how they live their lives through improved nutrition and exercise, it’s important to keep hope alive.
Some survivors live years or even a decade or more past their initial prognosis.
Diagnosed in 2005, Chris Gibney far surpassed his pleural mesothelioma diagnosis. In March 2017, he and his wife welcomed a group of exchange students from Germany to their home. Gibney credits his excellent medical team and a family support group for surviving more than a decade past his prognosis.
At the time of Beth Mixon’s peritoneal mesothelioma diagnosis in 2000, the majority of patients lived less than two years after treatment. Despite a grim prognosis, Mixon is still going strong 17 years after an aggressive cytoredutive surgery.
Diagnosed with peritoneal mesothelioma in 2010, Kasie Coleman underwent several cycles of chemotherapy and HIPEC treatments. Her cancer went into remission in 2012.
A cancer’s prognosis includes the chances of recovery, which is called remission.
Remission involves a measurable tumor size decrease, which can be described as partial or complete.
Remission is partial when the cancer shrinks in size. Partial remission usually involves at least a 50 percent reduction in tumor size.
Remission is complete when the cancer disappears entirely.
Surgery, chemotherapy, radiation therapy and immunotherapy have the potential to send mesothelioma into partial or complete remission. But complete remission is rare with mesothelioma.
Partial remission is more common than complete when it comes to mesothelioma. Patients can live for years in partial remission.
Unfortunately, mesothelioma tends to recur whether partial or complete remission is achieved. When mesothelioma recurs, it usually recurs locally or regionally rather than distantly. Many clinical trials look for patients with a mesothelioma recurrence to test new and innovative therapies.
Mesothelioma clinical trials are constantly investigating second-line therapies to control the cancer when it recurs. Many of these trials involve different combinations of chemotherapy drugs. Some trials combine chemotherapy with immunotherapy.
The goal of these trials is to find more ways to keep mesothelioma in control once it returns. Researchers need a wide range of participants. Patients with prior treatment who are now living with an advanced disease are ideal candidates for clinical trials.
A cancer’s death rate, also called mortality rate, influences how doctors determine a patient’s prognosis. The mortality rate describes how many people die from the cancer.
Mesothelioma mortality rates are often defined in relation to patient age, gender, race and state of residence.
For example, from 1999-2015, a total of 45,221 people died from malignant mesothelioma. Nearly 80 percent of those deaths occurred among men. About 37 percent of those deaths occurred among people between the ages of 75 and 84.
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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