Mesothelioma Prognosis

While your mesothelioma prognosis depends on your cancer stage, general health, type of mesothelioma and other factors, prognosis is generally not favorable because most people with this asbestos-related cancer live less than a year. But eating healthier, quitting smoking and cancer treatments can improve your outcome.

What Is the Typical Mesothelioma Prognosis?

Doctors describe the typical mesothelioma prognosis as an overall outlook of how the cancer will affect you. Prognosis is often measured in terms such as "good," "favorable," "bad" or "poor." It includes the prospect of recovery and how the disease will impact your body and overall health.

People diagnosed with mesothelioma, which is an incurable disease, face a difficult prognosis because life expectancy for the majority of patients is less than a year.

Although prognosis varies greatly from person to person, some people are beating the typical mesothelioma prognosis more frequently because of advances in treatment and care. Survivors credit life span increases to multimodal treatment, improvements in their diet and complementary therapies.

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However, other factors you cannot control, such as age, gender and type of mesothelioma, also determine whether your prognosis will be good or bad. For example, patients with peritoneal mesothelioma have a far better prognosis than those diagnosed with the pleural type.

Definitions

  • Prognosis: Likely outcome of how a disease will affect your body and life span.
  • Life expectancy: Average age a person is expected to live, which can be cut short by mesothelioma.
  • Survival rate: Average amount of time people live after a mesothelioma diagnosis.
Karen Frantz and her daughter

"Mesothelioma can be a frightening reality to be faced with. The chance of recovery may seem grim…But do not give up on life. You still can get through with a faith in God." Karen Frantz, peritoneal mesothelioma survivor diagnosed in 2015

Factors Affecting Your Prognosis

Dr. Fontaine explains what treatments give patients the best chance to live longer.

In addition to your cancer stage, overall health, gender and history of asbestos exposure, there are unique qualities of your cancer, such as the exact type, cellular subtype and how far your cancer has spread, that are equally important in shaping prognosis.

These factors also determine the treatments your doctor will recommend. Younger patients diagnosed before the cancer spreads qualify for the most aggressive and successful treatments.

Types

Pleural Mesothelioma 5-Year Survival Chart

About 10 percent of pleural mesothelioma patients survive more than 5 years

Pleural Mesothelioma

The prognosis for patients with pleural mesothelioma is not favorable because research shows that approximately 40 percent of patients with this type of the disease survive for one year after diagnosis. However, some patients who undergo multimodal treatment and complementary therapies survive more than two years.

Peritoneal Mesothelioma

Prognosis is better for peritoneal patients because studies show they have a better chance at long-term survival than those with any other type. New treatments for peritoneal, such as heated chemotherapy, have increased five-year survival to nearly 50 percent.

Pericardial Mesothelioma

The prognosis for pericardial mesothelioma is generally worse than for the pleural and peritoneal types. Around half of patients survive six months. Rare cases of five-year survival have been reported and usually involve treatment with surgery and chemotherapy.

Testicular Mesothelioma

While 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.

Learn more about the different types of mesothelioma

Stages

The size of a tumor and how far it has spread (metastasized) from its 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 stage) will typically have a better prognosis than patients with stage 3 or stage 4 (advanced).

Early-Stage Mesothelioma

The early stages of pleural mesothelioma are categorized as stage 1 and stage 2. At the first stage, small tumors form along the lining of one lung. During the second stage, the tumors begin to spread to the underlying lung tissue or the diaphragm. However, cancer cells are not present in the lungs and lymph nodes at these stages.

Stage 3 Mesothelioma

By stage 3, the cancer may still be operable, but the cancer has metastasized beyond the lung and its lining, into the chest wall, nearby lymph nodes or the heart’s lining. Surgery is less effective at this stage, but chemotherapy, radiation therapy and immunotherapy are effective. Average survival is 16 months at stage 3.

Stage 4 Mesothelioma

Metastasis at stage 4 is so extensive — tumors spread beyond the chest and into the spine, abdomen or other body parts — that surgery becomes ineffective. Chemotherapy, radiation therapy, immunotherapy and palliative care help people live longer. Average survival is around one year at stage 4.

Learn more about mesothelioma stages

Cell Type

The type of cells that make up your tumor, what doctors call histology, can impact your prognosis. Patients with epithelial mesothelioma generally live longer than those with either the sarcomatoid or biphasic subtypes. People with epithelial tumors live an average of 200 days longer.

Learn more about cell types

Symptoms

Patients suffering from serious symptoms, such as severe chest pain or difficulty breathing, may have a worse outlook. This is because the presence of symptoms often means cancer has already progressed to a later stage of development.

Learn more about symptoms

Health

People in otherwise good health may qualify for treatments that are more intensive. On the other hand, if you have pre-existing health issues, you may not be able to tolerate aggressive surgery or chemotherapy. Additionally, non smokers often have a better mesothelioma prognosis than patients who smoke.

David Sugarbaker M.D.

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Improving and Beating Your Prognosis

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, gender 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.

Once you've started treatment, you can take a few extra steps to improve your chances of recovery. If you're a smoker, find a cessation program. Because smoking increases your risk of lung complications if you opt for surgery, you should stop immediately.

Those diagnosed early in the cancer’s development have the best prognosis and longest survival. If doctors can diagnose the disease before it spreads into lymph nodes and to other parts of the body, treatment is more successful.

Early diagnosis is rare. Most people are diagnosed in stage 3 or 4, which is when the cancer begins to cause symptoms. Treatment is available at every stage, and clinical trials recruit patients at every stage of the cancer. No matter how advanced your cancer may be, treatment is available to help you live longer and palliative care can maintain your quality of life.

Dr. W. Charles Conway

“Even if they’re not doing surgery…[patients] can actually live longer just by maintaining their fitness.” — Dr. W. Charles Conway explains how cancer patients can improve their prognosis.

What Treatment Options Improve My Prognosis?

People diagnosed in stage 1, 2 or 3 may qualify for surgery, which offers the greatest opportunity for long-term survival. Surgery can involve removal of one entire lung, part of the lung or only the removal of the lung lining. 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.

Chemotherapy, radiation therapy and immunotherapy are available for people diagnosed in stage 3 and 4. The chemotherapy success rate is around 41 percent, meaning that nearly half of mesothelioma patients experience tumor shrinkage or no new tumor growth. Palliative care, which aims to control symptoms and side effects, and improve quality of life, is available at all stages.

Patients with peritoneal mesothelioma can improve their prognosis with the HIPEC procedure. It involves adding chemotherapy drugs to a heated saline solution and pumping that new solution directly into the patient’s abdomen. Some people who underwent this procedure lived more than five years.

Learn more about mesothelioma treatment

Should I Seek a Mesothelioma Specialist?

Consider seeking an opinion from a mesothelioma specialist. These doctors are highly trained and extensively experienced in mesothelioma treatment.

Certain pleural mesothelioma surgeons, including Drs. David Sugarbaker and Robert Cameron, are considered experts and pioneers in the field. Drs. Paul Sugarbaker, Edward Levine and Brian Loggie are recognized as innovators in peritoneal mesothelioma surgery.

Patients who don’t qualify for surgery can work with expert mesothelioma oncologists, who manage treatment with chemotherapy and radiation therapy. For example, Dr. Hedy Kindler at the University of Chicago and Dr. James Ohr at Hillman Cancer Center in Pittsburgh specialize in peritoneal mesothelioma oncology.

Pleural mesothelioma oncologists are located throughout the U.S., including Dr. Anne Tsao at the University of Texas MD Anderson Cancer Center and Dr. Thierry M. Jahan at the UCSF Helen Diller Family Comprehensive Cancer Center in San Francisco.

Read more about top mesothelioma doctors

Can I Enter a Mesothelioma Clinical Trial?

Enrolling in a clinical trial might improve your mesothelioma prognosis. These studies test experimental therapies that may be more effective than current treatment options.

Mesothelioma clinical trials are constantly looking to recruit participants. Mesothelioma is a rare cancer, which means there are fewer patients to participate in clinical trials compared to more common ones such as prostate and breast cancers. More participants with mesothelioma are needed to make advancements in treatment.

Each new treatment may pose side effects or certain risks. Make sure you learn all you can about each trial that you consider. Participation is entirely voluntary. You can drop out of a trial at any time. Certain treatment costs are included when you participate.

Learn more about clinical trials

Does Integrative Oncology Improve Prognosis?

Adding complementary therapies to traditional anti-cancer treatment is known as integrative oncology. Complementary therapies may ease symptoms or side effects of treatment, improve immunity, boost energy and relieve pain.

While no complementary therapy is proven to cure mesothelioma or any other cancer, the therapies can improve quality of life and may boost survival in some people.

Ask your oncologist about complementary therapies that can help control your symptoms. You can also talk to an oncology dietitian about how to strengthen your body through your diet.

Learn more about complementary therapies

Survivors Who Surpassed Their Prognosis

Survivor, Judy G

Judy G.

Judy, diagnosed with pleural mesothelioma in 1990, survived 18 years. She improved her prognosis with surgeries, radiation therapy, mangosteen juice and the power of prayer.

Survivor, Wayne N

Wayne N.

Wayne, a former union electrician diagnosed with peritoneal mesothelioma in 1991, survived more than 20 years. He attributed his success to antioxidants in red tart cherries, which he ate nightly.

Survivor, Kassie C

Kasie Coleman

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

Importance of Keeping Hope Alive

Every day, people 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.

We've seen patients and families rebuild their lives and change their prognoses for the better. You can, too.


Karen Selby is a registered nurse and a Patient Advocate at The Mesothelioma Center. She worked in several subspecialties within nursing before joining Asbestos.com in 2009.

  1. American Cancer Society. (2015, May 18). What are the key statistics of malignant mesothelioma? Retrieved from http://www.cancer.org/Cancer/MalignantMesothelioma/DetailedGuide/malignant-mesothelioma-key-statistics
  2. National Cancer Institute. (2015, April 2). Malignant mesothelioma Treatment (PDQ). Retrieved from http://www.cancer.gov/cancertopics/pdq/treatment/malignantmesothelioma/patient#Keypoint5
  3. National Cancer Institute. (2013). SEER Cancer Statistics Reviews 1975-2010: Mesothelioma. Retrieved from http://seer.cancer.gov/archive/csr/1975_2010/results_merged/sect_17_mesothelioma.pdf
  4. Lindenmann, J., Matzi, V., Neuboeck, N., et al. Multimodal therapy of malignant pleural mesothelioma: Is the replacement of radical surgery imminent? Interactive CarioVascular and Thoracic Surgery. 2012; 16:237-243. doi: 10.1093/icvts/ivs465
  5. Leuzzi, G., Rea, F., Spaggiari, L., et al. Prognostic score of long-term survival after surgery for malignant pleural mesothelioma: A multicenter analysis. Ann Thorac Surg. 2015; doi: 10.1016/j.athoracsur.2015.04.087
  6. Sugarbaker, D.J., et al. (2011). Clinical and pathological features of three-year survivors of malignant pleural mesothelioma following extrapleural pneumonectomy. Eur J Cardiothorac Surg., 40(2): 298-303. doi: 10.1016/j.ejcts.2010.12.024. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21310625

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