Mesothelioma Prognosis

A patient’s prognosis is an estimate of what the outcome will likely be of how cancer will affect their body and life span. Prognosis depends on the stage and type of malignant mesothelioma along with the general health of the patient.

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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.

Mesothelioma prognosis is often confused with life expectancy or the average survival rates of the asbestos-related cancer. 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.

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.

Prognosis by Mesothelioma Type

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.

Pleural Mesothelioma

The prognosis for patients with pleural mesothelioma — the most common type — is not favorable because 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 10 percent of pleural mesothelioma patients survive more than five years.

Peritoneal Mesothelioma

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 increased five-year survival to nearly 50 percent.

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Pericardial Mesothelioma

Prognosis for pericardial mesothelioma is generally poor because of 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.

Testicular Mesothelioma

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.

Other Factors Affecting Mesothelioma Prognosis

Aside from the type of mesothelioma, doctors individualize a prognosis based on a variety of factors. Most of these factors are outside of your control, including your age, gender and unique qualities of your diagnosis.

You can hope to improve your prognosis with the latest treatments and by living a healthy lifestyle.

Gene Hartline and his wife, Mickie

“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

Stage

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).

Cell Type

The type 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.

Symptoms

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

Health and Lifestyle

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, nonsmokers often have a better mesothelioma prognosis than patients who smoke. Because most mesothelioma patients are diagnosed after age 70, many may be too weak to undergo an aggressive surgical procedure. A qualified mesothelioma specialist can determine the best treatment options for each patient.

How to Improve or Beat Your Mesothelioma 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, 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.

Stop Smoking

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.

Eat Healthy

Maintaining proper nutrition is important because many mesothelioma patients lose essential muscle and tissue after a diagnosis. Weight loss can negatively impact a patient’s prognosis.

Eating healthy and loading your body with vitamins and nutrients strengthen the immune system, which helps the body heal from surgery and recover from side effects of other treatments such as chemotherapy.

“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.

Stay Active

Remaining healthy and strong should be a priority for mesothelioma patients. Research shows exercise and physical activity can help reduce side effects from treatment such as fatigue, pain and stiffness in muscles and joints. Even light activity including walking and yoga can improve sleep and reduce anxiety.

Consider Treatments and Clinical Trials

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.

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

Survivors Who Surpassed Their Prognosis

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.

Chris Gibney

Chris Gibney

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.

Beth Mixon

Beth Mixon

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.

Survivor, Kasie C

Upcoming Mesothelioma Symposium Filled with Hope

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

What Treatment Options Improve My Prognosis?

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.

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. 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.

Learn more about mesothelioma treatment

Does Integrative Oncology Improve Prognosis?

Adding complementary therapies to traditional anticancer 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.

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Karen Selby, RN and Patient Advocate at The Mesothelioma Center

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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Sources
  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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