Written By: Dr. Daniel A. Landau,
Last modified: September 16, 2021

What Is the Prognosis for Mesothelioma?

Mesothelioma is an aggressive cancer with an average life expectancy of 14 to 22 months after diagnosis.

The prognosis for mesothelioma 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.

The prognosis for most mesothelioma patients is generally poor because there is no cure for this disease.

When patients ask about their prognosis, what they usually want to know is how long they will live.

How Long Do You Live After Being Diagnosed with Mesothelioma?

Most patients live about one year after being diagnosed with mesothelioma.

How long you live with mesothelioma depends on the stage you are diagnosed at and how well you respond to mesothelioma treatments.

Early-Stage Prognosis

People diagnosed early, in stage 1 or stage 2, often qualify for surgery, which offers the best chance at long-term survival. Approximately 20% 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.

Late-Stage Prognosis

Most patients are diagnosed late, at stage 3 or 4, and do not qualify for surgery. Stage 4 mesothelioma patients who undergo treatment have a median life expectancy of 14.9 months.

Although statistics play a part in determining your prognosis, every mesothelioma case is unique.

Some mesothelioma patients are beating the typical outlook thanks to advances in treatment and care. Survivors credit life span increases to multimodal treatment, improvements in their diet and complementary therapies.

Watch: Learn what peritoneal mesothelioma survivor Tamron Little wishes she had known after receiving a diagnosis.

Improving a Mesothelioma Prognosis

Average mesothelioma prognosis with treatment
Average life expectancy of mesothelioma patients who undergo treatment

You can choose to be proactive and take steps to improve your prognosis. You can’t change important prognostic factors such as your age, mesothelioma type or cancer stage. But, you can improve your overall health and elect anti-cancer treatment such as chemotherapy.

In addition to undergoing treatments that control the cancer, you should follow a healthy nutrition plan with a well-balanced diet. Good nutrition can also ease treatment side effects and cancer symptoms.

Mesothelioma Nutrition Guide from Asbestos.com
Free Mesothelioma Nutrition Guide
Eating right and balancing your diet while undergoing mesothelioma treatment can help ease your symptoms.

Treatment Options for Mesothelioma

The most effective treatments for mesothelioma include surgery and chemotherapy. Radiation therapy and immunotherapy play a role in multimodal therapy and clinical trials.

Most patients are diagnosed too late to qualify for surgery and only undergo chemotherapy. Chemotherapy, radiation therapy and immunotherapy are available for patients at all stages.

Experimental therapies, such as immunotherapy and photodynamic therapy, are available through clinical trials and compassionate use programs.

Cancer therapies are expensive, but many patients are eligible for financial compensation to cover the costs of mesothelioma treatment. Veterans may qualify for free or low-cost treatment at a VA hospital.

A specialized mesothelioma lawyer can advise patients on other possible sources of compensation.

Mesothelioma treatment options that can help improve prognosis video

Watch: Mesothelioma specialist Dr. Marcelo DaSilva shares the best treatment options to help improve your mesothelioma prognosis.

Mesothelioma Prognosis After Chemotherapy

The chemotherapy response rate is nearly 50%. This means 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.

Mesothelioma Prognosis After Surgery

People diagnosed with stage 1, 2 or 3 pleural mesothelioma may qualify for aggressive surgery. Tumor-removing surgery 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. It can improve survival by years in some patients.

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.

Did You Know?

The average cost of mesothelioma treatment is $11,000 to $12,000 a month.

An experienced mesothelioma lawyer can help you and your family get money to cover treatment costs, travel expenses and more.

Mesothelioma Prognosis After Radiation Therapy

Radiation therapy on its own is used to shrink painful tumors growing into the chest wall. This application does not directly impact prognosis.

When combined with other therapies, such as surgery, radiation therapy can help delay or prevent local cancer recurrence.

Prognosis by Mesothelioma Type

Pleural Mesothelioma Prognosis

Research shows approximately 40% of pleural mesothelioma patients survive at least one year after diagnosis.

Some patients who undergo multimodal treatment and complementary therapies survive several years after diagnosis. About 9% of patients with pleural mesothelioma survive more than five years.

Mesothelioma survivor Gene Hartline and his wife
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

Peritoneal Mesothelioma Prognosis

The prognosis for peritoneal patients is typically favorable when compared to other forms of mesothelioma cancer.

Peritoneal mesothelioma patients survive approximately six to 12 months without cancer treatment. However, the prognosis for surgical candidates is significantly better. About half of peritoneal patients who receive surgery with heated chemotherapy live longer than five years.

Prognosis for Rare Mesothelioma Types

Prognosis for pericardial mesothelioma is generally poor. 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.

Prognosis by Mesothelioma Stage

Mesothelioma Prognosis at Stage 1

Patients diagnosed with stage 1 mesothelioma have the best prognosis. Aggressive treatments are recommended to people in otherwise good health.

  • Stage 1A: The two-year survival rate is 46% and the five-year survival rate is 16%.
  • Stage 1B: The two-year survival rate is 41% and the five-year rate survival is 13%.
  • Median overall survival at stage 1 is 22.2 months with surgery.

Mesothelioma Prognosis at Stage 2

Patients diagnosed with stage 2 mesothelioma have a better prognosis than late-stage patients. Aggressive treatment plans are also recommended at this stage.

  • The two-year survival rate for pleural mesothelioma is 38% and the five-year survival rate is 10%.
  • Median overall survival at stage 2 is 20 months with surgery.

Watch: Learn the prognosis for mesothelioma patients when the cancer is in its early stages.

Mesothelioma Prognosis at Stage 3

Prognosis becomes more unfavorable for patients diagnosed in stage 3. Some stage 3 mesothelioma patients qualify for aggressive treatment plans.

  • Stage 3A: The two-year survival rate is 30% and the five-year survival rate is 8%.
  • Stage 3B: The two-year survival rate is 26% and the five-year survival rate is 5%.
  • Median overall survival at stage 3 is 17.9 months with surgery.

Mesothelioma Prognosis at Stage 4

The prognosis for patients with stage 4 mesothelioma is generally poor. 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% and the five-year survival rate is less than 1%.
  • Median overall survival at stage 4 is 14.9 months with treatment.
Mesothelioma specialist speaking with a patient and his wife
Connect with a Top Mesothelioma Doctor
Get help finding a specialist who knows how to treat and relieve the symptoms of stage 4 mesothelioma.

Other Factors Affecting Mesothelioma Prognosis

Cell Type

The types of cells that make up the tumor can impact your prognosis.

  • Epithelioid cells: Patients with this cell type tend to live longer than those with other cell types. People with epithelioid tumors live an average of 200 days longer.
  • Sarcomatoid cells: These cells are associated with the poorest prognosis because they are considered more aggressive and harder to treat.
  • Biphasic cells: The prognosis for this type depends on the ratio of sarcomatoid to epithelial cells. The more epithelial cells, the better the prognosis.

Biological factors may impact the typical prognoses associated with cell types. For example, according to a 2020 study published in Oncology Reports, the prognosis of epithelioid patients is affected by a protein called connective tissue growth factor. Those with lower levels of the protein had a better prognosis and longer survival.

Age

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. Under a third of patients diagnosed over age 75 live that long.

Gender

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. Peritoneal carries a better prognosis than pleural mesothelioma.

Race

Race plays a role in mesothelioma prognosis. In 2013, the five-year survival rate was 8.7% for whites and 10% for blacks.

Black women tend to live the longest with mesothelioma. In 2013, the five-year survival rate was 13.6% for white women and 30.1% for black women.

Mesothelioma Remission and Recurrence

A cancer’s prognosis includes the chances of recovery, which is called remission. It 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% reduction in tumor size.
  • Remission is complete when the cancer disappears entirely.

Complete remission is rare with mesothelioma. Partial remission is more common. 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.

Clinical Trials

Many clinical trials look for patients with a mesothelioma recurrence to test new and innovative therapies. They test second-line therapies to control the cancer when it recurs.

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.

Doctor conducting medical testing using lab equipment
Clinical Trials for Mesothelioma Patients
Get help improving your prognosis by finding a mesothelioma clinical trial today.

Understanding Prognostic Terms

Life Expectancy

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.

Survival Rates

Survival rates measure how long most people live with mesothelioma. Your prognosis is primarily based on the cancer’s average survival rates.

The National Cancer Institute says the five-year survival rate for mesothelioma was 9% between 2007 and 2013.

Death Rates

A cancer’s death rate, also called mortality rate, describes how many people die from the cancer. It plays a role when doctors estimate a patient’s prognosis.

Mesothelioma mortality rates are often defined in relation to patient age, gender, race and state of residence.

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
Pleural mesothelioma survivor

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
Peritoneal mesothelioma survivor

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.

Kasie Coleman
Peritoneal mesothelioma survivor

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

Common Questions About Mesothelioma Prognosis

Is mesothelioma always fatal?

Mesothelioma is not always fatal. A small number of patients have outlived their prognosis by more than a decade and died of another cause.

How can mesothelioma clinical trials improve prognosis?

Mesothelioma clinical trials conduct research with the goal of improving prognosis and finding a cure. They improve prognosis by discovering more effective treatment options.

How can a mesothelioma specialist improve prognosis?

Mesothelioma specialists have spent years learning about mesothelioma treatment, and they know how to treat the cancer better than general oncologists. Working with a specialist is the best way to improve your prognosis.

Will a positive COVID-19 diagnosis affect my mesothelioma prognosis?

The SARS-CoV-2 virus that causes COVID-19 significantly affects the respiratory tract and can cause permanent damage. Pleural mesothelioma patients have compromised lung function due to cancer surrounding the lungs and chest cavity. A COVID-19 diagnosis can worsen the prognosis for mesothelioma patients due to an increased risk of respiratory complications.

Could having the COVID-19 antibodies impact my prognosis?

The presence of COVID-19 antibodies in your blood indicates a previous infection of COVID-19 and a lower chance of reinfection. It may mean you have built some immunity to the disease and might positively affect a mesothelioma prognosis. However, the World Health Organization cautions that the degree of COVID-19 protection is currently unknown.


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