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What Is the Prognosis for Mesothelioma?

Most patients live about one year after being diagnosed with mesothelioma. How long you live with mesothelioma primarily depends on the stage at diagnosis and how well you respond to mesothelioma treatments.

A mesothelioma prognosis is what doctors describe as an overall outlook for a specific patient. It is both individual and based on the average survival of other mesothelioma patients diagnosed in the past. Although statistics play a part in determining your prognosis, every mesothelioma case is unique.

  • Survival Rates: Survival rates measure how long most people live with mesothelioma. Your prognosis is primarily based on the cancer’s average survival rates.
  • Life Expectancy: This term 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.
  • Death Rate: 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.

While you cannot change certain prognostic factors, such as the cancer’s location or stage, you can undergo treatment that may improve your survival by months or years. Some patients have lived more than a decade with mesothelioma and receive ongoing treatment to keep the cancer under control.

What Tamron Little Wished She Had Known When Receiving a Mesothelioma Diagnosis

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

Factors Affecting Prognosis

The most important factors that affect your mesothelioma prognosis include where the cancer first formed, what kind of cancer cells make up the tumors, the stage of cancer progression, your overall health and other personal factors.

Mesothelioma Tumor Location

Research shows approximately 40% of pleural mesothelioma patients survive at least one year after diagnosis. About 9% of patients with pleural mesothelioma survive more than five years.

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 pericardial mesothelioma is generally poor. About 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 of mesothelioma, its prognosis is typically the best. Average survival is around two years and some patients live more than a decade.

Histologic Cell Type

The types of mesothelioma cells that make up the tumor can impact your prognosis. Histology is the study of the structure of cells, and its application to mesothelioma involves how cell structure affects response to treatment. Identifying which cells are present is an important part of diagnosing mesothelioma.

  • 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. The average prognosis is six to eight months.
  • 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.

Cancer Stage and Metastasis

The stage of the cancer’s progression has a significant impact on your prognosis because treatment becomes less effective in later stages.

Stage 1 patients who undergo surgery have a median life expectancy of 22.2 months. Stage 4 mesothelioma patients who undergo treatment have a median life expectancy of 14.9 months.

The four stages of mesothelioma include:
  • Stage 1A: Cancer has not yet reached the lymph nodes.
  • Stage 1B: Cancer has advanced into the chest wall, mediastinum or pericardium.
  • Stage 2: Cancer has spread to nearby lymph nodes.
  • Stage 3A: Cancer has reached the chest wall, heart lining and a lymph node on the same side.
  • Stage 3B: Cancerous cells have spread to lymph nodes opposite of the origin. The tumor may extend into one or multiple areas near the chest, spine or heart.
  • Stage 4: Metastasis sites typically include the liver, kidneys, bone, abdominal lining, inner lung or pleural lining on the other lung.

In the final stage, mesothelioma metastasis occurs if tumors spread from their original location to other areas in the body, forming new sites of cancer growth. Mesothelioma is more likely to spread locally than to distant parts of the body. About 10% to 50% of stage 4 mesothelioma cases develop distant metastases.

Overall Patient Health and Demographics

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

Gender has a significant impact on mesothelioma prognosis. Women with mesothelioma typically live longer than men.

Race also plays a role in mesothelioma prognosis. In 2013, the five-year survival rate was 8.7% for white patients and 10% for Black patients.

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.

Treatment

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

Treatments used to improve mesothelioma prognosis include surgery, chemotherapy, immunotherapy, targeted therapy, radiation therapy and Tumor Treating Fields.

Tumor-removing surgery offers the greatest opportunity for patients to live years beyond the average one-year survival. Approximately 20% of pleural mesothelioma patients are diagnosed early enough to qualify for surgery.

About half of mesothelioma patients who undergo chemotherapy experience tumor shrinkage or no new tumor growth for a period of time. Adding targeted therapy or Tumor Treating Fields to chemotherapy improves average survival from 12 months to approximately 18 months.

Clinical trials have improved the prognoses of many patients who responded to the drug or treatment under investigation.

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Improving Prognosis

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

Clinical trials offer an opportunity to try new drugs or new combinations of treatments that may be more effective for you than conventional therapies.

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

Mental and emotional support can help cancer patients overcome the challenges that accompany a cancer diagnosis. Research shows participating in cancer support groups may reduce anxiety and emotional distress and ease fatigue and pain.

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

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 who have had prior treatment and are now living with an advanced disease are ideal candidates for clinical trials.

Some clinical trials are also investigating new ways to measure a patient’s mesothelioma prognosis. In 2021, researchers determined that a specific protein, called programmed death-ligand 1 (PD-L1), plays a central role in the antitumor immune response. The scientists concluded PD-L1 could be a predictor of prognosis and efficacy for PD-L1 and programmed death 1 (PD-1) blockade therapy.

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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 support research with the goal of improving prognosis and finding a cure. These trials 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 it 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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