Mesothelioma Prognosis

A mesothelioma prognosis is the predicted course a patient’s cancer will take, usually describing both life expectancy and survival rate. The average life expectancy for mesothelioma is roughly 1-2 years, with only about 10% of patients surviving 5 years after diagnosis. One of the most effective ways to improve mesothelioma prognosis is through curative treatments like surgery.

What Is the Prognosis for Mesothelioma?

If you were diagnosed with mesothelioma, your prognosis is the expected progression and outcome of the cancer. Your doctor will determine your prognosis based on your cancer location, cell type, and other factors.

According to the Centers for Disease Control and Prevention (CDC), patients with mesothelioma have a median survival of about 1 year from the time of diagnosis.

Despite this grim statistic, however, each case of mesothelioma is unique, with some patients surviving 5 years or longer. No matter your prognosis, you can work with your doctor and care team to create a customized, effective treatment plan.

Life Expectancy vs. Survival Rate

Your mesothelioma prognosis will likely include your life expectancy, as well as the survival rate for the cancer.

Mesothelioma life expectancy is the average amount of time, measured in months, doctors expect a patient to live after diagnosis. The majority of mesothelioma patients are given a life expectancy of 12-21 months.

Mesothelioma survival rate is the percentage of patients who survive for a specific amount of time, usually in 1-, 3-, and/or 5-year increments after diagnosis. The 1- and 5-year survival rates for pleural mesothelioma (all stages) and peritoneal mesothelioma are shown below.

Mesothelioma Type 1-Year Survival Rate 5-Year Survival Rate
Pleural Mesothelioma 33% 5%
Peritoneal Mesothelioma 92% 65%
These survival statistics were collected from a study of 10,000 patients published in the Journal of Thoracic Oncology.

Mesothelioma Prognosis by Type

One of the most significant influences on prognosis is mesothelioma type.

Peritoneal mesothelioma, which develops in the lining of the abdomen (peritoneum), has the best prognosis of all types, despite it being much less common than pleural mesothelioma, which affects the lining of the lungs (pleura).

Pleural Mesothelioma Prognosis

Stage at diagnosis is one of the main factors influencing the prognosis for malignant pleural mesothelioma.

Doctors usually stage pleural mesothelioma using the tumor-node-metastasis (TNM) staging system, which uses four stages to describe how far a patient’s cancer has spread. In general, prognosis is better the earlier you are diagnosed.

Pleural Mesothelioma Stage Median Life Expectancy 2-Year Survival Rate
Stage 1 22.2 months (with surgery) 41-46%
Stage 2 20 months (with surgery) 38%
Stage 3 17.9 months (with surgery) 26-30%
Stage 4 14.9 months (with treatment) 17%

Early-stage (stages 1 and 2) pleural mesothelioma patients in otherwise good health often make excellent surgery candidates, giving them a much better prognosis than late-stage (stages 3 and 4) patients.

Once cancer has reached distant parts of the body in later stages, it becomes nearly impossible to remove fully through surgery, and treatment is focused on symptom management and improving quality of life. This is what contributes to the poorer prognosis in later stages.

Peritoneal Mesothelioma Prognosis

Peritoneal mesothelioma has the best prognosis on average of all mesothelioma types. Its median survival is around 51.5 months for patients with the epithelioid cell type who received cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC).

Reasons why this cancer may have a more favorable prognosis include:

  • Treatment: Patients may be better able to withstand more rigorous treatments in the abdominal area compared to the heart and lungs.
  • Cancer progression: Malignant peritoneal mesothelioma seems to progress at a slower rate than other types and tends to remain in the abdomen instead of spreading to other areas of the body.
  • Demographics: Peritoneal mesothelioma patients also tend to be younger and have a higher proportion of females, traits associated with a better prognosis.

Like all mesothelioma types, undergoing curative treatment is the most effective way to improve prognosis. For example, a 2015 study reported that 19 peritoneal mesothelioma patients who received a combination of surgery and chemotherapy had a 100% 1-year survival rate and a 91% 3-year survival rate.

Prognosis of Rare Types of Mesothelioma

Pericardial Mesothelioma Prognosis

Between its rarity and location near the delicate heart, this mesothelioma cancer has the worst prognosis of all types. On average, 50-60% of pericardial mesothelioma patients do not live more than 6 months after diagnosis.

Testicular Mesothelioma Prognosis

Little is known about the extremely rare testicular mesothelioma, however, its survival rates are typically high if the cancer is caught before it has spread. 49% of testicular mesothelioma patients can expect to live at least 5 years after diagnosis.

Factors That Affect Mesothelioma Prognosis

  • Age: Younger patients are often able to withstand more rigorous treatments and fight cancer more effectively, making their prognosis better on average.
  • Blood characteristics: Abnormal levels of white blood cells, red blood cells, and platelets are linked to shorter survival time.
  • Cell type: Epithelial cells are the least aggressive type of mesothelioma cells, often responding better to standard cancer treatments like surgery and chemotherapy. Biphasic and sarcomatoid cells may have a worse prognosis.
  • Gender: Women tend to live longer with mesothelioma and respond more positively to treatment than men. Researchers are still trying to determine why this is.
  • Type of mesothelioma: Whether mesothelioma is pleural or peritoneal impacts on how it spreads, treatment options, and other important factors.
  • Stage at diagnosis: Early-stage mesothelioma patients often have a much better prognosis than those diagnosed at a later stage. Early-stage patients have the best chance of being able to undergo life-extending surgery.
  • Treatment options: Patients able to undergo aggressive treatments like surgery often have a much better prognosis than those who cannot. Surgery may greatly increase the effectiveness of some other cancer treatments like chemotherapy.

One of the main reasons for mesothelioma’s poor prognosis is that over 65% of patients are diagnosed after the cancer is already advanced, according to the National Cancer Institute (NCI).

For this reason, and because there are so many prognostic factors, it’s important to see a mesothelioma specialist as soon as possible after you suspect symptoms to help ensure early detection and diagnosis.

Improving Prognosis for Mesothelioma

A malignant mesothelioma prognosis is generally poor but may be improved through treatment. Lifestyle changes may also help mesothelioma patients live as long and as well as possible.

Improving Prognosis Through Treatment

If you are healthy enough to undergo surgery, you likely have a better shot at improving your mesothelioma prognosis.

“Surgery is more likely to have long-term benefits in early-stage cancers, where there’s a better chance that most or all of the cancer can be removed.”

– American Cancer Society

However, some cancer cells may still be left behind after mesothelioma surgery, growing and dividing again. Many patients respond best to a combination of surgery, chemotherapy, and/or radiation, surviving for months or even years after treatment. This is called multimodal treatment.

Some patients who cannot undergo surgery still experience tumor shrinkage or slowed growth with chemotherapy alone. Additionally, radiation therapy may be used on its own to help shrink mesothelioma tumors and reduce painful symptoms.

As oncologists improve current malignant mesothelioma treatments and discover new ones through clinical trials, mesothelioma patients may have access to better survival rates or even a cure.

Improving Prognosis Through Healthier Lifestyle

Lifestyle factors, especially those that impact overall health, may influence a patient’s prognosis. Changing and improving these factors may, in turn, improve mesothelioma prognosis in some cases.

Mesothelioma patients may improve their prognosis by:

  • Maintaining good overall health: Mesothelioma patients in poor health may be unable to undergo life-extending surgery simply because doctors fear their bodies may not survive the rigorous operation. On the other hand, good health may enhance a patient’s ability to recover quickly and fully from cancer treatment.
  • Eating well: Mesothelioma patients should be especially careful to follow the recommendations of care staff regarding their diet. Getting the right nutrition can help support the immune system, giving patients undergoing treatment the best chance of survival and recovery.
  • Exercising: Exercise has many benefits, including stress reduction, improved blood flow, and an increased chance of preventing secondary health issues like bedsores. Not all patients under treatment can muster the energy to exercise. Light aerobic exercise is usually the best tolerated.
  • Managing stress: A patient’s recovery time and overall health may be affected by too much stress, so patients should practice stress management with activities like meditation, mindfulness, yoga, and regular exercise.
  • Not smoking: Smoking harms a patient’s health in many ways, making it more difficult to maintain health during mesothelioma treatment or tolerate chemotherapy. Smoking may even reduce a patient’s health to the point where they cannot undergo life-extending surgery.

Common Questions About Mesothelioma Prognosis

How does diagnosis differ from prognosis?

Before a doctor gives a patient their prognosis, they must make a diagnosis. A mesothelioma diagnosis is the identification and confirmation of a patient’s mesothelioma. It usually requires a piece of the cancer tissue obtained through a biopsy.

Once a mesothelioma specialist diagnoses a patient with mesothelioma, they assess how advanced the patient’s mesothelioma is and other relevant factors. They can then obtain a prognosis — the estimated course a patient’s cancer will take.

Can mesothelioma go into remission?

Mesothelioma remission is the term doctors use to describe cancer that can no longer be detected in a patient’s body. Mesothelioma is an incredibly aggressive cancer, and even the most thorough surgeries, chemotherapy sessions, and radiation treatments do not eliminate every cancer cell.

Mesothelioma patients who receive early and effective treatment may achieve remission, surviving for years without any signs of cancer. Eventually, however, mesothelioma nearly always returns. This is called mesothelioma recurrence.

What is the death rate for mesothelioma?

The mesothelioma death rate, or mortality rate, measures the ratio of deaths to the population of all mesothelioma patients. According to the CDC, from 1999-2015, the mesothelioma death rate in the United States was roughly 8 deaths per million people.

Mortality rate statistics, such as a sharp decrease in the death rate in recent years, enable a mesothelioma doctor to predict prognosis more accurately.

Beating the Odds of Your Mesothelioma Prognosis

A mesothelioma prognosis generally means doctors will not be able to cure the disease and that it will progress quickly. However, every case is different.

Some mesothelioma survivors have lived for several years with their cancer. Even though many of the factors influencing a mesothelioma prognosis are not controllable, there are steps patients can take to increase the odds of living longer than their prognosis.

To learn more about improving your prognosis, get a free Mesothelioma Guide today.

Mesothelioma Support Team
Reviewed by:Dr. Mark Levin

Certified Oncologist and Hematologist

  • Fact-Checked
  • Editor

Mark Levin, MD has nearly 30 years of experience in academic and community hematology and oncology. In addition to serving as Chief or Director at four different teaching institutions throughout his life, he is also still a practicing clinician, has taught and designed formal education programs, and has authored numerous publications in various fields related to hematology and oncology.

Dr. Mark Levin is an independently paid medical reviewer.

Mesothelioma Hope was founded by a team of advocates to educate people about this aggressive form of cancer. Mesothelioma affects thousands of people each year. We help give hope to those impacted by mesothelioma.

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