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Mesothelioma Prognosis

A prognosis is a disease’s outlook or forecast. It also encompassed how likely the patient is to achieve recovery. Doctors provide patients with a prognosis on an ongoing basis as the disease evolves. The typical prognosis for mesothelioma patients is an estimated life expectancy of one year or less after diagnosis.

Understanding Your Mesothelioma Prognosis

Prognosis varies from patient to patient and depends on many factors, including treatment options. Based on these factors, a prognosis can either improve, remain the same, or decline. In other words, a prognosis is fluid and not necessarily firm. Many people end up living well beyond their initial prognosis.

Only a doctor can give an accurate prognosis. They have the experience and expertise to determine which types of treatments are available to patients. With this knowledge, a doctor can provide a more accurate prognosis based on the treatment options the patient undergoes.

General Prognosis

Because relatively little is known about mesothelioma, a prognosis can be difficult to give. Doctors do their best to identify as many factors as possible before they give an official prognosis.

Having a realistic prognosis empowers patients and their families to seek the best potential treatments and symptom management options as possible. This helps them to preserve or restore their quality of life as best as possible.

Pleural Mesothelioma Prognosis

Generally speaking, the prognosis for pleural mesothelioma patients who do not receive treatment is poor. Many patients only live 6 to 12 months after diagnosis. However, multimodal treatment and early diagnosis improve this prognosis greatly. Some mesothelioma sufferers achieve remission and can survive with the disease for several years.

Peritoneal Mesothelioma Prognosis

Peritoneal mesothelioma is often believed to have a better prognosis when compared to pleural mesothelioma. The typical prognosis for peritoneal mesothelioma patients is approximately 1 year. When the cytoreduction technique is used to surgically remove malignant tumors from the peritoneum, the overall prognosis and life expectancy improves. Many patients who receive this treatment live over 5 years longer than their prognosis. Some even survive longer than 7 years.

Pericardial Mesothelioma Prognosis

The prognosis for pericardial mesothelioma is poor with an expected 6-month life expectancy after diagnosis. With this type of mesothelioma, tumors are located near the heart. The potential for damage to the heart is very high, and there are risks of treatment complications. However, specific surgical treatments exist for pericardial mesothelioma patients that can help extend their life expectancy.

In one case, a patient underwent a pericardiectomy and was mesothelioma-free after 3 years. Another patient is known to have survived longer than 5 years after undergoing a pericardiectomy.

Prognosis Factors

There are multiple factors that doctors look at when they update their patients with a prognosis. Doctors look at prognosis factors specific to cancer and then specific to mesothelioma. Doctors must also factor in the unique health and wellness characteristics of the individual patient.

Mesothelioma Location and Stage

One of the most pertinent mesothelioma prognosis factors is the location of the mesothelioma. Certain types of mesothelioma are more difficult to treat and, therefore, have a different prognosis. Whether the mesothelioma was found in the chest, abdomen, or heart doctors can determine a prognosis accordingly.

For pleural mesothelioma specifically, doctors look at the stage at which the disease was diagnosed or has progressed to. A prognosis is based on how quickly the disease is moving through the four stages.

Tumor Size and Growth

Beyond the location and stage of mesothelioma, doctors will also look at the tumors specifically. They will look at the size of the tumors and how rapidly they are growing to determine a prognosis. Treatments that control or stop tumors from growing can improve the prognosis.

Doctors must look at whether tumors have begun to metastasize, or spread to surrounding areas, organs, and systems. If this has occurred, it must also be factored into the prognosis.

Patient Health

Though doctors look at survival statistics and disease facts, determining a realistic mesothelioma prognosis depends greatly on the individual patient. A patient’s overall level of health will determine their ability to combat the disease, withstand treatments, and recover.

Health factors like the person’s age, activity level, diet, and cardiovascular and respiratory health are taken into consideration. Doctors also consider the gender of the patient in their prognosis. The disease overwhelmingly affects men rather than women, meaning there are fewer past cases to refer to for women with a mesothelioma diagnosis.

Treatments

A fourth and vital mesothelioma prognosis factor is the patient’s treatment course.

This includes factors like:

  • Whether the patient is receiving treatment
  • The types of treatment, including multimodal treatments
  • If the tumors can be removed surgically
  • How the patient is responding to treatment
  • How well the patient is able to recover from treatment
  • Potential complications that may occur during treatment (i.e., surgery)

If any of the above factors are at play, it can either improve or worsen the prognosis. Doctors look at treatment success as a critical factor in how the disease will affect the patient.

Other Factors

The four primary factors of determining a mesothelioma prognosis are disease location, tumor size, patient health, and treatment response.

A mesothelioma prognosis is also affected by the following factors:

  • How much fluid buildup is in the patient’s chest
  • How much abdominal swelling the patient is facing
  • The specific type of mesothelioma cells and how they look when analyzed under a microscope
  • The white blood cell and hemoglobin count in the blood
  • How long ago the initial mesothelioma diagnosis was reached
  • Whether the mesothelioma reached remission previously

Mesothelioma Life Expectancy

As part of a prognosis, doctors will determine a life expectancy for their patients. Life expectancy is the amount of time (typically given in months) that the patient is expected to live with their disease. Life expectancy is also measured on a median, or average, basis for a particular disease.

Mesothelioma life expectancy rates vary between the different locations of the disease. Life expectancies are also never certain. They vary greatly between each unique patient and their particular health condition. Health professionals look at past patient examples and factor in many different considerations when they provide a life expectancy.

There is no way to determine an exact life expectancy. However, there are certain things that all patients can do to improve their life expectancy. In addition to extending their life expectancy, patients can also improve their quality of life during the remainder of the disease course.

Pleural Mesothelioma

Patients with pleural mesothelioma have a median life expectancy of between 6 and 17 months. Early diagnosis and multimodal treatments can significantly improve life expectancy in many cases. Approximately 15% of pleural mesothelioma patients survive up to 5 years, and others have been in remission for much longer.

Peritoneal Mesothelioma

Without treatment, peritoneal mesothelioma patients have a median life expectancy of 12 months after diagnosis. However, multimodal treatments for peritoneal mesothelioma patients greatly improve life expectancy. Multimodal treatments that include successful cytoreduction surgery result in a median life expectancy of 4 to 5 years.

Pericardial Mesothelioma

Pericardial mesothelioma is an extremely rare form of the disease. By its nature, pericardial mesothelioma can rapidly progress to a life-threatening point because of how it affects the heart. Doctors have limited knowledge at this point about pericardial mesothelioma and how it develops. Because it is rare, there are limited past cases to draw from to determine a life expectancy. Currently known cases of pericardial mesothelioma put the average life expectancy at 6 weeks to 15 months.

Increasing Life Expectancy

It is possible for mesothelioma patients to do better than their prognosis indicated. Surgery is one of the ways that mesothelioma patients can outlive their prognosis.

Here are some ways to increase life expectancy after a mesothelioma diagnosis:

  • Ask about and pursue multimodal treatments
  • Maintain a healthy diet and activity levels
  • Stop or reduce the use of harmful substances such as cigarettes and alcohol
  • Include complementary treatments such as physiotherapy and pain management
  • Stay in communication with your health care team and let them know of any changes in symptoms and health conditions

Though still limited, more is understood about mesothelioma now than ever before. This improved knowledge of mesothelioma etiology (causes) has created emerging treatments and a better understanding of how to control and manage the disease. Patients diagnosed with mesothelioma now have more ways to improve their quality of life and extend their life expectancy.

Thanks to ongoing investments in research, doctors today can help patients live much longer than patients who were diagnosed 10 years ago.

Mesothelioma Survival Rates

Mesothelioma survival rates have improved in the past 20 years. More is understood about the disease and which treatments are most effective. Survival rates depend on different factors, including mesothelioma type, stage, treatments. They also depend on patient factors like age, sex, race, and genetics.

Pleural Mesothelioma

Pleural mesothelioma survival rates are significantly dependent on how quickly a diagnosis is reached. After diagnosis, survival rates can vary dramatically depending on the unique patient and their treatments.

Examples of survival rates of different pleural mesothelioma cases include:

  • 73% of patients survive 1 year after diagnosis
  • 12% of patients survive 5 years after diagnosis
  • 19% of patients survive 2 years with chemotherapy treatments only
  • 40% of patients survive 2 years when undergoing a pleurectomy

Peritoneal Mesothelioma

Peritoneal mesothelioma currently has higher survival rates as compared to pleural mesothelioma. This is due in part to the effectiveness of cytoreduction surgery used on peritoneal patients.

Examples of survival rates of different peritoneal mesothelioma cases include:

  • 92% of patients survive 1 year after diagnosis
  • 65% of patients survive 5 years after diagnosis
  • 50% of patients survive 5 years after diagnosis after undergoing cytoreduction surgery

On average for all types of mesothelioma combined, survival rates vary between 6 months at 55% and 5 years at 9% after diagnosis.

Mesothelioma Remission

In some cases, mesothelioma patients can achieve remission. This means that though the cancer does not go away, it stops spreading. It can remain in this inactive state for an extended period of time. Mesothelioma remission can either be full or partial.

Full remission happens when mesothelioma treatments, such as surgery, chemotherapy, and radiation, completely remove and eliminate any signs of cancer. Partial remission occurs when the cancer responds to mesothelioma treatments in part, but the cancer still has not been completely removed.

Many mesothelioma patients can achieve partial remission when they have tumors removed or when tumors do not grow or spread. Doctors continue to monitor mesothelioma patients after treatment to ensure it is still in partial remission. By monitoring the cancer during remission, doctors are able to watch for any signs of its return.

When mesothelioma returns after treatment, it is called recurrent cancer. If it comes back near the location where the cancer first started, it is called local recurrence. When the cancer comes back and spreads to other systems and organs, such as the heart, liver, or brain, it is called distant recurrence.

Because mesothelioma is a particular type of cancer that is difficult to remove entirely, it often comes back. In these cases, additional treatments, including new treatment strategies, can be implemented to try to shrink tumors or control their spread. Clinical trials are valuable in helping patients achieve remission again through emerging mesothelioma treatments and the latest research.

Mesothelioma Second Opinion

There is currently a limited understanding of mesothelioma compared to other types of cancer. It is a unique form of cancer with specific causes and treatment requirements. In many cases, a general physician may not have the full and updated knowledge of mesothelioma. This can potentially lead to incomplete or unrealistic prognoses and information regarding a patient’s unique life expectancy.

Getting a second opinion from another doctor or from a physician who specializes in mesothelioma can be an important and even life-saving decision. Like any profession, it is possible to make mistakes or miss certain important factors. This can sometimes happen with physicians when it comes to interpreting diagnostic test results, making a diagnosis, and determining prognosis.

Mesothelioma specialists deal exclusively with asbestos-related diseases and malignant mesothelioma. These physicians are able to provide a second opinion based on their specific experience in working with and treating other mesothelioma patients.

Remember that you can always seek the opinion of another physician before you accept your prognosis. Doing so can provide you with options you may not have known about. This may help you to extend your life expectancy, better manage painful symptoms, and improve your quality of life.

Mesothelioma Support Team

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.

View 12 References
  1. https://www.cancer.gov/types/mesothelioma/patient/mesothelioma-treatment-pdq

  2. http://www.cancerresearchuk.org/about-cancer/type/mesothelioma/living/coping-with-mesothelioma

  3. http://www.nhs.uk/conditions/mesothelioma/Pages/Definition.aspx#outlook

  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994863/

  5. http://www.medscape.com/viewarticle/759119_7

  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1767997/

  7. https://academic.oup.com/carcin/article/36/1/76/377221/Mesothelioma-patients-with-germline-BAP1-mutations

  8. http://www.sciencedirect.com/science/article/pii/S1556086415318451

  9. http://circ.ahajournals.org/content/early/2015/10/14/CIRCULATIONAHA.115.016418

  10. https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/survival-statistics.html

  11. https://www.cancer.org/cancer/malignant-mesothelioma/treating/by-extent.html

  12. https://www.pennmedicine.org/cancer/types-of-cancer/mesothelioma/prognosis

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