Mesothelioma Prognosis

Quick Summary

A mesothelioma prognosis describes the expected outcome of a patient’s cancer. Mesothelioma generally has a poor prognosis. Thankfully, veterans with mesothelioma may be able to access free VA treatment to improve their prognosis.

Medically edited and fact-checked by: Todd Gersten, MD Reviewed by Todd Gersten, MD Double Board-Certified Oncologist and Hematologist

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What Is the Prognosis for Mesothelioma?

A malignant mesothelioma prognosis takes into account 2 main factors: life expectancy and survival rate.

  • Mesothelioma life expectancy is the average length of time a patient can expect to live after their diagnosis. The average life expectancy is 10-21 months for pleural mesothelioma and 28-35 months for peritoneal mesothelioma.
  • Mesothelioma survival rates measure the percentage of patients still alive after a specified length of time. The 1-year survival rate is 73.1% for pleural mesothelioma and 91.6% for peritoneal mesothelioma.

Many mesothelioma patients are older so their prognosis can feel discouraging. However, a prognosis can change. With prompt medical treatment, patients can live for months or even years past their initial prognosis.

Factors That Determine Mesothelioma Prognosis

A patient’s individual traits play a major role in determining their prognosis.

Notable factors that affect prognosis include:

  • Mesothelioma location
  • Cell type
  • Treatment options
  • Patient history

Some mesothelioma types have a better prognosis than others. For example, peritoneal mesothelioma is easier to treat than pleural and thus it has a better prognosis.

Pleural Mesothelioma Prognosis

Pleural mesothelioma is often diagnosed at later stages. A late diagnosis makes curative surgery a less likely option, which means the patient will usually have a poor prognosis.

Pleural Mesothelioma Prognosis by Stage

Malignant pleural mesothelioma has 4 stages. Patients in early stages (1 and 2) have a better prognosis, while those in advanced stages (3 and 4) have a worse prognosis.

Pleural mesothelioma patients have a median life expectancy of 18 months and a 5-year survival rate of only 10%, a fairly poor prognosis when compared to other cancers.

Stage Prognosis Median Life Expectancy
Stage 1 Patients diagnosed in stage 1 have the best prognosis. 21.2 months
Stage 2 The prognosis for patients diagnosed at stage 2 is still relatively good. 18.9 months
Stage 3 Stage 3 has a poorer prognosis. 14.3 months
Stage 4 Patients diagnosed at stage 4, the most advanced stage of the cancer, have the worst prognosis. 10.1 months

Peritoneal Mesothelioma Prognosis

Malignant peritoneal mesothelioma has the best prognosis of all types. It is less likely to spread from its area of origin, so it is usually easier to treat.

Peritoneal Mesothelioma Prognosis by Stage

This type of mesothelioma has a median survival time of 28-35 months. 50% of patients live for at least 5 years after their diagnosis.

Those with peritoneal mesothelioma have a better prognosis if they are diagnosed before the cancer spreads. In these cases, surgery and chemotherapy can help patients live longer.

Prognosis worsens for peritoneal mesothelioma patients diagnosed when their cancer is more advanced. Typically, these patients are no longer good candidates for surgery and instead opt for comfort-focused palliative treatments.

Prognosis of Other Mesothelioma Types

Pericardial mesothelioma has the worst prognosis of all mesothelioma types. It is almost never diagnosed in an early stage and spreads quickly to distant parts of the body. The median life expectancy for pericardial mesothelioma is just 5-6 months.

On the other hand, testicular mesothelioma has a relatively good prognosis depending on how quickly it is diagnosed. Patients with testicular mesothelioma can expect to live 23 months on average if they are diagnosed early and undergo surgery.

Mesothelioma Cell Type

In addition to mesothelioma type, a patient’s cell type (histology) may impact prognosis as well. Some types of mesothelioma cells respond better to treatment, leading to a better prognosis.

Epithelioid Mesothelioma Prognosis

Epithelioid mesothelioma has the best prognosis of all mesothelioma cell types. This is because its cells clump together to form tumors that are easier to remove. Mesothelioma patients with an epithelioid cell type have a median life expectancy of 14 months.

Sarcomatoid Mesothelioma Prognosis

Patients with sarcomatoid mesothelioma often face a worse prognosis. Sarcomatoid cancer cells spread quickly, making tumors resistant to many standard treatment options.

The average life expectancy for patients with the sarcomatoid cell type is just 4 months.

Biphasic Mesothelioma Prognosis

Biphasic tumors contain both epithelial and sarcomatoid cells. Because of this, the prognosis for biphasic mesothelioma can vary widely depending on the ratio of each cell type.

In general, patients with this cell type respond more readily to treatment than those with sarcomatoid cells but less readily than those with epithelial cells. Biphasic mesothelioma patients have a median life expectancy of 10 months.

Mesothelioma Prognosis by Treatment Type

While there is no cure for this cancer, proper mesothelioma treatment can improve a patient’s prognosis by months or even years in some cases.

Mesothelioma Prognosis After Surgery

Surgery is one of the most effective malignant mesothelioma treatments. Successful mesothelioma surgery can mean the difference between a relatively good prognosis and a poor one.

Below, learn more about how different surgeries can improve prognosis.

Prognosis After Pleural Mesothelioma Surgery
Surgery Type Life Expectancy5-Year Survival Rate
Extrapleural Pneumonectomy 25 months19%
Pleurectomy with Decortication 33 months49%
Prognosis After Peritoneal Mesothelioma Surgery
Surgery Type Life Expectancy5-Year Survival Rate
Cytoreduction with HIPEC63 months50%

Mesothelioma Prognosis After Chemotherapy

Chemotherapy is used by almost all mesothelioma doctors and generally improves prognosis. How much it helps depends on both the type of chemotherapy and the mesothelioma location.

For example, hyperthermic intraperitoneal chemotherapy (HIPEC) — chemotherapy applied directly to the site of the cancer during surgery for peritoneal mesothelioma — may add 5 years or more to a patient’s survival.

Mesothelioma Prognosis After Radiation Therapy

When used alone, radiation therapy is most useful as a palliative treatment to improve quality of life for mesothelioma patients.

When used alongside surgery or chemotherapy in a multimodal treatment plan, radiation can also help to extend survival time and improve prognosis.

Studies have shown that when used after surgeries like pleurectomy with decortication (P/D), it increased median life expectancy by more than a year in some cases.

Mesothelioma Prognosis Without Treatment

The prognosis for mesothelioma patients is very poor without treatment.

With treatment, the median life expectancy of a pleural mesothelioma patient is 18 months. Without treatment, it ranges from 4 to 12 months.

Demographic Factors Affecting Mesothelioma Prognosis

Demographic traits may impact how well a patient responds to mesothelioma treatment.

Age

Since mesothelioma takes 20-50 years to develop, it often affects seniors. That said, younger people diagnosed with this cancer tend to have a better prognosis.

Younger people have better overall health and can often withstand aggressive treatments.

Age5-Year Survival Rate
<5038%
50-6415.1%
>646.4%

Gender

Female patients have a better prognosis than male patients. In fact, women are nearly 10% more likely to survive mesothelioma for 5 years than men.

Race

Data shows that race can also impact prognosis. Caucasian people are more likely to develop mesothelioma, but they do not have the best prognosis.

Race5-Year Survival Rate
Black 15.3%
White9.5%
Asian/Pacific Islander8.1%

Mesothelioma Prognosis and Survival

Can I Survive Mesothelioma?

Long-term survival does happen in rare cases, with some patients outliving an initially poor prognosis. Treatments are improving all the time as doctors and researchers continue to discover new ways of fighting mesothelioma.

Mesothelioma Survivors Who Have Beaten the Odds

  • Sandy, 6-Year Survivor: In 2011, Sandy was diagnosed with pleural mesothelioma. She underwent several surgeries, including a pleurectomy in 2012. Thanks to this surgery, Sandy has survived well past her initial prognosis.
  • David, 7-Year Survivor: In 2010, 63-year-old David was diagnosed with stage 4 mesothelioma and given only a few months to live. However, he underwent an emerging chemotherapy treatment that allowed him to survive much longer.
  • Tom, 15-Year Survivor: In 2002, Tom was diagnosed with pleural mesothelioma. His initial life expectancy was 12 months. Tom underwent surgery to remove his diseased lung. Today, Tom is called a mesothelioma survivor. His story gives hope to all patients who have been given a poor initial prognosis.

Can Mesothelioma Be Cured?

There is currently no cure for mesothelioma, but proper treatment can improve prognosis. In some cases, it may even lead to long-term survival.

Can Mesothelioma Go Into Remission?

In some cases, mesothelioma treatment is so successful that the cancer goes into remission where it is no longer growing or spreading. Mesothelioma remission is not the same as a cure, but it can extend lifespan by months or even years.

What Is Mesothelioma Recurrence?

Mesothelioma recurrence is when the cancer comes back after going into remission. These cancers may resist treatments and worsen a patient’s prognosis.

Improve Your Mesothelioma Prognosis

Early detection and treatment are the keys to improving a mesothelioma prognosis. Thankfully, Veterans have access to some of the world’s top mesothelioma doctors through the United States Department of Veterans Affairs (VA) health care system.

Mesothelioma specialists at VA hospitals and other cancer centers have decades of experience, allowing patients access to the most effective treatments and therapies.

If you have questions about mesothelioma prognosis or connecting with a specialist, give us a call today or get your Free Veterans Packet.

Veterans Support Team
Todd Gersten, MD PhotoReviewed by:Todd Gersten, MD

Double Board-Certified Oncologist and Hematologist

  • Fact-Checked
  • Editor

Todd Gersten, MD is a double board-certified medical oncologist and hematologist specializing in general adult oncology and hematologic disease. He is a physician partner with the Florida Cancer Specialists and practices in Wellington, Florida.

Dr. Todd Gersten is an independently paid medical reviewer.

Christopher Dryfoos PhotoWritten by:

Contributing Author

Christopher Dryfoos is a journalist and member of the American Medical Writers Association (AMWA). As the grandson of the U.S. Navy’s first forensic pathologist, he aims to help veterans with mesothelioma access needed care.

View 33 Sources
  1. Abramson Cancer Center. “Prognosis.” Retrieved from: https://www.pennmedicine.org/cancer/types-of-cancer/mesothelioma/prognosis. Accessed on September 14th, 2017.
  2. American Cancer Society. “Survival Statistics for Mesothelioma.” Retrieved from: https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/survival-statistics.html. Accessed on September 14th, 2017.
  3. Faig, Jennifer. Translational Oncology. “Changing Pattern in Malignant Mesothelioma Survival.” Retrieved from: http://www.transonc.com/article/S1936-5233(14)00136-3/fulltext. Accessed on September 14th, 2017.
  4. Minatel, Emilio. Lung Cancer. “Radical pleurectomy/decortication followed by high dose of radiation therapy for malignant Pleural Mesothelioma. Final results with long-term follow-up.” 2014. Retrieved from: http://www.sciencedirect.com/science/article/pii/S0169500213004571. Accessed on September 14th, 2017.
  5. National Cancer Institute. “Malignant Mesothelioma Treatment.” Retrieved from: https://www.cancer.gov/types/mesothelioma/patient/mesothelioma-treatment-pdq. Accessed on September 14th, 2017.
  6. National Health Services UK. “Mesothelioma.” Retrieved from: http://www.nhs.uk/conditions/mesothelioma/Pages/Definition.aspx#outlook. Accessed on September 14th, 2017.
  7. Rusch, VW. Journal of Thoracic Oncology. “Initial analysis of the international association for the study of lung cancer mesothelioma database.” Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/23070243. Accessed on September 14th, 2017.
  8. Amin, W., Linkov, F., Landsittel, D. P., Silverstein, J. C., & Becich, M. J. (2018). Factors influencing malignant mesothelioma survival: A retrospective review of the National Mesothelioma Virtual Bank cohort. F1000Research, 7, 1184. doi:10.12688/f1000research.15512.1
  9. Baratti, D., Kusamura, S., Cabras, A. D., Bertulli, R., Hutanu, I., & Deraco, M. (2013). Diffuse malignant peritoneal mesothelioma: Long-term survival with complete cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (HIPEC). European Journal of Cancer, 49(15), 3140-3148. doi:10.1016/j.ejca.2013.05.027
  10. Chekol, S. S., & Sun, C. (2012). Malignant Mesothelioma of the Tunica Vaginalis Testis: Diagnostic Studies and Differential Diagnosis. Archives of Pathology & Laboratory Medicine, 136(1), 113-117. doi:10.5858/arpa.2010-0550-rs
  11. Chemotherapy for Malignant Mesothelioma. (n.d.). Retrieved May 30, 2020, from https://www.cancer.org/cancer/malignant-mesothelioma/treating/chemotherapy.html
  12. Dolly, S. O., Migali, C., Tunariu, N., Della-Pepa, C., Khakoo, S., Hazell, S., . . . Banerjee, S. (2017). Indolent peritoneal mesothelioma: PI3K-mTOR inhibitors as a novel therapeutic strategy. ESMO Open, 2(1). doi:10.1136/esmoopen-2016-000101
  13. Faig, J., Howard, S., Levine, E. A., Casselman, G., Hesdorffer, M., & Ohar, J. A. (2015). Changing Pattern in Malignant Mesothelioma Survival. Translational Oncology, 8(1), 35-39. doi:10.1016/j.tranon.2014.12.002
  14. Hospice care: Comforting the terminally ill. (2019, January 30). Retrieved May 31, 2020, from https://www.mayoclinic.org/healthy-lifestyle/end-of-life/in-depth/hospice-care/art-20048050
  15. Malignant Mesothelioma Early Detection, Diagnosis, and Staging. (n.d.). Retrieved May 31, 2020, from https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging.html
  16. Malignant Mesothelioma Stages. (n.d.). Retrieved May 31, 2020, from https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/staging.html
  17. Melamed, D. (2020, May 26). ONCOS-102 Plus Chemo Showing Sustained Benefit in Mesothelioma Trial. Retrieved May 31, 2020, from https://immuno-oncologynews.com/2020/05/26/oncos-102-plus-chemo-showing-sustained-benefit-phase-2-mesothelioma-trial/
  18. Mesothelioma - Introduction. (2019, June 26). Retrieved May 31, 2020, from https://www.cancer.net/cancer-types/mesothelioma/introduction
  19. Mesothelioma. (2018, September 07). Retrieved May 30, 2020, from https://www.cancerresearchuk.org/about-cancer/mesothelioma/treatment/surgery/peritoneal-mesothelioma
  20. Meyerhoff, R. R., Yang, C. J., Speicher, P. J., Gulack, B. C., Hartwig, M. G., D'amico, T. A., . . . Berry, M. F. (2015). Impact of mesothelioma histologic subtype on outcomes in the Surveillance, Epidemiology, and End Results database. Journal of Surgical Research, 196(1), 23-32. doi:10.1016/j.jss.2015.01.043
  21. Nilsson, A., & Rasmuson, T. (2009). Primary Pericardial Mesothelioma: Report of a Patient and Literature Review. Case Reports in Oncology, 2(2), 125-132. doi:10.1159/000228894
  22. Radiation Therapy for Malignant Mesothelioma. (n.d.). Retrieved May 30, 2020, from https://www.cancer.org/cancer/malignant-mesothelioma/treating/radiation.html
  23. Rea, F., Marulli, G., Bortolotti, L., Breda, C., Favaretto, A. G., Loreggian, L., & Sartori, F. (2007). Induction chemotherapy, extrapleural pneumonectomy (EPP) and adjuvant hemi-thoracic radiation in malignant pleural mesothelioma (MPM): Feasibility and results. Lung Cancer, 57(1), 89-95. doi:10.1016/j.lungcan.2007.02.004
  24. Sarcomatoid Mesothelioma, Symptoms & Treatment. (n.d.). Retrieved May 31, 2020, from https://moffitt.org/cancers/mesothelioma/types/sarcomatoid-mesothelioma/
  25. SEER*Explorer. (n.d.). Retrieved May 31, 2020, from https://seer.cancer.gov/explorer/application.html?site=111
  26. Shavelle, R., Vavra-Musser, K., Lee, J., & Brooks, J. (2017). Life Expectancy in Pleural and Peritoneal Mesothelioma. Lung Cancer International, 2017, 1-8. doi:10.1155/2017/2782590
  27. Surgery for Malignant Mesothelioma. (n.d.). Retrieved May 30, 2020, from https://www.cancer.org/cancer/malignant-mesothelioma/treating/surgery.html
  28. Treatment of Mesothelioma Based on the Extent of the Cancer. (n.d.). Retrieved May 31, 2020, from https://www.cancer.org/cancer/malignant-mesothelioma/treating/by-extent.html
  29. US Department of Veterans Affairs, Veterans Health Administration. (2013, December 06). Public Health - Asbestos. Retrieved May 31, 2020, from https://www.publichealth.va.gov/exposures/asbestos/index.asp
  30. What Is Cancer Recurrence? (n.d.). Retrieved May 31, 2020, from https://www.cancer.org/treatment/survivorship-during-and-after-treatment/understanding-recurrence/what-is-cancer-recurrence.html
  31. What Is Malignant Mesothelioma? (n.d.). Retrieved May 31, 2020, from https://www.cancer.org/cancer/malignant-mesothelioma/about/malignant-mesothelioma.html
  32. What's New in Malignant Mesothelioma Research? (n.d.). Retrieved May 31, 2020, from https://www.cancer.org/cancer/malignant-mesothelioma/about/new-research.html
  33. Zhang, W., Wu, X., Wu, L., Zhang, W., & Zhao, X. (2015). Advances in the diagnosis, treatment and prognosis of malignant pleural mesothelioma. Annals of translational medicine, 3(13), 182. https://doi.org/10.3978/j.issn.2305-5839.2015.07.03
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