Mesothelioma Prognosis

What is a Prognosis?

A prognosis is a medical term referring to the likely outcome or outlook of the disease. Doctors determine a prognosis for patients to help them understand what to expect. This is both in terms of how the disease will progress and how long the patient can expect to live.

A prognosis is usually given as the number of months you or years you can expect to live with your disease. Some patients choose not to learn this number, and it’s okay if you don’t. It’s important for veterans to understand that a prognosis is not a definite outcome. Different factors, such as types of treatments the patient receives, can help improve a prognosis.

The Truth About Mesothelioma Prognosis

Doctors give a prognosis based on past patient cases and survival statistics. They take average survival rates and then consider different factors before delivering an individual prognosis.

A mesothelioma prognosis is difficult to give. Mesothelioma is still a rare and relatively unknown form of cancer. It’s hard for many doctors to predict exactly how it will progress. Because there is a limited number of patient cases, a mesothelioma prognosis isn’t always reliable. Also, the survival rates you hear about can be misleading because they may not isolate cases where patients received specialized care.

Remember that each person’s case is unique. Many patients are given a poor prognosis at first, only to respond to treatments better than expected. In these cases, patients can go on to outlive their prognosis by several years. Some patients even go on to be declared mesothelioma survivors.

As the Abramson Cancer Center says, “Although in general the prognosis of mesothelioma is poor, many factors come into play and long-term mesothelioma survivors do exist.”

Experts predict that the overall prognosis of mesothelioma will only continue to improve as researchers perfect existing treatments and develop new ones.

Factors That Determine Prognosis

Doctors provide patients with a prognosis after they’ve been diagnosed.

They determine a prognosis based on several factors, including:

• Mesothelioma location (pleural, peritoneal or pericardial)
• Mesothelioma stage (pleural mesothelioma)
• Mesothelioma cell type (epithelioid, sarcomatoid or biphasic)
• Patient age and overall health level
• Types of treatments patient receives

Mesothelioma Location

Certain mesothelioma locations have a better prognosis than others. Generally, doctors feel that peritoneal mesothelioma is easier to manage with treatment and has a better 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.

Pericardial mesothelioma has the worst prognosis because it’s the rarest and affects the heart. There are specific, life-extending treatments for each mesothelioma location.

Mesothelioma Stage

Pleural mesothelioma is diagnosed using a staging system from 1 to 4. This helps doctors determine how far the disease has spread and guess how long the patient will live.

Stage 1 is the least advanced. This indicates the mesothelioma hasn’t spread past its starting point. Stage 4 is the most advanced, and indicates the mesothelioma has spread aggressively to other parts of the body.

Peritoneal and pericardial mesothelioma don’t have official staging systems. But the same general rules apply. Localized mesothelioma has a better prognosis. This also depends on other sets of factors and can be improved by the right treatments.

Mesothelioma Cell Type

Mesothelioma cell type also factors into a patient’s prognosis. Cell type refers to how the mesothelioma cells appear when analyzed under a microscope. They can appear as three distinct types: epithelioid, sarcomatoid or biphasic.

• Epithelioid cells spread the least aggressively, making them easier to treat and gives it the best prognosis.
• Sarcomatoid cells spread the most aggressively, making this cell type more difficult to treat and giving it the worst prognosis.
• Biphasic tumors consist of both cell types. A biphasic tumor is largely determined by the ratio between epithelioid and sarcomatoid cells. If a biphasic tumor has more epithelioid cells, then the patient will have a better prognosis. If there are more sarcomatoid cells, the patient will have a worse prognosis.

Patient Health

Health level is a significant factor in a patient’s prognosis. Healthier people respond to and recover from treatments better than those in poor health. Doctors assess a patient’s overall health level before delivering a prognosis.

A person’s age, dietary habits, physical activity level and overall lifestyle are all factors. Doctors also look at whether the patient has any additional health problems like cardiovascular disease or respiratory illnesses. If a patient is already combating other diseases, it can cause further complications when they are diagnosed with mesothelioma.

Bettering your lifestyle after a mesothelioma diagnosis can improve your quality of life and maybe your prognosis. Living a healthy lifestyle could make you strong enough for a surgery that improves your prognosis by months or years.

Mesothelioma Treatments

The treatment you receive is the most important factor in improving your prognosis. Patients who receive treatment are far more likely to survive longer. The type of treatment a patient undergoes also determines how the disease will progress. For example, surgically removing tumors can double a patient’s life expectancy in many cases.

How patients respond to treatment and their ability to recover from it also plays a large role in their prognosis. Doctors will adjust a prognosis according to how patients have responded to treatment.

Veterans with mesothelioma may be able to access free treatment through the VA Health Care System. Some of the best mesothelioma surgeons handle cases within VA, and offer surgeries proven to improve a prognosis. Talk to one of our veteran’s advocates to learn more about getting treatment in the VA.

Mesothelioma Life Expectancy

Life expectancy means the number of months a mesothelioma patient is expected to live after their diagnosis. It’s important for patients and their families to understand that a life expectancy isn’t a guarantee. It should be regarded as a general expectation based on average cases. It’s also not a death sentence.

There are many options for improving your life expectancy. Be sure to discuss these options with your specialized health care team.

Different diagnoses, such as location, stage or cell type have different life expectancies. In general, mesothelioma patients can expect to live anywhere between 12 and 21 months with their disease.

Here are the life expectancies based on mesothelioma location:

• Pleural Mesothelioma: 12-21 months
• Peritoneal Mesothelioma: 12-54 months
• Pericardial Mesothelioma: 6-12 months

Here are the median life expectancies based on pleural mesothelioma stage:

• Stage 1: 21 months or more
• Stage 2: 19 months
• Stage 3: 16 months
• Stage 4: 12 months

Here are the life expectancies based on cell type:

• Epithelioid: 19-27 months
• Sarcomatoid: 8-18 months
• Biphasic: 10-21 months

Patients today have much higher life expectancies than patients diagnosed 10 years ago. Treatments, especially surgeries, can drastically increase a patient’s life expectancy. Most patients are given a life expectancy of around 12 months.

Mesothelioma Survival Rates

Mesothelioma patients may hear the terms life expectancy and survival rate used interchangeably. They provide the similar data but in different ways.

Life expectancy is given in months or as a time range (i.e. 12-18 months). Survival rate is given as a percentage of patients who survived for a certain period of time after their diagnosis. Survival rates are usually given for 12 months, 3 years or 5 years after diagnosis.

Improving Survival Rates

Survival rate data, like life expectancy averages, is not always reliable. Survival rates take into account all past cases. This includes patients who didn’t receive treatment at all and patients who didn’t receive treatment from a specialist. But survival rates can’t factor in cases of patients currently living, some of whom have lived years past their diagnosis. This results in skewed data.

Recent studies focus on ways to improve the data published on mesothelioma survival rates. Some studies look specifically at how survivorship has increased over the past 20 years thank to advanced treatment.

Here are some of the most favorable survival rates from this study:

• 1-year survival rate: 73% for pleural mesothelioma and 92% for peritoneal mesothelioma
• 3-year survival rate: 23% for pleural mesothelioma and 73% for peritoneal mesothelioma
• 5-year survival rate: 12% for pleural mesothelioma and 65% for peritoneal mesothelioma

The study also revealed that nearly 40% of peritoneal mesothelioma patients are living past 10 years thanks to a specialized treatment called cytoreduction with HIPEC.

Survivors

If you or a loved one have been diagnosed with mesothelioma, it’s important to know that there are many stories of survivors. These are mesothelioma patients who were once told they’d only have a few months left. But, thanks to specialized treatments, these patients have gone on to be declared survivors.

Some examples of mesothelioma survivors include:

David B — 7-Year Survivor

In 2010, 63-year-old David was diagnosed with stage 4 mesothelioma. He was given only a few months to live. However, David underwent an emerging chemotherapy treatment that has allowed him to survive well past his initial prognosis.

Sandy M — 6-Year Survivor

In 2011, Sandy was diagnosed with pleural mesothelioma. She underwent multiple surgeries and eventually had a pleurectomy in 2012. Thanks to this aggressive surgery, Sandy has survived well past her initial prognosis.

Tom G — 15-Year Survivor

In 2002, Tom was diagnosed with pleural mesothelioma. His initial life expectancy was 12 months. Tom underwent an extrapleural pneumonectomy 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.

Remission

While there is no cure for mesothelioma, patients may be able to achieve remission. Remission occurs when doctors can no longer find any evidence of disease activity in a patient. Remission happens because the treatments the patient underwent were successful.

The types of treatment that can help patients achieve remission include:

• Aggressive curative surgeries
• Chemotherapy
• Radiation therapy
• Emerging treatments in clinical trials

Though successful treatments can send patients into remission, there is always a chance that the mesothelioma will return. How long a patient remains in remission depends on factors like the patient’s health level.

Patients can increase their chances of staying in remission by maintaining good overall health and adopting healthy lifestyle habits that support their immune system.

Improving Your Prognosis

Patients should never assume the worst when they receive an initial prognosis. There are always options for increasing life expectancy and improving quality of life. Patients should work with their health care team to learn all the available options for fighting mesothelioma.

Here are some of the ways to take charge and improve your mesothelioma prognosis:

• Ask your doctor about all available treatment options
• Participate in clinical trials so you can take advantage of new treatments
• Maintain a healthy diet and exercise routine
• Quit smoking and reduce alcohol consumption
• Pursue physiotherapy that reduces pains and improves mobility

It’s also important to remain in regular communication with your health care team. If you notice any changes in your overall health, tell your doctor. They will be able to adjust your treatments or add new ones accordingly.

Ask your doctor today about the options veterans have for improving their prognosis. By taking charge of your treatment plan, you can far outlive your initial prognosis. Learn more about prognosis in our free Mesothelioma Veterans Packet.