Mesothelioma Prognosis

Quick Summary

A mesothelioma prognosis describes the expected outcome of a patient’s cancer. Mesothelioma generally has a poor prognosis, but treatments are helping more people live longer. Thankfully, veterans with mesothelioma may be able to access treatment from the U.S. Department of Veterans Affairs (VA) or private doctors 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 is how doctors describe the expected health outcomes after someone is diagnosed. A prognosis takes two main factors into account: 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 12-21 months for patients with pleural mesothelioma and over 60 months for those with 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..

Improving Mesothelioma Prognosis

Many patients feel discouraged by their prognosis, as mesothelioma is highly aggressive and there is no known cure. However, a mesothelioma prognosis is not set in stone.

In fact, some patients who were originally given a poor prognosis went on to live for many months or years longer than expected.

Here are some tips to improve your mesothelioma prognosis:

Work with a mesothelioma specialist
Oncologists (cancer doctors) across the country specialize in treating different forms of this cancer. Some of these doctors created groundbreaking treatments to help patients live longer. Working with these experts offers you the best chance of improving your prognosis. Several specialists have partnered with the VA to provide treatments to veterans with mesothelioma.

Undergo surgery
Mesothelioma surgeries allow doctors to remove all visible traces of the cancer, preventing it from spreading. While not every patient will qualify — as the side effects can be risky — most mesothelioma specialists agree that surgeries offer the best chance to improve lifespan.

Get support
A mesothelioma diagnosis can bring a lot of stress and uncertainty to you and your loved ones. With help from friends, extended family, Veterans Service Officers (VSOs), and even mesothelioma attorneys, you can get the emotional and financial support needed to battle this cancer.

Factors That Determine Mesothelioma Prognosis

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

Key prognostic factors 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. Thankfully, there are treatment options to help patients live longer no matter what type of mesothelioma they have.

Get more information about the factors that affect prognosis in our free mesothelioma packet made for veterans.

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Pleural Mesothelioma Prognosis

Pleural mesothelioma, which develops in the lining of the lungs, is often diagnosed in its later stages. A late mesothelioma diagnosis makes 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 as the cancer is still largely contained to the lung linings.

Those in advanced stages (3 and 4) have a worse prognosis as the cancer may have spread to the lymph nodes and throughout the body.

Stage	Median Life Expectancy
Stage 1	21 months
Stage 2	19 months
Stage 3	16 months
Stage 4	12 months

Source: Frontiers in Oncology, 2018

Peritoneal Mesothelioma Prognosis

Malignant peritoneal mesothelioma, which develops in the peritoneum (abdominal lining), has the best prognosis of all types due to advancements in treatment options.

This type of mesothelioma has a median survival time of roughly 63 months. Roughly 65% of patients live for at least 5 years after their diagnosis.

Those with peritoneal mesothelioma have a better prognosis if they are diagnosed before their 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 may opt for palliative treatments to improve their quality of life.

Prognosis of Other Mesothelioma Types

Pericardial mesothelioma has the worst prognosis of any type of mesothelioma. 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 roughly 6 months.

On the other hand, testicular mesothelioma has a relatively good prognosis. Patients with testicular mesothelioma can expect to live 26-36 months on average if they are diagnosed early and undergo surgery.

Mesothelioma Cell Type

In addition to where the cancer develops in the body, a patient’s cell type (histology) impacts a mesothelioma prognosis as well. Some types of mesothelioma cells respond better to treatment, leading to an improved 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 an average life expectancy of 18 to 23 months depending on their treatment plan, according to the American Society of Clinical Oncology (ASCO).

Sarcomatoid Mesothelioma Prognosis

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

The average life expectancy for patients with sarcomatoid cells is just 3.5-8 months.

Biphasic Mesothelioma Prognosis

Biphasic tumors contain both epithelial and sarcomatoid cells. Because of this, the prognosis for biphasic mesothelioma can vary depending on how many epithelioid and sarcomatoid cells are present. If more epithelioid cells make up the tumors, the patient may have a better prognosis.

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, as noted by researchers who studied the National Mesothelioma Tumor Bank.

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. The three most common forms of mesothelioma treatment to improve life expectancy are surgery, chemotherapy, and radiation therapy.

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

There are two main surgeries used to treat pleural mesothelioma:

Extrapleural pneumonectomy (EPP): This surgery removes the lung closest to the cancer, the lung lining, and all visible cancer tumors. Patients have an average life expectancy of 35.6 months. The typical 5-year survival rate following this surgery is 25%.
Pleurectomy with decortication (P/D): With this surgery, doctors remove the lung lining and cancerous tumors but keep both lungs intact. The average life expectancy following this surgery is 33 months, and the 5-year survival rate is 49%.

The most commonly used surgery to treat peritoneal mesothelioma is cytoreductive surgery. This surgery removes visible cancer tumors from the abdomen lining. Once the surgery is complete, doctors bathe the abdomen in heated chemotherapy drugs.

Following this procedure, patients have an average life expectancy of 53 months. The 5-year survival rate is 47%.

Outside of surgery, chemotherapy is used by almost all mesothelioma oncologists. 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 — is crucial to helping patients live for years afterward. It kills microscopic cancer cells that surgeons couldn’t remove.

Radiation therapy may also be used to supplement surgery. Studies have shown that when used after surgery, radiation increased median life expectancy by more than a year in some cases. Radiation is also useful as a palliative treatment to improve quality of life for mesothelioma patients.

Finally, clinical trials may offer other ways to improve a mesothelioma prognosis outside of standard treatment options. Clinical trials test new treatments to see if they improve quality of life and/or lifespan.

Newer mesothelioma treatments such as immunotherapy and tumor treating fields (TTFields) were approved for mainstream use after clinical trials successfully showed they could help patients live longer.

Mesothelioma Prognosis Without Treatment

The prognosis for mesothelioma patients who do not undergo cancer treatment is very poor.

For example, the average life expectancy of a pleural mesothelioma patient who receives treatment is 12-21 months. Without treatment, it ranges from 4-12 months.

Demographic Factors Affecting Mesothelioma Prognosis

Demographic traits also may impact a mesothelioma patient’s prognosis. Demographic factors include a person’s age, gender, and race.

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 tend to have better overall health and can often withstand aggressive treatments.

Age	5-Year Survival Rate
<50	42.1%
50-64	16%
>64	7.7%
Average of All Ages	11.5%

Source: SEER 5-year relative survival rates for mesothelioma, 2011-2017

Gender

Female patients have a better prognosis than male patients.

The Surveillance, Epidemiology, and End Results (SEER) program found that the 5-year survival rate of women diagnosed with mesothelioma was 18.2%. The average 5-year survival rate for men was just 9.1%.

Race

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

Race	5-Year Survival Rate
Black	14%
White	11%
Asian/Pacific Islander	9%

Source: SEER 5-year relative survival rates for mesothelioma, 2011-2017

Mesothelioma Prognosis and Survival

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

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 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.

Learn more about long-term mesothelioma survivors in our free veterans packet.

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Treatment Options
Mesothelioma Specialists
Veterans Benefits

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Can Mesothelioma Go Into Remission?

In some cases, mesothelioma treatment is so successful that the cancer goes into remission. Mesothelioma remission means the cancer is no longer growing, according to the American Cancer Society (ACS).

Mesothelioma remission is not the same as a cure, but it can extend lifespan by months or even years. In some cases, elderly patients with mesothelioma successfully went into remission and did not have their cancer return before they passed away.

What Is Mesothelioma Recurrence?

Mesothelioma recurrence is when the cancer comes back after going into remission. Despite treatments, microscopic cancer cells may still exist in the body. These cancer cells can then multiply and cause tumors to regrow.

Fortunately, mesothelioma specialists can recommend treatments to patients in the event of a recurrence that can help them live longer.

“Our patients are then monitored closely with regular CT scans and follow-up visits every three to six months. At the first sign of tumor recurrence, we are able to utilize one of a number of treatments, such as radiation, chemotherapy and cryoablation to attack it.”

– Dr. Robert Cameron

Take Action to Live Longer With Mesothelioma

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 VA Health Care System.

Mesothelioma specialists at VA hospitals and other cancer centers often have decades of experience. Qualifying patients may be able to access some of the most effective treatments and therapies.

If you have questions about your mesothelioma prognosis, give us a call today or get your free veterans packet.

Questions About Mesothelioma Prognosis

Is mesothelioma always fatal?

No. While often fatal, many mesothelioma patients have been able to live for years or decades despite initially poor prognoses. Depending on treatments and individual factors, some people have lived for 15-20 years after their diagnosis.

Is there a cure for mesothelioma?

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

Doctors, researchers, and nonprofit organizations continue to study new mesothelioma treatments and search for a cure.

For example, doctors recently approved immunotherapy as a mainline treatment for mesothelioma after encouraging results in clinical trials. A notable 2020 trial found that immunotherapy kept more patients alive for longer periods of time when compared to chemotherapy.

Can a mesothelioma prognosis change?

Yes. Some patients who were initially given a very poor mesothelioma prognosis surprised their medical teams by living months or years longer than expected.

Your mesothelioma prognosis may change depending on how the cancer responds to treatments. When you work with leading mesothelioma specialists, they can recommend treatments designed to help you live longer.

See if you could connect with a mesothelioma specialist by calling (877) 450-8973.

Reviewed 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.

Written by:Christopher Dryfoos

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.

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