Mesothelioma Prognosis

Quick Summary

A mesothelioma prognosis describes the expected outcome of a patient’s cancer. Mesothelioma generally has a bad prognosis, but veterans with this cancer may be able to access free treatment through the VA Health Care System.

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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 patients are older when diagnosed so their prognosis can feel discouraging, but it is not final. By seeking prompt medical treatment, mesothelioma patients may be able to extend their prognosis by months or even years.

Factors That Determine Mesothelioma Prognosis

A patient’s individual traits play a major role in determining this outcome.

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

Certain mesothelioma types (peritoneal vs pleural) 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 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

Pleural mesothelioma has 4 stages, which greatly affect a patient’s prognosis. In general, early stages (stages 1 and 2) have better prognoses, while more advanced stages (stages 3 and 4) have worse prognoses.

Pleural mesothelioma has 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

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

Peritoneal Mesothelioma Prognosis by Stage

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

When peritoneal mesothelioma is diagnosed early — in other words, before the cancer has spread from the abdominal area — it has the most favorable prognosis. In these cases, a combination of surgery and chemotherapy is usually successful at extending patients’ lifespans.

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 it 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 this rare mesothelioma type can expect a median life expectancy of 23 months if they are diagnosed early and undergo curative surgery.

Mesothelioma Cell Type

In addition to mesothelioma type, a patient’s cell type (histology) may significantly 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 largely 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 face a significantly 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

Because biphasic tumors contain both epithelial and sarcomatoid cells, 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 mesothelioma, 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 patients and generally improves prognosis. The extent of improvement depends on both the type of chemotherapy and the mesothelioma location.

For example, hyperthermic intraperitoneal chemotherapy (HIPEC) — a special type of 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 together with surgery or chemotherapy, a technique called multimodal treatment, radiation can also help to extend survival and improve prognosis.

Studies have shown that when used after surgeries like pleurectomy with decortication (P/D), it can lead to significant increases in median life expectancy — more than a year, in some cases.

Mesothelioma Prognosis Without Treatment

Without cancer treatment, the prognosis for mesothelioma patients is very poor.

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

Demographic Factors Affecting Mesothelioma Prognosis

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


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

This is largely because younger people have better overall health and can better withstand aggressive treatments in most cases.

Age5-Year Survival Rate


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


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%
Asian/Pacific Islander8.1%

Mesothelioma Prognosis and Survival

Can I Survive Mesothelioma?

Although it is rare, long-term survival does happen, 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 multiple surgeries and eventually had a pleurectomy in 2012. Thanks to this aggressive 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 has allowed him to survive well past his initial prognosis.
  • 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.

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

– Abramson Cancer Center

What Is Mesothelioma Recurrence?

Mesothelioma recurrence occurs when the cancer comes back after going into remission. In some cases, recurrent cancers become resistant to treatment, worsening the patient’s prognosis.

Improve Your Mesothelioma Prognosis

Veterans have access to some of the world’s leading 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 with this cancer, 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.

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