A prognosis is the expected outcome of a disease. In general, a mesothelioma prognosis is poor. The cancer is typically not caught until after it has spread, and there is no cure. However, a prognosis can change over time — and patients may improve their prognosis by seeking the best doctors and treatments.
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 mesothelioma 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 mesothelioma prognosis.
Some people have lived well past their mesothelioma prognosis. Some patients were told they had months to live and defied the odds by living 10-15 years after their initial diagnosis.
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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.
Many of the mesothelioma life expectancy statistics and survival rates are outdated. Mesothelioma research is advancing rapidly. New treatments under development are drastically improving prognoses. Many of these success stories aren’t included in the current data.
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 mesothelioma 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 received a mesothelioma diagnosis.
They determine a mesothelioma 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
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. 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.
Pleural mesothelioma is diagnosed using a staging system from 1 to 4. Looking at stages of mesothelioma 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
Cell type also factors into a patient’s mesothelioma prognosis. Mesothelioma 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 mesothelioma cells spread the least aggressively, making them easier to treat and gives it the best prognosis.
- Sarcomatoid mesothelioma cells spread the most aggressively, making this cell type more difficult to treat and giving it the worst prognosis.
- Biphasic mesothelioma 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.
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Health level is a significant factor in a patient’s mesothelioma 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.
The treatment you receive is the most important factor in improving your mesothelioma prognosis. Patients who receive mesothelioma 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.
A 2014 study evaluated pleural mesothelioma patients eligible for surgery. Patients who had surgery followed by a high dose of radiation therapy had a median survival of 33 months. Over half of the patients were still alive 3 years later.
How patients respond to treatment and their ability to recover from it also plays a large role in their mesothelioma 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.
Mesothelioma Life Expectancy
The number of months a mesothelioma patient is expected to live after their diagnosis is called mesothelioma life expectancy. 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 Mesothelioma12-21 months
- Peritoneal Mesothelioma12-54 months
- Pericardial Mesothelioma6-12 months
Here are the median life expectancies based on pleural mesothelioma stage:
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.
Pleural mesothelioma patients who undergo either an extrapleural pneumonectomy (EPP) or a pleurectomy with decortication (P/D), have a median life expectancy of roughly 2 years instead of 12 months. And peritoneal mesothelioma patients who undergo cytoreduction with HIPEC have a median survival time of 4-5 years.