Mesothelioma Life Expectancy

Understanding Life Expectancy

Life expectancy is the expected survival time of cancer patients. Life expectancy is typically measured in months. The median life expectancy for mesothelioma patients is 12 to 21 months.

Here are the life expectancies of mesothelioma based on stage:

• Stage 1 — 21 months
• Stage 2 — 19 months
• Stage 3 — 16 months
• Stage 4 — 12 months

The stage isn’t the only factor in life expectancy. According to statistics, the median survival for all mesothelioma patients is 17.5 months, but this doesn’t explain the difference in cell types or treatment among these patients. For example, patients with epithelioid cell type respond the best to surgery. One study tested trimodality therapy with chemotherapy, radiation and surgery. Over 87% of patients had an epithelioid tumor and 67% had stage 3 Pleural Mesothelioma. The median survival for patients was 35.6 months. This is double the median survival of all stage 3 mesothelioma. This is because some stage 3 patients have different cell types and metastasis.

If you have an advanced diagnosis, you may not be a candidate for curative treatments like surgery. Treatment for advanced mesothelioma is palliative, it helps relieve pain and lets patients live out their lives more comfortably.

Understanding the Median Survival Time

Life expectancy can be measured as an average or a median. Doctors would rather use a median survival time because averages can be misleading. There are always patients with unusual survival times. They can sway the average in a way that doesn’t represent the typical mesothelioma patient.

For example, if there are a few patients who only lived a few months, the average survival time will be lower than normal. The median picks the survival time of the patient at the very middle. The median survival of 21 months shows that half of all patients lived longer than the median.

Let’s take a hypothetical example of 5 patients to explain median and average survival. First, note that this is only an example. A true statistical analysis would require many more than 5 patients.

Here is an example of 5 patients with mesothelioma:

1. Patient 1: John
   • Stage 2, mostly healthy
   • EPP surgery with chemotherapy
   • Lives 4 years after diagnosis
2. Patient 2: Marco
   • Stage 3
   • Takes part in a clinical trial of P/D surgery with radiation
   • Lives 2.5 years after diagnosis
3. Patient 3: Sam
   • Stage 3 patient with a heart condition
   • Surgery is not possible
   • Lives for 15 months with chemotherapy
4. Patient 4: Frank
   • Stage 4 diagnosis after ignoring symptoms for more than a year
   • Previous history of smoking and heart disease
   • Lives for 1 month after diagnosis
5. Patient 5: Stanley
   • Stage 1 diagnosed in his 50’s
   • Very healthy compared to other mesothelioma patients.
   • After surgery and other treatments, lives 7 years after diagnosis.

Of these 5 patients, the average survival time is 35.6 months. But Frank and Stanley are not typical cases. Take away Frank and the average goes up to 44.3 months. Take away Stanley and the average plummets to 23.5 months.

The median explains life expectancy more accurately. The median in this example is 30 months. While this is only an example, it paints a picture of why patients shouldn’t look at the statistics too much. It also goes to show that some patients live well beyond the median with the right treatment.

Things that Impact Life Expectancy

Your life expectancy depends on several factors, including:

• Age. The older you are, the shorter is your life expectancy. Older mesothelioma patients don’t tolerate treatments as well as younger patients. Older patients may not be offered the most aggressive treatments. In one study, those diagnosed at age 65 or younger lived about 359 days after diagnosis. Those 65-74 years of age lived about 242 days.
• Stage. Stage 1 and stage 2 patients have the best survival times. Their cancer hasn’t yet spread to distant areas, giving them more Treatment Options. There is treatment for all mesothelioma stages.
• Mesothelioma location. People with Peritoneal Mesothelioma tend to live longer than those with Pleural Mesothelioma. Pericardial mesothelioma patients have the shortest life expectancy because it’s so rare.
• Cell type. Mesothelioma has several cell types. Epithelioid mesothelioma patients respond to treatment better than sarcomatoid patients. This is because epithelioid cells spread slower than sarcomatoid cells. So patients with epithelioid mesothelioma live longer on average. Those that have mixed type mesothelioma have an uncertain life expectancy. Generally, the more epithelioid cells you have, the better your prognosis.
• Gender. There are far more men with mesothelioma than women. Yet, women tend to have a better life expectancy. This difference in life expectancy is slight but statistically significant. Scientists aren’t quite sure why women fare better.
• Overall health. Those who are in good health live longer than those who are in poor health. That’s no secret, and it applies to mesothelioma patients. For example, an anemic patient may have a shorter life expectancy than one who isn’t. Patients without coexisting health problems are better candidates for surgery. They also respond to treatment better because they can recover faster.
• Surgical treatment. There are several surgeries for mesothelioma. Surgical treatments drastically improve life expectancy for mesothelioma patients. The authors of one study in 2017 said, “While the best approach to malignant Pleural Mesothelioma has yet to be demonstrated, surgery remains the mainstay of treatment.” Surgery can extend your life expectancy by years, even leading to remission.

Surgery and Life Expectancy

Specialists and researchers widely regard surgery as the best way to extend your survival time. Surgery combined with other treatments can extend life expectancy by months or even years because surgery removes visible tumors. This is where most cancer cells are found. By removing these tumors, there are fewer mesothelioma cells in the body with the ability to spread. This slows the overall progress of the disease.

There are countless studies that show the benefits of surgery on life expectancy. In these studies, researchers refer to life expectancy as the “median survival time.” This median survival refers specifically to the patients in a certain study. We can compare the median survival time in these studies to the average life expectancy of mesothelioma patients. This gives us a picture of how much surgery helps.

Here are some examples of how surgery has improved patient survival time:

• Extrapleural pneumonectomy and radiation. Patients in this study had a median survival time of 25.5 months. They received a high dose of radiation after EPP. Patients who had this treatment were in either stage 1, 2 or 3 Pleural Mesothelioma.
• EPP with heated chemotherapy. There were 24 patients evaluated in the study who had either stage 1 or 2 mesothelioma. They had EPP and intraoperative chemotherapy. The median survival for these patients was 39 months. Pleurectomy with heated chemotherapy. There were 41 patients who had P/D and heated intraoperative chemotherapy. The average patient was 68 years old with an epithelioid cell type. The median survival was 49 months for epithelioid types. Biphasic and sarcomatoid cell type patients had a survival time of 21 months.
• Pleurectomy and photodynamic therapy. A group of patients in stage 3 and 4 mesothelioma had P/D plus photodynamic therapy. The median survival for all patients was 31.7 months. Patients with no lymph node involvement had a median survival of 57 months.
• Pleural Mesothelioma surgery plus intraoperative chemotherapy. One study found that patients who received EPP or P/D plus heated intraoperative chemotherapy lived longer. 72 patients who had surgery plus chemotherapy had a median survival of 35.3 months. The group that only had surgery had a median survival of 22.8 months.
• Surgery for Peritoneal Mesothelioma. Cytoreduction with HIPEC (heated intraperitoneal chemotherapy) extends life expectancy by years. A 2013 study found the median survival was 63.2 months or about 5.3 years. The authors also remarked that patients surviving longer than 7 years “appeared to be cured” and that the “cure rate was 43.6%.”

Extending Your Life Expectancy

Finding a mesothelioma specialist is the first step toward improving your prognosis. These doctors have an in-depth understanding of mesothelioma and can guide you toward the best Treatment Options.

When thinking about life expectancy, remember that:

• Survival times are just numbers
• Many patients outlive their initial prognosis
• There are people ready to help right now

Surgery is the best way to improve your prognosis. If you’re ready, get help finding a mesothelioma surgeon now. If you’re not eligible for surgery, you might want to consider a second opinion.