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Mesothelioma Life Expectancy, Prognosis And Treatment Options

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Mesothelioma Life Expectancy, Prognosis And Treatment Options

Mesothelioma Life Expectancy and Prognosis

When doctors talk about a mesothelioma cancer patient’s prognosis, they are determining the overall outlook for that specific individual. Typically, when patients inquire about their mesothelioma prognosis, what they’re interested in is information about life expectancy.

Mesothelioma patients have an average life expectancy of 14 to 22 months after diagnosis. Approximately 40% of pleural mesothelioma patients survive at least one year after diagnosis. The prognosis for mesothelioma is considered poor because it has no cure. Treatment can improve a patient’s prognosis.

While there is no total treatment, the outlook for each patient varies depending on factors such as the patient’s age, overall health, how early a diagnosis is made and if their prognosis can be improved with treatment and the adoption of a healthy lifestyle.

A mesothelioma prognosis is what doctors describe as an overall outlook for a specific patient.

Mesothelioma is an aggressive cancer with an average life expectancy of 14 to 22 months after diagnosis.

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The prognosis for mesothelioma is often measured in terms such as “good,” “favorable,” “bad” or “poor” based on how the cancer is expected to progress. It includes the prospect of recovery and helps determine what treatment options may be available.

The prognosis for most mesothelioma patients is generally poor because there is no cure for this disease.

When patients ask about their prognosis, what they usually want to know is how long they will live.

Key Factors

Stage and cell type are factors that most affect mesothelioma prognosis. Age, gender and overall health also affect outlook. Younger patients and women have a better mesothelioma prognosis than older men. People diagnosed with the peritoneal mesothelioma type also have a greater chance of survival.

Prognostic Terms

Life Expectancy: The term “life expectancy” refers to the average age a person or population is expected to live based upon their location and other demographics. Mesothelioma can shorten a person’s life expectancy by several years or decades. It all depends on their age at diagnosis and how long they live with mesothelioma.

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For example, a healthy 70-year-old man has a life expectancy of 14 years. If he is diagnosed with stage 4 mesothelioma, his life expectancy is reduced to two years.

Survival Rates: Survival rates measure how long most people live with mesothelioma. Your prognosis is primarily based on the cancer’s average survival rates.

The National Cancer Institute says the five-year survival rate for mesothelioma was 9% between 2007 and 2013.

Death Rates: A cancer’s death rate, also called mortality rate, describes how many people die from the cancer. It plays a role when doctors estimate a patient’s prognosis.

Mesothelioma mortality rates are often defined in relation to patient age, gender, race and state of residence.

Ways to Improve Prognosis

Eating a nutrient-rich diet, staying healthy, undergoing cancer treatments and making healthier lifestyle choices can improve malignant mesothelioma prognosis and well-being. For example, quitting smoking and receiving flu and pneumonia vaccinations improves lung function and overall health.

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How Long Can People Live with Mesothelioma?

Most patients live about one year after being diagnosed with mesothelioma.

How long you live with mesothelioma depends on the stage you are diagnosed at and how well you respond to mesothelioma treatments.

Early-Stage Prognosis

People diagnosed early, in stage 1 or stage 2, often qualify for surgery, which offers the best chance at long-term survival. Approximately 20% of pleural mesothelioma patients are diagnosed early enough to qualify for surgery. Stage 1 patients who undergo surgery have a median life expectancy of 22.2 months.

Late-Stage Prognosis

Most patients are diagnosed late, at stage 3 or 4, and do not qualify for surgery. Stage 4 mesothelioma patients who undergo treatment have a median life expectancy of 14.9 months.

Although statistics play a part in determining your prognosis, every mesothelioma case is unique.

Some mesothelioma patients are beating the typical outlook thanks to advances in treatment and care. Survivors credit life span increases to multimodal treatment, improvements in their diet and complementary therapies.

Improving a Mesothelioma Prognosis

Image Credit: Asbesto.com
Average life expectancy of mesothelioma patients who undergo treatment

You can choose to be proactive and take steps to improve your prognosis. You can’t change important prognostic factors such as your age, mesothelioma type or cancer stage. But, you can improve your overall health and elect anti-cancer treatment such as chemotherapy.

In addition to undergoing treatments that control the cancer, you should follow a healthy nutrition plan with a well-balanced diet. Good nutrition can also ease treatment side effects and cancer symptoms.

Treatment Options for Mesothelioma

The most effective treatments for mesothelioma include surgery and chemotherapy. Radiation therapy and immunotherapy play a role in multimodal therapy and clinical trials.

Most patients are diagnosed too late to qualify for surgery and only undergo chemotherapy. Chemotherapy, radiation therapy and immunotherapy are available for patients at all stages.

Experimental therapies, such as immunotherapy and photodynamic therapy, are available through clinical trials and compassionate use programs.

Cancer therapies are expensive, but many patients are eligible for financial compensation to cover the costs of mesothelioma treatment. Veterans with mesothelioma may qualify for free or low-cost treatment at a VA hospital.

A specialized mesothelioma lawyer can advise patients on other possible sources of compensation.

Mesothelioma Prognosis After Chemotherapy

The chemotherapy response rate is nearly 50%. This means about half of mesothelioma patients experience tumor shrinkage or no new tumor growth for a period of time.

A 2016 study published in the journal Clinical Epidemiology found that patients receiving chemotherapy lived an average of 12 months, while those who elected no treatment lived an average of four months.

Mesothelioma Prognosis After Surgery

People diagnosed with stage 1, 2 or 3 pleural mesothelioma may qualify for aggressive surgery. Tumor-removing surgery offers the greatest opportunity for long-term survival. Surgery can involve removal of an entire lung, part of the lung or only the removal of the lining of the lung, known as the pleura.

Many people wonder if a person can live with one lung, and the answer is yes. Surgery is regularly combined with chemotherapy and sometimes radiation therapy or immunotherapy. It can improve survival by years in some patients.

Patients with peritoneal mesothelioma can improve their prognosis with a combination of surgery and hyperthermic intraperitoneal chemotherapy (HIPEC).

It involves adding chemotherapy drugs to a heated saline solution and pumping it directly into the patient’s abdomen. Research shows roughly half of patients who underwent this procedure survived more than five years.

Mesothelioma Prognosis After Radiation Therapy

Radiation therapy on its own is used to shrink painful tumors growing into the chest wall. This application does not directly impact prognosis.

When combined with other therapies, such as surgery, radiation therapy can help delay or prevent local cancer recurrence.

Prognosis by Mesothelioma Type

Pleural Mesothelioma Prognosis

Research shows approximately 40% of pleural mesothelioma patients survive at least one year after diagnosis.

Some patients who undergo multimodal treatment and complementary therapies survive several years after diagnosis. About 9% of patients with pleural mesothelioma survive more than five years.

Peritoneal Mesothelioma Prognosis

The prognosis for peritoneal patients is typically favorable when compared to other forms of mesothelioma cancer.

Peritoneal mesothelioma patients survive approximately six to 12 months without cancer treatment. However, the prognosis for surgical candidates is significantly better. About half of peritoneal patients who receive surgery with heated chemotherapy live longer than five years.

Prognosis for Rare Mesothelioma Types

Prognosis for pericardial mesothelioma is generally poor. Around half of patients survive six months. Rare cases of five-year survival have been reported and usually involve treatment including surgery and chemotherapy.

Although testicular mesothelioma is the rarest type, its prognosis is typically the best. Average survival is around two years and some patients live more than a decade.

Prognosis by Mesothelioma Stage

Mesothelioma Prognosis at Stage 1

Patients diagnosed with stage 1 mesothelioma have the best prognosis. Aggressive treatments are recommended to people in otherwise good health.

  • Stage 1A: The two-year survival rate is 46% and the five-year survival rate is 16%.
  • Stage 1B: The two-year survival rate is 41% and the five-year rate survival is 13%.
  • Median overall survival at stage 1 is 22.2 months with surgery.

Mesothelioma Prognosis at Stage 2

Patients diagnosed with stage 2 mesothelioma have a better prognosis than late-stage patients. Aggressive treatment plans are also recommended at this stage.

  • The two-year survival rate for pleural mesothelioma is 38% and the five-year survival rate is 10%.
  • Median overall survival at stage 2 is 20 months with surgery.

Mesothelioma Prognosis at Stage 3

Prognosis becomes more unfavorable for patients diagnosed in stage 3. Some stage 3 mesothelioma patients qualify for aggressive treatment plans.

  • Stage 3A: The two-year survival rate is 30% and the five-year survival rate is 8%.
  • Stage 3B: The two-year survival rate is 26% and the five-year survival rate is 5%.
  • Median overall survival at stage 3 is 17.9 months with surgery.

Mesothelioma Prognosis at Stage 4

The prognosis for patients with stage 4 mesothelioma is generally poor. Palliative treatments are recommended at this stage to control symptoms and extend survival as long as possible.

  • The two-year survival rate for pleural mesothelioma is 17% and the five-year survival rate is less than 1%.
  • Median overall survival at stage 4 is 14.9 months with treatment.

Other Factors Affecting Mesothelioma Prognosis

Cell Type

The types of cells that make up the tumor can impact your prognosis.

  • Epithelioid cells: Patients with this cell type tend to live longer than those with other cell types. People with epithelioid tumors live an average of 200 days longer.
  • Sarcomatoid cells: These cells are associated with the poorest prognosis because they are considered more aggressive and harder to treat.
  • Biphasic cells: The prognosis for this type depends on the ratio of sarcomatoid to epithelial cells. The more epithelial cells, the better the prognosis.

Biological factors may impact the typical prognoses associated with cell types. For example, according to a 2020 study published in Oncology Reports, the prognosis of epithelioid patients is affected by a protein called connective tissue growth factor. Those with lower levels of the protein had a better prognosis and longer survival.

Age

Younger people have a better prognosis with mesothelioma than older people. More than half of patients diagnosed under age 50 live at least a year with mesothelioma. Under a third of patients diagnosed over age 75 live that long.

Gender

Gender has a significant impact on mesothelioma prognosis. Women with mesothelioma live longer than men do.

Researchers do not fully understand why women live longer. They suspect that hormones may play a role. They do know that women are more often diagnosed with peritoneal mesothelioma. Peritoneal carries a better prognosis than pleural mesothelioma.

Race

Race plays a role in mesothelioma prognosis. In 2013, the five-year survival rate was 8.7% for whites and 10% for blacks.

Black women tend to live the longest with mesothelioma. In 2013, the five-year survival rate was 13.6% for white women and 30.1% for black women.

Mesothelioma Remission and Recurrence

A cancer’s prognosis includes the chances of recovery, which is called remission. It involves a measurable tumor size decrease, which can be described as partial or complete.

  • Remission is partial when the cancer shrinks in size. Partial remission usually involves at least a 50% reduction in tumor size.
  • Remission is complete when the cancer disappears entirely.

Complete remission is rare with mesothelioma. Partial remission is more common. Patients can live for years in partial remission.

Unfortunately, mesothelioma tends to recur whether partial or complete remission is achieved. When mesothelioma recurs, it usually recurs locally or regionally rather than distantly.

Clinical Trials

Many clinical trials look for patients with a mesothelioma recurrence to test new and innovative therapies. They test second-line therapies to control the cancer when it recurs.

The goal of these trials is to find more ways to keep mesothelioma in control once it returns. Researchers need a wide range of participants. Patients with prior treatment who are now living with an advanced disease are ideal candidates for clinical trials.

Some clinical trials are also investigating new ways to measure a patient’s mesothelioma prognosis. In 2021, clinical researchers determined that a specific protein, called programmed death-ligand 1 (PD-L1), plays a central role in the antitumor immune response. The scientists concluded PD-L1 could be a predictor of prognosis and efficacy for PD-L1 and programmed death 1 (PD-1) blockade therapy.

Frequently Asked Questions (F.A.Q) About Mesothelioma Prognosis

Question: Is mesothelioma always fatal?

Answer: Mesothelioma is not always fatal. A small number of patients have outlived their prognosis by more than a decade and died of another cause.

Question: How can mesothelioma clinical trials improve prognosis?

Answer: Mesothelioma clinical trials conduct research with the goal of improving prognosis and finding a cure. They improve prognosis by discovering more effective treatment options.

Question: How can a mesothelioma specialist improve prognosis?

Answer: Mesothelioma specialists have spent years learning about mesothelioma treatment, and they know how to treat the cancer better than general oncologists. Working with a specialist is the best way to improve your prognosis.

Question: Will a positive COVID-19 diagnosis affect my mesothelioma prognosis?

Answer: The SARS-CoV-2 virus that causes COVID-19 significantly affects the respiratory tract and can cause permanent damage. Pleural mesothelioma patients have compromised lung function due to cancer surrounding the lungs and chest cavity. A COVID-19 diagnosis can worsen the prognosis for mesothelioma patients due to an increased risk of respiratory complications.

Question: Could having the COVID-19 antibodies impact my prognosis?

Answer: The presence of COVID-19 antibodies in your blood indicates a previous infection of COVID-19 and a lower chance of reinfection. It may mean you have built some immunity to the disease and might positively affect a mesothelioma prognosis. However, the World Health Organization cautions that the degree of COVID-19 protection is currently unknown.

Mesothelioma Treatment Options

The most common treatment for mesothelioma involves a combination of surgery, chemotherapy and radiation therapy. Supportive treatments can help relieve symptoms and improve quality of life for many mesothelioma patients.

Mesothelioma cancer is treated with conventional therapies such as surgery, chemotherapy and radiation, according to the latest study in the American Society of Clinical Oncology. Emerging cancer treatments, including immunotherapy, are also available for some patients. Though not every patient is eligible for each type of mesothelioma cancer treatment, most patients can benefit from palliative care to help manage symptoms.

How Is Mesothelioma Treated?

Current recommendations for treating mesothelioma come from The American Society of Clinical Oncology. This group reviews and implements evidence-based updates on an ongoing basis. Specialists follow these clinical practice guidelines when treating asbestos-related diseases.

TRADITIONAL TREATMENTS

  • Surgery: These procedures are used for diagnosing disease, removing tumors and easing pain. Extrapleural pneumonectomy or pleurectomy and decortication surgeries offer the greatest chance of survival for patients with strong health and limited cancer spread.

    Patients diagnosed in the early stages benefit most from mesothelioma surgery. It offers them the best chance at living longer lives. These procedures, often performed with chemotherapy, remove all visible tumors from the chest area and improve quality of life.

  • Chemotherapy: More than 70% of patients undergo chemotherapy. The therapy’s strong drugs shrink tumors and kill cancer cells but also come with treatment side effects.

    Doctors may recommend chemotherapy to mesothelioma patients deemed ineligible for surgery. Chemotherapy also helps extend survival rates. A 2016 Wayne State University study found patients given a chemo drug combination lived three times longer than patients without it.

  • Radiation Therapy: Radiation therapy can be administered at any cancer stage. Doctors use it to reduce pain and slow tumor growth. It is often combined with surgery and chemotherapy.

    Radiation therapy controls symptoms when surgery is not an option. It eases symptoms such as chest pain and discomfort. Radiation can also reduce the risk of local recurrence when combined with surgery, and it can be used as a palliative procedure.

  • Immunotherapy: Immunotherapy drugs control cancer growth and help some mesothelioma patients live longer. Doctors use immunotherapy at any stage, and success rates vary for each patient.

    Bevacizumab is an ASCO-recommended immunotherapy drug for mesothelioma that uses antibodies to limit tumor growth. Other types of immunotherapy for treating mesothelioma, such as the FDA-approved pembrolizumab (Keytruda), help the immune system identify and kill cancer cells.

  • Tumor Treating Fields (TTFields): This FDA-approved cancer therapy treats pleural mesothelioma. TTFields works in combination with chemotherapy to limit cancer growth and improve survival.

    Tumor Treating Fields, or TTFields, uses alternating electrical fields to disrupt cancer cells and limit growth. FDA approved, and ASCO recommended, a portable battery device delivers this treatment for malignant pleural mesothelioma through the skin via insulated adhesive pads.

  • Clinical Trials: Researchers and doctors offer these experimental therapies to eligible patients across the nation. Mesothelioma clinical trials can lead to new or improved treatments.

  • Multimodal Therapy: Multimodality treatment is the combination of two or more conventional treatments to treat the pleural and peritoneal types of mesothelioma. This combined approach controls cancer growth better than using only one treatment.

Treatments by Mesothelioma Type

The primary treatment options for pleural and peritoneal mesothelioma include surgery, chemotherapy and radiation therapy. These treatments can relieve symptoms, improve prognosis and extend life expectancy.

Benefits and risks of each option depend on cancer type and stage. For example, hyperthermic intrathoracic chemotherapy (HITHOC) for pleural mesothelioma is considered experimental and has not yet yielded the success rate that heated intraperitoneal chemotherapy (HIPEC) has for peritoneal mesothelioma.

TYPES OF MESOTHELIOMA

Pleural Mesothelioma Treatments

Pleural mesothelioma affects the pleura, the outer lining of the lungs. Almost 75% of mesothelioma cases are pleural. Doctors prescribe treatments to remove or shrink pleural tumors, minimizing symptoms and improving quality of life.

Surgery

Extrapleural Pneumonectomy (EPP): EPP removes the entire affected lung and all nearby areas where mesothelioma has spread, including lymph nodes, chest and heart linings and diaphragm.Pleurectomy Decortication (P/D):_ P/D spares the lung and only removes cancerous parts of the pleural lining, chest wall lining, heart lining and diaphragm. P/D is less aggressive than EPP but is still major surgery.

Chemotherapy

Combination Chemotherapy: For first-time, or first-line, treatment with mesothelioma chemotherapy drugs, doctors often prescribe pemetrexed (Alimta) with cisplatin. If cancer returns, second-line options may include gemcitabine (Gemzar) or carboplatin.

Radiation

External Beam Radiation Therapy: EBRT is the most common radiation treatment for mesothelioma. An external machine delivers X-ray beams to kill cells at the cancer site. Doctors may use EBRT before or during surgery.

Brachytherapy: This type of radiation is internal and uses a radioactive implant inside the patient to kill nearby cancer cells. Similar to EBRT, doctors may combine brachytherapy with other conventional treatments.

Palliative Care for Mesothelioma

Mesothelioma palliative treatment is also known as supportive care with a focus on controlling symptoms. It can improve quality of life and relieve cancer and treatment symptoms.
  • Thoracentesis

    This procedure involves a long needle inserted into the pleura to remove fluid buildup around the lungs.
  • PleurX Catheter

    Surgeons place this small drain in the chest to prevent fluid buildup around the lungs.
  • Pleurodesis

    A more invasive procedure, this surgery eliminates the space in the pleura where fluid can develop.
  • Radiation

    Radiotherapy in combination with other treatments can shrink tumors to reduce chest pain and other cancer symptoms.
  • Paracentesis

    Similar to a thoracentesis, this procedure for peritoneal patients uses a long needle to remove fluid buildup and reduce pressure from the abdominal area.
  • Pericardiocentesis

    To remove fluid and pressure from the sac surrounding the heart, doctors perform a pericardiocentesis, similar to thoracentesis and paracentesis.

Clinical Trials & Emerging Treatments

Mesothelioma doctors and researchers are testing these emerging treatments in clinical trials to ensure safety and efficacy.

The goal of clinical trials is to find a mesothelioma cure or improve life expectancy. At some point, these experimental therapies could become conventional options.

EMERGING TREATMENTS FOR MESOTHELIOMA

Cryotherapy: Cryotherapy is a minimally invasive surgical procedure that freezes cancer cells to kill them. Patients may receive the therapy before surgery to shrink tumors, after surgery to treat recurrences or as a palliative treatment to control symptoms.
Gene Therapy: Genetically modifying cells and viruses can help control cancer. For example, repairing the defective tumor-suppressing p53 gene kills cancer cells before they can replicate out of control.
Photodynamic Therapy: After injecting a light-sensitive drug into the patient, doctors use laser light energy to activate the drug and kill cancer cells.
Virotherapy: Virotherapy is a cancer treatment that uses viruses to find and attack cancer cells. Some types of virotherapy involve gene therapy or immunotherapy to make the treatment more effective.

Nutrition & Self-Care During Mesothelioma Treatment

A healthy diet and mindful self-care routines are essential techniques to round out a complete mesothelioma treatment plan. Overall wellness can help reduce side effects, improve mesothelioma prognosis and extend patient survival.

IMPORTANT SELF-CARE TIPS TO CONSIDER

Diet & Nutrition

Following proper nutrition guidelines, advice and a treatment plan from a dietitian can improve a patient’s well-being and recovery time.

As a part of any treatment plan, patients should try to keep a balanced diet to maintain weight and energy. Maintaining an appropriate weight before surgery can reduce the risk of infection.

Diets rich in protein and calories can benefit every cancer patient before, during and after treatments such as chemotherapy and surgery.

Protein allows muscles to heal faster from damage during surgery. Increased caloric intake gives your body the energy to repair cells and tissues injured during chemotherapy or radiation

However, some mesothelioma treatments can make eating more difficult. Several techniques, including certain foods and meals, can manage these challenges. Some patients may consider taking over-the-counter vitamins or supplements, but they should always talk with their doctor first.

Complementary & Alternative Medicine

While these practices and supplements are not conventional cancer treatments, some patients may use these alongside their cancer treatments to reduce pain or improve well-being. Patients should consult their doctor before using any supplement or alternative medicine.

  • TENS Therapy

    Small at-home devices use low-voltage electrical stimulation over the skin to relieve muscle pains.
  • Acupuncture & Massage

    Thin needles stimulate nerves and muscles to relieve pain. Therapeutic massage can lower fatigue and anxiety.
  • Medical Marijuana

    Natural compounds reduce chemotherapy side effects such as nausea and vomiting, loss of appetite, pain and insomnia.
  • Herbal Medicine

    Botanical products that may ease symptoms related to treatment or the cancer, and they may improve immunity.
  • Energy Therapies

    Treatments such as music therapy, Therapeutic Touch or reiki may soothe patients but are not effective in cancer care.
  • Mind-Body Therapies

    Techniques such as hypnosis and biofeedback may reduce pain and discomfort using thought exercises and whole-body mindfulness.

Frequently Asked Questions (F.A.Q) About Mesothelioma Treatment

Question: What are the main types of treatment for mesothelioma?

Answer: The primary types of mesothelioma treatment included chemotherapy, surgery, radiation therapy and multimodal therapy, which is a combination of two or more of these treatments. New treatments, such as immunotherapy and gene therapy, are available through clinical trials.

Question: Are there any new treatment types that have shown to be effective for mesothelioma?

Answer: Yes. The FDA approved a new type of treatment called Tumor Treating Fields for pleural mesothelioma in May 2019. Average survival is around one year for mesothelioma with chemotherapy. Adding Tumor Treating Fields to chemotherapy helps patients extend average survival by six months.

Question: Are there doctors who specialize in mesothelioma?

Answer: There are specialized oncologists, surgeons and other types of doctors who have extensive experience treating mesothelioma. These doctors can confirm a mesothelioma diagnosis and develop an effective treatment plan for a particular type of mesothelioma.

Question: Will a COVID-19 diagnosis affect my mesothelioma treatment?

Answer: Yes, developing COVID-19 could delay cancer treatments such as chemotherapy, surgery or immunotherapy. Due to the severe effects of COVID-19, patients must first recover from infection before their doctor can continue treating mesothelioma.

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