Overview

The prognosis and survival rate of malignant mesothelioma are poor. Recent emerging treatment options do improve life expectancy by a few years but death is almost always certain.

Mesothelioma is classifieds into four stages according to the status of the disease at the time of diagnosis. The early stages are stages 1 and 2. The late stages are 3 and 4. Diagnosis and treatment in the early stages have a better prognosis. Detection in the advanced stages limits the scope of aggressive treatment leading to a shortened life span.

The diagnosis of malignant mesothelioma is often rather late. It is often detected in the advanced stages when the symptoms may start setting in.

You should first know that the latency period of this malignancy is extremely long, about 20 to 60 years.

This means that you will develop mesothelioma 20 to 60 years after you have been exposed to asbestos, its causative agent.

Additionally, very few patients are diagnosed in the early stages, and that too accidentally. Early diagnosis leads to early treatment, which can be aggressive. This can improve the prognosis and add a few more years to survival

Secondly, because the mesothelioma symptoms resemble those of many other common diseases and, being an extremely rare disease, doctors do not have mesothelioma in their differential diagnosis when examining the patient. Diagnosis becomes late and this makes the prognosis of mesothelioma poor.

Most patients with pleural mesothelioma have a life expectancy of one to four years after diagnosis. If they stay without treatment, the life expectancy reduces to about six months.

There are several factors that influence prognosis and survival. For example, the type of mesothelioma and its stage at the time of diagnosis greatly influence prognosis.

The right treatment options can improve your prognosis and survival time.

Mesothelioma survival without treatment is 6 months. Malignant mesothelioma always has had a poor prognosis. Research, however, has given newer treatment options that have extended survival time.

Currently, malignant mesothelioma patients have an average life expectancy of 18 – 31 months with effective treatment options.

Mesothelioma treatments that improve prognosis

Treatment is the only way to improve the prognosis and prolong survival for mesothelioma cancer. Some treatments have proven to be more effective in improving prognosis than others.

Mesothelioma prognosis after multimodal treatment

Multimodal treatments use a combination of more than one therapy in treating the mesothelioma patient. Such options may include different combinations of chemotherapy, immunotherapy, radiation, or surgery.

In most patients with malignant mesothelioma, such an approach has proved to be more effective. Stats show that patients who receive a multimodal treatment live about 2 to 6 years.

For pleural mesothelioma, an effective multimodal treatment combination is known to be extrapleural pneumonectomy (EPP) or pleurectomy/decortication (P/D) surgery followed by hyperthermic intrathoracic chemotherapy (HITHOC). One study showed that with this combination therapy, patients lived about 3.5 years.

For peritoneal mesothelioma, cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) increased survival from two to more than 6.5 years.

Mesothelioma prognosis after chemotherapy

Studies show pleural mesothelioma patients treated with chemotherapy live about 14 months after being diagnosed.

Chemotherapy may prove most beneficial in those cases where the tumors cannot be operated upon. It can also be useful as part of multimodal treatment.

Chemotherapy given to peritoneal mesothelioma patients during HIPEC procedures can extend lifespan by five years or more.

It does have its side effects but they can be managed with proper dosage and other means. Secondly, a preference for a better prognosis is essential.

Mesothelioma prognosis after immunotherapy

In studies, the prognosis for pleural mesothelioma patients receiving immunotherapy treatments, survival ranged from 18 to 24 months. Thus far, these studies have been done mostly on pleural mesothelioma.

Checkpoint inhibitor immunotherapy has helped such patients with complicated cases such as those with inoperable tumors or non-epithelial cell types. For patients with non-epithelial cases, chemotherapy drugs could improve prognosis by up to 100%.

A single treatment plan may involve multiple immunotherapies. One of the most widely used immunotherapy treatments for pleural mesothelioma is the FDA-approved combination of Opdivo and Yervoy. The success of this combination of Opdivo and Yervoy is promising. About 50% of people are alive at 7.5 years.

Mesothelioma prognosis after radiation therapy

The prognosis improves in mesothelioma patients who received radiation therapy. Pleural mesothelioma patients receiving radiation combined with other treatments live more than 2 years.

Radiation is very often given before or after other forms of cancer treatments and forms a part of multimodal treatment plans.

Side effects of radiation can occur but not in all patients. Here again, the benefits outweigh the risks.

Mesothelioma prognosis after surgery

Therapeutic surgery for cancer, not alone, but as part of a multimodal treatment plan can improve the prognosis for some patients.

Doctors often recommend chemotherapy or radiation after surgery in an effort to kill residual cancer cells. This extends lifespan by about 2 to 6 years.

Other options for improving prognosis

The patient should follow certain practices himself to improve the prognosis of his condition. He should:

  • Improve overall health and wellness.
  • Adopt a healthy lifestyle
  • Stick with a nutritional diet
  • Exercise regularly
  • Quit smoking
  • Avoid alcohol
  • Practicing meditation, massage, and yoga regularly can also help ease mental and physical stress.

 Six factors that determine the prognosis of mesothelioma

The prognosis of mesothelioma depends on certain factors.

  1. Early detection. Early detection and prompt mesothelioma treatment when it is in the early stages (1st or 2nd stage) will be favorable as the mesothelioma is localized and not spread to other parts of the body
  2. Health condition of the patient. An overall healthy patient will have a better prognosis in view of his capacity to tolerate and respond to mesothelioma treatments, than a patient who has other preexisting health disorders.
  3. Lifestyle habits. Smokers have a poorer prognosis than nonsmokers.
  4. Type of mesothelioma. Pleural mesothelioma patients have a better prognosis than those affected by pericardial or peritoneal mesothelioma.
  5. Age of the patient. Those below the age of 55 years have a better prognosis than those above 55 years. Younger the patient, the better the prognosis.
  6. Sex of the patient. Females have a better prognosis than male patients. This is because of the expression of the estrogen gene which suppresses the tumor.