Exposure to asbestos is the cause of most cases of mesothelioma. It is a highly-aggressive cancer that results in only 3,000 mesothelioma new diagnoses each year. It can affect several areas of the body but is most commonly found in the pleural lining surrounding the lungs.
When any type of cancer is diagnosed, the doctor may also give the prognosis for the disease. It is the forecast of how severe the cancer may become and how fast that may occur. Mesothelioma is an aggressive, malignant cancer which typically has a poor prognosis with an average survival time of 12 to 21 months. Mesothelioma prognosis is determined by the location, type, stage and treatment of the disease but some patients have survived much longer than their prognosis indicated.
Because of improving medical technology, aggressive treatments and investigational medications and procedures, some patients are able to overcome the disease and live much longer than expected. For each type of mesothelioma, actions that treating physicians and patients take may have a significant impact on prognosis.
Improving Mesothelioma Prognosis
A prognosis is generally an indication of how long the patient diagnosed with mesothelioma is expected to live and may be stated a number of different ways. It may be given as a range of months, for example, “most patients live X months”. It may also be given as a “median” of life expectancy, for example, “50 percent or half of the patients diagnosed at this stage lived X months.” It may also be given as a percentage of survival, for example, “there is a 1-year survival rate of 45 percent”. No matter how it is stated, mesothelioma is a progressive disease that is malignant and fast-growing and is 100 percent fatal if not treated. Action must be taken right away to improve prognosis.
Pleural mesothelioma affects the pleural lining surrounding the lungs. It is the most common type of mesothelioma and is responsible for 70 to 75 percent of all cases. Usual treatments for pleural mesothelioma include chemotherapy, radiation and/or one of two types of surgery.
- Pleurectomy removes the tumor and a portion of healthy lung – most commonly used in earlier stages but may not be useful in later stages
- Pneumonectomy removes the entire diseased lung and may involve removal of the fifth rib
- Extrapleural pneumonectomy is the most invasive surgery and removes the affected lung, along with surrounding tissue – the recovery time is significant for this type of surgery but it may be the only choice in later stages
When diagnosed in late stages, the prognosis for pleural mesothelioma is 10 to 12 months but this may be extended to 28 to 30 months when treated by both surgery and radiation.
Peritoneal mesothelioma affects the peritoneal membrane that lines the abdomen. It is the second-most common type and affects about 20 percent of all patients. Peritoneal mesothelioma has traditionally been considered, “harder to treat”. Recent advances in treatments however, have drastically improved the prognosis for peritoneal mesothelioma. Prognosis is generally given as 10-11 months but treatments such as heated intraperitoneal chemotherapy (HIPEC) may improve the outlook. HIPEC is a combination of surgery and heated chemotherapy but only certain patients will qualify for the procedure. Some patients who were eligible and received HIPEC have lived five or more years.
Pericardial mesothelioma affects only about 1 percent of all mesothelioma victims. Pericardial mesothelioma causes tumor formation in the mesothelioma layer of the pericardium which surrounds the heart. It has a poor prognosis and many patients are not diagnosed while living. Treatment of pericardial mesothelioma is difficult as surgery and radiation are not generally considered due to the threat of destruction of vital heart tissue. Pericardial mesothelioma also has a poor prognosis because the cancer is not often identified until very late stages, where the patient may have only a few months remaining.
Testicular mesothelioma is a cancer which affects the mesothelial layer of the lining around the testicles. It is the rarest type of mesothelioma and is only responsible for less than 1 percent of all new cases each year. Despite its rarity, testicular mesothelioma has a better prognosis than most other types. Most people with testicular mesothelioma have a median survival of 20 to 23 months, however some patients have lived for up to 15 years.
After a mesothelioma diagnosis, it may be difficult to hear the prognosis. No patient is prepared to know how long they are expected to live, particularly when that may be measured in months. A prognosis is only an estimate and each patient may have a different experience. The factors that determine mesothelioma prognosis that a patient cannot control include:
- Type of mesothelioma
- Location of mesothelioma tumors
- Severity of symptoms
- Staging of cancer
- Treatment success
- Latency time period
- Overall health
Though there are certain things you cannot control regarding your prognosis, there are some things that you may be able to do to improve it. These include:
- Seek assistance from a mesothelioma specialist – Mesothelioma of any type is an extremely rare disease. Specialists have years of experience and expertise in treating this type of cancer. Many are involved in research and investigational trials which may improve success of treatments. There are mesothelioma specialists physicians in many areas who can help to improve a patient’s prognosis.
- Get a second opinion – Any time a diagnosis of a serious medical condition is given, the patient should seek a second opinion. Asking for a different physician to perform an evaluation is not an insult and each patient should exercise the right for a second opinion. In some cases, the original diagnosis may be incorrect or the prognosis may be better than expected. Seeking advice from a mesothelioma specialist is the best way to ensure that your diagnosis, prognosis and treatment plan is appropriate.
- Explore all treatment options – Mesothelioma research has advanced a great deal since the link to asbestos became well-known. In most cases, surgery is a curative option and may prolong the patient’s life. Pleural mesothelioma patients may extend the life expectancy by as much as 28 months when surgery and radiation are used together. Peritoneal patients who receive HIPEC treatment may outlast the prognosis by two to seven years. When surgery is not an option, traditional chemotherapy or enrollment in an investigational trial may increase the life expectancy.
- Improve overall health – Many people are unaware that a person with good overall health is more likely to survive cancer. When the immune system is in good shape, treatments such as chemotherapy, radiation and even surgery are easier to recover from. Making good dietary choices and exercising will help to improve health and may make an impact on mesothelioma prognosis.
Even though asbestos exposure may have occurred years before, mesothelioma is a highly-aggressive and malignant cancer, once discovered, the disease may progress rapidly. When a diagnosis is received, action should be taken immediately. Seeking immediate assistance from a specialist in mesothelioma is the best way to ensure that time is not wasted.