Mesothelioma Prognosis

Approximately 2,000 to 3,000 new cases of mesothelioma are diagnosed in the United States each year. Once a patient is diagnosed, a doctor will likely discuss their prognosis, or probable course of the cancer's influence on the body and recommend various treatment options. .The prognosis of a patient diagnosed with mesothelioma and the recommended treatments can vary greatly depending on the patient's age, sex, asbestos exposure history and the specific cells involved.
The best way to avoid a poor prognosis is through early detection of the cancer. When mesothelioma is detected early, the prognosis is generally more favorable, as the cancer may not have spread to other parts of the body and may be more receptive to various treatments and surgery. Following detection, the best way to improve a patient's prognosis is educating oneself about the latest mesothelioma treatments.
Those who have been exposed to asbestos may wish to alert their doctor, as this may aid in the early detection of mesothelioma or another asbestos-related disease.

Typical Mesothelioma Prognosis

The earlier a patient is diagnosed with mesothelioma, the better prognosis they can expect. The prognosis and treatments recommended are based on a patient’s age, sex, asbestos exposure and the specific cells that are involved. When the cancer is detected early, the prognosis is typically more favorable because it may not have spread, so the body will be more receptive to varying treatments and surgeries. Also, those under age 45 often have a better prognosis – about 20 percent of patients included in an American Cancer Society study from that age group survived for more than five years.
For those diagnosed with pleural, peritoneal or pericardial mesothelioma, the prognosis can take varying turns. Up to 60 percent of all cases are pleural mesothelioma, which has a typical survival rate of five years following diagnosis. That tends to be the most optimistic diagnosis for this cancer. On average, someone suffering from mesothelioma has about a one-year survival rate.
People experiencing shortness of breath or chest pains may have a poorer prognosis because those symptoms can indicate that the cancer has progressed to a later stage.
Overall Health: Patients diagnosed with mesothelioma who are otherwise healthy may have an easier time undergoing intensive treatment, such as chemotherapy, than someone with pre-existing health issues. Additionally,non-smokers often have a better prognosis than patients who smoke.
Stage of Mesothelioma: Doctors typically discuss the severity of a patient's cancer in terms of stages, ranging from stage I to stage IV. Patients with stage III or stage IV mesothelioma will typically have a poorer prognosis than patients with stage I or stage II mesothelioma.
For example, in a study published in the European Respiratory Journal involving 167 patients with pleural mesothelioma, participants with stage I pleural mesothelioma survived for 359 days, while those with stage III or stage IV (combined) mesothelioma survived approximately 112 days. In general, treatment options are typically more limited and surgery may not be an option once the cancer has progressed beyond stage II.
Stage I Mesothelioma Patients Averaged a 359-day Life Span Following Diagnosis
Overall Health: Patients diagnosed with mesothelioma who are otherwise healthy may have an easier time undergoing intensive treatment, such as chemotherapy, than someone with pre-existing health issues. Additionally,non-smokers often have a better prognosis than patients who smoke.
Stage of Mesothelioma: Doctors typically discuss the severity of a patient's cancer in terms of stages, ranging from stage I to stage IV. Patients with stage III or stage IV mesothelioma will typically have a poorer prognosis than patients with stage I or stage II mesothelioma.
For example, in a study published in the European Respiratory Journal involving 167 patients with pleural mesothelioma, participants with stage I pleural mesothelioma survived for 359 days, while those with stage III or stage IV (combined) mesothelioma survived approximately 112 days. In general, treatment options are typically more limited and surgery may not be an option once the cancer has progressed beyond stage II.
Stage I Mesothelioma Patients Averaged a 359-day Life Span Following Diagnosis
Stage III and IV Patients Averaged a 112-day Combined Life Span Following Diagnosis
Cell Type:Mesothelioma histology impacts a patient's prognosis, as those with epithelial mesothelioma have a greater life expectancy than those with sarcomatoid or biphasic mesothelioma.
Size and Location of the Tumor: The size and location of a patient's tumor can impact their prognosis. Patients with tumors that have progressed or spread to other parts of the body generally have a poorer prognosis. Patients with tumors that may be surgically removed often have a better prognosis.
Progression of Symptoms: Patients who are experiencing serious symptoms of mesothelioma, such as chest pain or shortness of breath, may have a weakened prognosis, because the prevalence of mesothelioma symptoms often indicates the cancer has progressed to a later stage of development.
Stage III and IV Patients Averaged a 112-day Combined Life Span Following Diagnosis
Cell Type:Mesothelioma histology impacts a patient's prognosis, as those with epithelial mesothelioma have a greater life expectancy than those with sarcomatoid or biphasic mesothelioma.
Size and Location of the Tumor: The size and location of a patient's tumor can impact their prognosis. Patients with tumors that have progressed or spread to other parts of the body generally have a poorer prognosis. Patients with tumors that may be surgically removed often have a better prognosis.
Progression of Symptoms: Patients who are experiencing serious symptoms of mesothelioma, such as chest pain or shortness of breath, may have a weakened prognosis, because the prevalence of mesothelioma symptoms often indicates the cancer has progressed to a later stage of development.


Factors that Affect Your Prognosis

Mesothelioma histology affects a prognosis, so it can be important in a treatment regimen. Mesothelioma histology is the study of various types of cells connected to the disease. By studying those cells, a doctor can better determine a course of treatment.
Also, the size and location of tumors can affect a prognosis. Patients whose tumors are surgically removed typically have a better prognosis than those whose tumors have spread to other parts of the body.
Those who have been exposed to asbestos should alert their doctor, which can help in early detection of mesothelioma or other asbestos-related diseases.

Improving a Mesothelioma Prognosis


While most doctors begin treatment of mesothelioma with chemotherapy, radiation and surgery, there are also less traditional alternative treatments being used and being widely touted by mesothelioma survivors. Some doctors practice what is called Complementary and Alternative Medicine, or CAM, combined with conventional medicine. This integrative medicine has no promise for a cure, but in some cases has subdued the pain and suffering associated with mesothelioma. In certain cases, it has been shown to improve survival rates. Various plant extracts, vitamins, minerals, herbal teas and amino acids like those used for centuries by ancient cultures are sometimes used as a supplemental treatment for mesothelioma.
Experimental therapies, like immunotherapy, show progress for the future. Also, researchers and scientists are constantly seeking out and testing new types of drugs and innovating new therapies as they search for a cure.

Mesothelioma Treatment



Mesothelioma can be hard to treat, whether the cancer is resectable or not. It’s very important that you understand the goal of treatment before it starts – whether it is to try to cure the cancer or to help relieve symptoms – as well as the possible benefits and risks. This can help you make an informed decision when looking at your treatment options.

Despite years of research since the disease was first identified, it’s still difficult to identify the best approach to treating the disease, says David Rice, MD, a cardiothoracic surgeon and nationally known mesothelioma expert who practices at the University of Texas MD Anderson Cancer Center in Houston, TX.
The very rareness of the cancer—only about 3,000 people a year are diagnosed in the United States—makes it difficult to run the kind of research studies needed to compare treatments and determine the ideal therapy at each stage of the disease. “There isn’t a lot of evidence-based science in this disease,” Dr. Rice admits. So when his patients ask him what the best treatment is for the disease, he tells them what we tell you in this section, adding that “we don’t have a reliable cure for this disease.”
Thus, a major goal of treatment is to reduce pain and suffering and prolong a patient’s life as long as possible while providing them with the highest quality of life possible.
Choosing the right mesothelioma doctor is an important first step in planning for treatment.
There are a number of mesothelioma experts, like Dr. Rice, practicing in specialized clinics throughout the country. Each of these cancer specialists has an acute knowledge of the behavior and pathology of Malignant Pleural Mesothelioma and its treatment. It is likely that if you are diagnosed with mesothelioma, you will be referred by your personal physician to a larger scale comprehensive cancer center.
The most important consideration in mesothelioma treatment is the cancer stage and type, said Dr. Rice. Treatment decisions also depend on whether the cancer is localized to the chest or has spread to the chest wall, diaphragm, or lymph nodes, your age and overall health, and the center where you’re being treated. Learn more about finding a doctor here.
 
Conventional treatments for mesothelioma involve surgery, chemotherapy, and radiation therapy.
As with most solid tumors, doctors turn to surgery, radiation and chemotherapy to manage mesothelioma. When exploring the various treatment options available with your doctor it is important to be informed about the risk and benefits of each one before making a final decision.
The stage (extent) of a mesothelioma is an important factor in determining treatment options. But other factors, such as whether the doctor feels the cancer is resectable (all visible cancer can be removed by surgery), as well as a person’s general health and preferences, also play a role.



Types of Mesothelioma



There are three main types of mesothelioma, and each affects a different area of the body.  The three types of this deadly cancer are:
  • Pleural Mesothelioma
  • Peritoneal Mesothelioma
  • Benign Mesothelioma

Pleural Mesothelioma

Pleural mesothelioma is the most common type of malignant mesothelioma (accounting for an approximate 75% of all documented cases of the disease) and affects the section of the mesothelium called the pleura. Although the most common type of malignant mesothelioma, the disease is still somewhat of a rarity. As a result, pleural mesothelioma is often confused with other types of diseases, such as lung cancer and viral pneumonia. Lung cancer can be caused by Asbestos (asbestos lung cancer), though it differs from pleural mesothelioma in that it is a malignancy of the lung tissue itself, as opposed to pleural mesothelioma which is a malignancy of the tissue casing of the lungs. Viral pneumonia shares certain symptomatic similarities with pleural mesothelioma and is often misdiagnosed as such.
The most common presenting symptom of pleural malignant mesothelioma is chronic chest pain. A buildup of fluid inside the pleural space can cause severe and chronic chest pains; this is called pleural effusion. Steps can be taken to drain the fluid and relieve the pain (with the possibility of recurrence) or surgery can be performed to close the pleural space (with virtually no possibility of recurrence). Some of the other notable symptoms associated with pleural mesothelioma include:
  • Shortness of breath
  • Chronic coughing
  • Weight loss
  • Fever
Raw asbestos fibers

Pericardial Mesothelioma

Pericardial mesothelioma is much less common than malignant mesothelioma of the pleura or peritoneal. Peritoneal mesothelioma is the second most common type of malignant mesothelioma (accounting for an approximate 10% to 20% of all documented cases of the disease) and affects the section of the mesothelium called the peritoneum (the mesothelial lining of the abdomen). Peritoneal mesothelioma is most often caused by the ingestion of carcinogenic asbestos fibers. Inhaled Asbestos fibers can become lodged in mucous lining the mouth and esophagus. Once swallowed, it travels through the digestive system where it can potentially become lodged and develop into a tumor.
 In fact there are only about 150 cases ever reported in the medical literature. It affects the section of the mesothelium called the pericardium (the mesothelial lining of the heart). People in the fourth to seventh decades of life are most likely to have this cancer, and there is a 2:1 male to female ratio. Currently, surgical excision (removal) of the pericardium is the treatment for pericardial mesothelioma, primarily to lessen symptoms of constriction around the heart.

Symptoms that are associated with pericardial mesothelioma include:
  • Chest pain
  • Fluid buildup around the heart
  • A mass in the space between the lungs
  • Abnormal or difficult breathing (dyspnea)
  • Chronic coughing
  • Irregular heartbeat (palpitations)

 

Malignant Versus Benign

The aforementioned types of mesothelioma are malignant forms, and are thusly the most dangerous. Malignant mesothelioma is often the product of asbestos inhalation from individuals who have worked or resided in areas not up to current health and safety standards. Since the disease has a high latency period, often times it is not diagnosed until it has progressed far beyond any rectifiable measure.
As the name suggests, benign mesothelioma is a form of non-malignant mesothelioma that is easily treatable. While benign tumors can at times be cancerous, unlike malignant mesothelioma, the tumors do not spread, making it easier to isolate and remove.

Mesothelioma of the Tunica Vaginalis Testis

Mesothelioma of the tunica vaginalis testis is the least common type of malignant mesothelioma (amounting to less than 100 of all documented cases of the disease) and affects the section of the mesothelium called the tunica vaginalis testis (the mesothelial lining around the testes). Most patients are in their 50s or older, but about ten percent of the patients are younger than 25 years. Patients generally present with a hydrocele (an accumulation of serous fluid in a sac-like cavity (as the scrotum)) or hernia. Treatment is usually a high inguinal orchiectomy (surgical excision of the entire affected testis through an incision in the lower abdomen - called also orchidectomy). Prognosis is somewhat better than for pleural mesothelioma.
Symptoms that are associated with this cancer include:
  • Hydrocele (a fluid filled sac attached to a testicle)
  • Suspected hernia