A mesothelioma diagnosis comes with many important questions. Perhaps the most crucial question is – what is the prognosis? In fact, the prognosis of mesothelioma varies depending on a number of variables. These variables include:
The patient – their age, biology, and state of health
The cancer – has the mesothelioma spread or is it localized when it is diagnosed and what is the cell type
The treatment or treatments selected
The expertise of the treatment team (doctors and other clinicians)
The Patient’s Health
A patient’s general state of health is an important prognostic factor in fighting any disease and mesothelioma is no exception. In addition, a patient’s biology or physiology also plays a role. For example, will chemotherapy work or can it be tolerated? Does the patient have a heart condition so that surgery is not an option? How will the patient’s biology interact with the treatment? The answers to these questions can all play a role in the prognosis.
The spread or lack of spread of the cancer is also an important factor. If mesothelioma is localized it can be easier to treat. In fact, surgery is usually only an option if the cancer has not metastasized. If it has spread then treatment options may be more limited. In addition, there are three cell types of mesothelioma – epithelioid, biphasic, and sacramatoid. The first, epithelioid, often has the best prognosis of the three.
The treatment or therapies selected is also important. Patients can select from conventional therapies (radiation, chemo, and surgery), clinical trials or integrative or alternative modalities. Not every therapy works in every patient. There is an important connection between a person’s physiology, cancer and the treatments selected. The interchange or intersection of these three factors often dictate what the treatment outcome and prognosis will be. Unfortunately, it is often difficult to predict because how a tumor or a treatment acts in a patient’s body is often not known until after the fact.
The Doctors’ Expertise
The last factor is the expertise of your doctors or licensed care givers. How these people do their jobs can be a key factor in prognosis. Are the surgeons experienced with mesothelioma? For example, what is their mortality rate for surgery? The smallest rate bodes better than the highest rate. Also, what options can these treaters suggest? Do they only offer chemo or can they offer a wide range of different modalities and treatment options. All these factors play a role in the prognosis of mesothelioma.
Below are some more details about the prognosis for mesothelioma.
Prognosis of Pleural Mesothelioma
The prognosis of pleural mesothelioma with standard treatment is typically not great. Median overall survival is a little over a year. However, there are a number of factors that affect prognosis.
A number of studies have been performed over the years to determine what treatments are optimum for mesothelioma and what factors lead to a better prognosis. Below, we report on several of these.
In a September 2016 Austrian study, a total of 210 patients with malignant pleural mesothelioma were followed.
167 (79.5%) were men and 43 (20.5%) were women
The average age was 67 at the time of diagnosis
Asbestos exposure was confirmed in 109 (69.4%) patients
The majority of patients had epithelioid cell type (67.2%)
Sarcomatoid comprised 16 (7.6%)
Biphasic was found in 28 patients (13.3%)
In 25 patients, the cell type was not specified
Data about survival was available for 185 patients. The study found:
Median overall survival was 19.1 months.
Pleural mesothelioma patients with early-stage disease (stages I, II) had an overall survival of 26.4 months.
Pleural mesothelioma patients with late-stage disease (stages III, IV) had an overall survival of 13.0 months .
Patients with epithelioid cell type had overall survival of 25.1 months.
Patients with sarcomatoid or biphasic cell type had overall survival of 10.2 months.
There was no survival difference between males and females.
There was no survival difference between patients below or above the age of 65 years.
Survival was significantly better in patients undergoing surgery. However, these patients were significantly younger, had earlier-stage disease, better performance status, and more often had epithelioid subtype.
The study concluded that factors that indicated a better prognosis included: higher Karnofsky score, earlier stage disease, epithelioid cell type, and surgery within multimodality treatment.
Management of malignant pleural mesothelioma – part 3 : Data from the Austrian Mesothelioma Interest Group (AMIG) database. Klikovits T, et al., Wien Klin Wochenschr. 2016 Sep;128(17-18):627-34.
Prognosis of Peritoneal Mesothelioma
The prognosis of peritoneal mesothelioma has become much better with the advent of surgery and HIPEC. The following studies illustrate the improvements in prognosis over the last several years.
Peritoneal Mesothelioma Prognosis with Chemotherapy
In a 2011 Greek Study, chemotherapy was used to treat peritoneal mesothelioma patients. Six patients with peritoneal mesothelioma were treated with 6 cycles of pemetrexed (500 mg/m2) and cisplatin (75 mg/m2). Chemotherapy was administered on an outpatient basis every 3 weeks. The estimated median overall survival was 24 months.
Systemic chemotherapy with pemetrexed and cisplatin for malignant peritoneal mesothelioma: a single institution experience. Lainakis G, et al., Tumori. 2011 Jan-Feb;97(1):25-9.
Peritoneal Mesothelioma Prognosis with HIPEC
An April 2014 United States Study examined 65 patients with pleural mesothelioma who underwent surgery and HIPEC (hyperthermic intraperitoneal chemoperfusion) between 2001 and 2010.
What is HIPEC for Mesothelioma?
HIPEC is where heated chemotherapy is used to bath the surgical cavity putting the chemo in direct contact where the tumor cells remain. The study found that overall mesothelioma survival was 46.2 months. The study also found that although survival was better, there were side effects associated with this treatment approach that included:
Six percent of the patients died within 60 days.
Of the 65 patients, 91 % were admitted to the intensive care unit (ICU) postoperatively, with median hospital length of 12 days.
A total of 12 patients (18 %) underwent reoperation: four patients (33 %) for enteric leak, 1 patient (8 %) for an intra-abdominal abscess, and seven patients (58%) for other reasons.
Factors that contributed to a poor prognosis included:
More widespread tumors
More aggressive cell type
The study concluded that better prognosis is associated with patients who have the epithelioid cell type, lower volume of tumor, and more effective surgery (most tumor removed).
Malignant peritoneal mesothelioma: prognostic factors and oncologic outcome analysis. Magge D., et al., Ann Surg Oncol. 2014 Apr;21(4):1159-65.
Mesothelioma Patient Data and Treatment Decisions-A group of scientists published a study on mesothelioma data to find trends on how patients are being treated, and how long they survive. Scientists from the University of Pennsylvania have published a study on malignant pleural mesothelioma (MPM) in the journal Cancer Medicine. They looked at data from the National Cancer Database to find trends in who is getting MPM, how they are being treated, and how long they survive after diagnosis. Conventional Treatment Malignant pleural mesothelioma (MPM) is an aggressive cancer that grows in the cells lining the lungs. It is usually caused by exposure to asbestos at work or at home. MPM occurs in about 2,000 people in the United States every year. Rates of pleural mesothelioma … Continue reading Mesothelioma Patient Data and Treatment Decisions»
Gut Response to Mesothelioma Treatment-An international team of researchers have found that the bacteria in the gut and tumors can affect how well someone responds to treatment for mesothelioma. The researchers looked at data from 86 patients with malignant mesothelioma. They studied the different types of bacteria in their tumors and how it affected their survival rates. Conventional Treatment Malignant mesothelioma is a rare cancer that affects the lining of organs like the lungs and abdominal cavity. It usually has a poor prognosis and limited treatment options. Mesothelioma is caused by exposure to asbestos. Conventional treatment for malignant mesothelioma typically includes chemotherapy, radiation, and surgery. The exact treatment plan will depend on many factors. Doctors will consider the type of mesothelioma, the condition of … Continue reading Gut Response to Mesothelioma Treatment»
Mesothelioma Patients with a Second Cancer-Researchers in Italy looked at patients with pleural mesothelioma to see if having a second cancer affected how long they lived. They found that having a second cancer did not make a big difference in survival for most patients, but for those with a certain type of mesothelioma, it did make things worse. Factors for Multiple Types of Cancer Mesothelioma is a type of cancer that starts in the lining of organs, usually the lungs or abdomen. Most cases are caused by being exposed to asbestos. However, some people may have certain genes that make them more likely to get mesothelioma. People who have a specific gene mutation called BAP1 are more likely to get mesothelioma. They could also be … Continue reading Mesothelioma Patients with a Second Cancer»
Women with Mesothelioma Have Better Odds than Men-Women who are diagnosed with malignant pleural mesothelioma usually have better odds of survival than men. This was one of the findings of a study published in the Journal of Surgical Oncology. The researchers looked at data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. Mesothelioma Rates Malignant pleural mesothelioma (MPM) is a rare form of cancer the grows in the lining of the lungs. People with MPM might feel shortness of breath caused by fluid around the lung, chest pain, cough, and fatigue. This cancer is caused by exposure to asbestos. This is a naturally occurring mineral found throughout the world. Even though it is toxic to humans, it is still used in manufactured materials in some parts … Continue reading Women with Mesothelioma Have Better Odds than Men»
Rare Mesothelioma Disease Combination-Doctors in Italy treated a patient who was diagnosed with both primary gastric Burkitt lymphoma (PGBL) and malignant pleural mesothelioma (MPM). This is a rare disease combination. The doctors in this case had a hard time reaching the correct diagnosis because the symptoms of these two cancers are very similar. The patient also did not have the usual risk factors for these cancers. For instance, the patient did not have any exposure to asbestos that might cause MPM. Two Rare Diseases MPM is a rare type of cancer that develops from the thin layer of tissue that covers the lungs and chest wall. Signs and symptoms may include shortness of breath due to fluid around the lung, chest pain, cough, … Continue reading Rare Mesothelioma Disease Combination»
Best Services to Quit Smoking for Mesothelioma Patients-A new study shows that a multifaceted approach to quitting smoking can help patients diagnosed with cancer. One rare type of cancer is mesothelioma. This cancer is caused by exposure to asbestos. It occurs in the lining of different parts of your body, usually in the abdomen or the lungs. Mesothelioma often takes decades to develop after being exposed to asbestos. The symptoms can be hard to diagnose because they look like other, more common diseases. This makes treating mesothelioma more difficult, too. The cancer has more time to spread while doctors are struggling to make a diagnosis. There are other factors that make cancers like mesothelioma difficult to treat. Smoking after a cancer diagnosis can lead to worse survival … Continue reading Best Services to Quit Smoking for Mesothelioma Patients»
New Mesothelioma Tool for Better Treatment and Prognosis-Researchers from China have come up with a tool to check prognosis in mesothelioma patients depending on where the cancer is located. Mesothelioma develops in the lining that covers many of the internal organs in you body. It is caused by exposure to asbestos. There are different types of mesothelioma depending on where it develops. Pleural mesothelioma grows in the lining of your lungs and chest wall. Peritoneal mesothelioma grows in the lining of your abdomen. Mesothelioma can also occur in the testis or around the heart. The location where mesothelioma grows can have a big impact on diagnosis. It also affects how well you respond to treatment. When it takes longer to make an accurate diagnosis, the disease has … Continue reading New Mesothelioma Tool for Better Treatment and Prognosis»
Caregiver Burden with Mesothelioma: Social Support and Family Resilience-A new study found that older or spousal caregivers of patients with lung cancer are more likely to suffer from caregiver burden. This discovery was made by researchers in China. Their goal was to find factors related to caregiver burden in lung cancer families. They also wanted to find out if family resilience can improve caregiver burden. Taking Care of a Loved One Malignant mesothelioma is a highly lethal type of membrane cancer. Most mesothelioma patients lived or worked around asbestos. When mesothelioma occurs in the lungs, it is called malignant pleural mesothelioma. There are approximately 2,000 cases of mesothelioma in the United States every year. People with mesothelioma might start to feel shortness of breath, chest pain, and weight … Continue reading Caregiver Burden with Mesothelioma: Social Support and Family Resilience»
Marital Status Effects Mesothelioma Outcomes-Being married may be a factor in positive mesothelioma outcomes. This is the finding of a study by researchers from a Chinese university published last October. Mesothelioma is an aggressive cancer caused by exposure to asbestos. There are about 2,000 cases of mesothelioma diagnosed in the United States every year. The global occurrence of mesothelioma has increased at a steady pace in recent years. Mesothelioma usually has a poor prognosis. This is because symptoms don’t begin to appear until the cancer has become difficult to treat. Some factors that affect prognosis are patient health, the type of treatment, and the type of mesothelioma. Married Mesothelioma Patients Have Lower Risk of Death In other cancers, marital status can affect the outcomes … Continue reading Marital Status Effects Mesothelioma Outcomes»
30 Years of Global Rise in Mesothelioma Cases-A new study has found that the rate of mesothelioma cases around the world has continued to increase over the past 30 years. The study was published in Critical Reviews in Oncology and Hematology. The study researchers summarized the most recent worldwide patterns in mesothelioma burden. It is the most recent and thorough study on the annual incidence, mortality, and loss of lifespan for mesothelioma. Mesothelioma and Asbestos Mesothelioma is a form of cancer that is caused by exposure to asbestos. Asbestos is a naturally occurring mineral found throughout the world and is toxic to humans. Many countries have banned or tried to limit the use of asbestos. Unfortunately, asbestos is still used in many places around the world. It … Continue reading 30 Years of Global Rise in Mesothelioma Cases»
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