Unfortunately, mesothelioma generally has a very poor prognosis for patients diagnosed with the disease. This is largely due to the long latency period of mesothelioma. Because of the lack of alerting symptoms, the disease typically isn’t caught until it is in its advanced stages when treatment is difficult or futile. On average, most patients only survive 4-18 months after diagnosis. However, there are various factors which determine the mesothelioma prognosis and approximately 10% of patients do go on to live more than 5 years after receiving a mesothelioma diagnosis.
A large study was completed by the University of Western Australia that used valuable data from cases of malignant pleural and peritoneal mesothelioma. The results in general indicated that survival was worse for men than women, worse for those with poor progress performance, and inversely related to age. The worst prognosis was for those with sarcomatoid histology versus those with epithelioid or biphasic mesothelioma cells. Despite the grim results, there were indications that survival time had risen by a month due to earlier diagnosis.1
Factors Affecting Mesothelioma Prognosis
Mesothelioma Stage
The stage of the mesothelioma is the most important factor for prognosis. Patients who have mesothelioma diagnosed in the early stages have a much better prognosis. Stages 1 and 2 have the best prognoses and the mesothelioma can often be treated with surgery. In Stage 1 mesothelioma, there is hope of remission. Patients diagnosed in Stages 3 or 4 typically have very poor prognoses. One study showed that patients with Stage 1 mesothelioma lived an average of 359 days whereas patients with Stage 3 or Stage 4 mesothelioma lived an average of 112 days after diagnosis.
Mesothelioma Cell Type
After the stage factor, it is mesothelioma cell type that is one of the most important indicators of prognosis. Certain mesothelioma cell types are more aggressive whereas others respond better to treatment. The epithelial mesothelioma cell type has a better prognosis than the other cell types which are sarcomatoid and biphasic.
Type of Mesothelioma
The type of mesothelioma – pleural, peritoneal, pericardial or testicular – affects the prognosis. In general, patients diagnosed with pleural mesothelioma have a better prognosis than those diagnosed with peritoneal or pericardial mesothelioma. Testicular mesothelioma is so rare that it is impossible to accurately compare prognoses.
A recent study on mesothelioma of the tunica vaginalis testes looked at the accuracy of biomarkers used in the diagnosis and prognosis of confirmed cases of testicular mesothelioma. However, the conclusions found that the biomarkers were accurate, that surgery is not a curative and 5 out of the 6 patients experienced a recurrence. Most testicular mesothelioma tumors are fatal.3
Patient Age and Health
The younger a patient is when diagnosed with mesothelioma, the better his/her prognosis. In one study performed by the American Cancer Society with nearly 3,000 participants, approximately 37% of patients younger than 45 years of age lived for five years after their initial diagnoses. Only 20% of patients 45 to 54 years of age lived longer than five years.
Healthy patients who do not have histories of other health problems are also much more likely to live longer after mesothelioma diagnoses. Healthy patients will also respond better to mesothelioma treatments. Smoking has shown to considerably worsen the mesothelioma prognosis which makes sense. Tobacco products have carcinogens in them, so their use promotes the development and growth of cancer. Smoking toxins damage and weaken cells.
Patients who experience quickly deteriorating mesothelioma symptoms – such as coughing or chest pain – tend to have worse prognoses as the symptoms are an indicator of the disease’s more rapid progression. Progression rate is a major factor in survival rate.
Gender
Generally, women have a better mesothelioma prognosis than men. One recent study led by researchers at the University of South Wales has attributed this to higher levels of estrogen in women; estrogen genes may suppress tumors.
There is a factor to be considered when considering statistics on men versus women who have mesothelioma. There is a good possibility that women were misdiagnosed more frequently than men in the past because malignant peritoneal mesothelioma and ovarian cancer are derived from the same coelomic epithelium or the same tissue. This has made it difficult for pathologists to correctly identify mesothelioma of the peritoneum versus adenocarcinoma of the ovary.2 The misdiagnoses could distort the statistics in many areas including latency and prognosis.
Recent Diagnoses
Patients who have been recently diagnosed with mesothelioma may have a much better prognosis than those diagnosed with the disease in the past. New medical knowledge and technology allows for earlier detection of mesothelioma and innovative new treatments may prolong prognosis. As researchers continue to explore the nature of mesothelioma, there is an expectation that one day people will be diagnosed long before the latency period ends, thus improving their chances of long term survival.
References
1 Bill Musk AW, Olsen N, Alfonso H, Reid A, Mina R, Franklin P, Sleith J, Hammond N, Threlfall T, Shilkin KB, de Klerk NH. (July 2011) Eur Respiratory Journal, Retrieved from PubMed.gov at: http://www.ncbi.nlm.nih.gov/pubmed/21737558
2 Smith, D. D. (December 2002) Women and Mesothelioma. Chest, v122:6; 1885-1886.
3 Hai B., Yang Y., Xiao, Y., Li B., and Chen, C. (Sep 2011) Diagnosis and prognosis of malignant mesothelioma of the tunica vaginalis testis, 1-4; doi: 10.5489/cuaj.10200.
