Mesothelioma Prognosis

Cancer of the serous membranes which surround the body’s moving organs such as the lungs and heart is called mesothelioma. Those serous membranes are called mesothelium. The mesothelium secretes the lubricating fluid which permits the vital internal organs to move.

Pleural mesothelioma affects the membrane surrounding the lungs and is the most common form of mesothelioma cancer. It appears among the population who were once exposed to asbestos fibers and so was tragically a preventable cancer.

Each year nearly 3,000 people are diagnosed with mesothelioma cancer. Today, according to the American Cancer Society, almost 40 percent of patients diagnosed with the cancer will survive a year or more while only ten percent will live more than five years.

The latency period is the time between initial exposure to asbestos fibers and the appearance of symptoms of mesothelioma cancer. In cases of pleural mesothelioma this time frame can be from approximately 20 to 50 years, thus giving the cancer a long time period to become established inside and to spread throughout patients’ bodies.

Early symptoms of the disease, which include labored breathing or shortness of breath, chest pain, persistent coughing, weight loss, night sweats, feelings of weakness, fever, etc., are often confused and misdiagnosed as other ailments. Unfortunately, often by the time pleural mesothelioma symptoms are correctly diagnosed, the cancer has already progressed to an advanced stage. Sadly, the prognosis for the diseasein this case is bleak.

The stage at which the cancer is detected impacts the prognosis for mesothelioma patients directly. In fact, it is one of the primary issues which will determine a patient’s prognosis.

Issues influencing a mesothelioma patient’s prognosis include the following:

• Stage of progression of the cancer—the prognosis depends on when, during the course of the disease, the disease is diagnosed. Due to the disease’s latency period, it often fails to be properly diagnosed until it has reached stage three or four; that is when symptoms finally appear that distinguish themselves from symptoms of other more common illnesses, such as respiratory ailments like the flu or pneumonia. Some patients with pleural mesothelioma have undergone a surgical procedure called extrapleural pneumonectomy in which their tumors have been successfully removed. The entire affected lung and the pleural lining of the chest wall are removed in this procedure. In February of 2011, the Division of Thoracic Surgery and Department of Pathology at Brigham and Women’s Hospital in Massachusetts conducted a study of 636 pleural mesothelioma patients and found that patients who underwent this aggressive surgery experienced extended survival. Another surgical procedure is called a pleurectomy / decortication. This procedure is palliative, meaning it helps improve and lessen symptoms but does not cure the disease. It is designed to remove fluid buildup and relieve pain and pressure on the lungs that the patient may be experiencing.
• Type of mesothelioma cancer (mesothelioma histology)—epithelial mesothelioma accounts for nearly half of all cases of the disease. Fifteen percent of those diagnosed with mesothelioma have the type of the disease called sarcomatoid mesothelioma. Thirty-five percent of patients have a mix of these two disease types. Patients diagnosed with epithelial mesothelioma have a better survival rate.
• Disease location—pleural mesothelioma affects the lining of the lungs. Peritoneal mesothelioma affects the lining of the abdomen and is generally more difficult to treat. Pericardial and testicular mesothelioma are also very difficult to treat, but are less common than pleural and peritoneal mesothelioma. Nearly 80 percent of patients with the disease have pleural mesothelioma.
• Overall patient health—stronger, younger patients have a better prognosis than older individuals who generally have other health problems, such as diabetes, hypertension, heart disease, etc. As patients age, surgery to remove the tumor, as well as more traditional cancer treatments such as chemotherapy and radiation therapy become more unsafe. Certain patients may not be eligible for certain treatment options.
• Metastasis—metastasis refers to the spreading of the cancer from its primary location, usually the pleura surrounding the lungs, to other nearby organs of the body and to the lymph nodes. A patient’s prognosis and options for treatment are determined by the extent to which the disease has metastasized.

In summary, those patients who have the best prognosis (opportunity for survival) have the following factors in their favor:

• The disease has been diagnosed while in stage one or stage two.
• The tumor is centrally located in its primary location; no metastasis has occurred.
• The patient is younger than age 55. An American Cancer Society study involving 2,959 mesothelioma patients younger than age 45 found that nearly 37 percent survived for longer than five years after initial diagnoses. Nearly 20 percent of mesothelioma patients who were ages 45 through 54 survived for that same amount of time.
• The patient is in generally good health overall.
• The cell type of the disease is epithelial.
• The patient is female and does not smoke.

In contrast, those patients with the poorest prognosis demonstrate the following:

• The disease has been latently diagnosed in stage three or stage four.
• The tumor has spread (metastasized) to other organs in the body.
• The patient is age 55 or older. The overall survival rate for mesothelioma patients according to the Journal of Thoracic Oncology is considered to be one year.
• The mesothelioma patient has poor general health with preexisting medical conditions such as heart disease or diabetes.
• The mesothelioma cell type is sarcomatoid or biphasic.
• The patient is a male who smokes.

Once patients are diagnosed with mesothelioma, they certainly want to know how to improve their prognosis. They may want to enroll in a clinical trial in which new medications and new treatments become available to them. Normal treatment options include surgery to remove the tumor and affected area as well as chemotherapy and radiation therapy.

The survival rate for patients with mesothelioma is statistically low; however, some patients have exceeded traditional life expectancy predictions and lived for several years after the disease has been diagnosed. However, the earlier the disease is diagnosed, the more treatment options patients have available to them.