Mesothelioma Prognosis

The term prognosis is used to describe:

• the likely outcome of a disease
• how long a diagnosed patient is expected to live
• the quality of life expected during that time

Malignant mesothelioma is extremely aggressive and cases are usually not detected until the disease is in the advanced stages. As a result the prognosis for such patients is often not favorable; the mesothelioma survival rate following diagnosis can be 6 to 18 months, longer in some cases.

Mesothelioma is usually one of three types, depending on the tissues involved: epithelial (50%), sarcomatoid mesothelioma (15%), mixed type (35%) (1). Epithelial mesothelioma has a better survival rate than the other types. Mesothelioma is also classified on the basis of location; pleural mesothelioma (lung) is the most common, accounting for approximately 80% of all cases. Peritoneal mesothelioma (abdominal) is much more rare.

The prognosis for mesothelioma cancer depends on how early the disease is diagnosed and how soon treatment is begun. One of the challenges that pathologists experience when attempting to diagnose mesothelioma is that the early mesothelioma symptoms are common to a wide range of respiratory disease that range from minor chest colds to full-blown lung cancer. By the time other diseases and conditions have been ruled out, the mesothelioma may have advanced quite far.

As the disease advances, chest pain and shortness of breath become worse, and is often followed by weight loss, night sweats, and anorexia. Eventually, the tumor obliterates the pleural space and replaces any pleural fluid, constricting the lung. Low oxygen levels result, leading to increased fatigue. Cancer may spread to other organs in the chest as well, including the heart, esophagus and trachea. It may also metastasize to any other part of the body.

Ironically, it is not the cancer itself that ultimately kills the patient, but rather the effect of the tumor on the internal organs. Extension into the abdomen may cause bowel obstruction; invasion of heart or pericardium may cause arrhythmia, heart failure or stroke.

Diffuse malignant peritoneal mesothelioma patients live about a year following a mesothelioma diagnosis on the average. There have been reports of a form of DMPM which progresses slowly; such patients usually have a better prognosis. Mesothelioma surgery to resection the affected bowel in such cases may improve survival rates.

Patients who are under the age of 65 and have been diagnosed with the epithelial type of mesothelioma, age under 65 years at diagnosis, are female and in better health otherwise usually have a better prognosis. Men over age 65 suffering from the sarcomatoid variety generally have a poor survival outlook.

These prognoses are based on averages among hundreds of patients; long-term survivors of mesothelioma do exist, however, some of whom have lived with the disease for a dozen years or more.

Sources

Sterman, D.H. and Albelda, S.M. "Advances in the diagnosis, evaluation and management of Malignant Pleural Mesothelioma." Respirology. 2005 June. Vol. 10 (3), pp 266-283.

Posted in: Mesothelioma