As with all cancers, a mesothelioma diagnosis is often accompanied by terms like survival rate, life expectancy, and prognosis. Hearing doctors provide estimates of the time you or your loved one have left to live can be traumatic, to say the least.
While these terms are similar in meaning, it’s important when talking to your doctors and loved ones that you understand how they differ.
Survival rates reflect the percentage of people with the same type and stage of cancer who survive for a specified amount of time after their diagnosis. For example, a 5-year survival rate of 50 percent indicates that about 50 out of every 100 people diagnosed are still alive 5 years after their diagnosis. Bear in mind, these people could live much longer than the initial 5 years being factored into the survival rates.
Life expectancy provides an estimation of the amount of time a patient is likely to live after a diagnosis. It factors in potential treatment options and their success rates, but ultimately relies on the statistics, averages, and historical data for all cases reported rather than the circumstances of each individual patient. Estimating life expectancy typically requires making assumptions, and as a result is difficult to pinpoint.
The term prognosis speaks to the likely development or expected progression of a disease. Similar to life expectancy, prognosis is an estimated forecast based on factors specific to the patient as well as historical data.
The important thing to remember is that you are not a statistic.
No one can predict how long you will live or how your body will respond to treatment. Maintaining a healthy level of optimism is vital for coping with a life-threatening diagnosis such as mesothelioma.
Mesothelioma is extremely rare — only accounting for 1 percent of all cancer diagnoses — making it difficult for doctors to accurately determine a patient’s life expectancy.
Because life expectancy is determined by a number of factors and each mesothelioma case is different, it should be an open discussion between you and your doctor. Determining life expectancy is largely reliant on estimations. While your doctors will do their best to help prepare you and your family for what is to come, it’s important to remember that life expectancy is not an exact science. Many patients live well beyond their initial estimations, while others do not.
Type of mesothelioma (i.e.: pleural, peritoneal, etc.), tumor cell type, stage, age, and your treatment plan are all unique to you and will help to determine your prognosis and guide your course of action for fighting the disease.
Mesothelioma Life Expectancy by Stage
Stage is one of the most significant determinants of a cancer patient’s life expectancy. It describes where the cancer is located, where it has spread, and whether it is affecting other parts of the body. For most types of cancer, doctors commonly follow a standardized staging system developed by the American Joint Committee on Cancer (AJCC) to determine a cancer’s stage.
- Stage 1
At stage 1, the cancer is generally small or the tumor has not grown deeply into nearby tissues. There is no spread to the lymph nodes or other parts of the body. It is often referred to as early-stage cancer.
- Stage 2 and Stage 3
In general, these 2 stages indicate larger cancers or tumors that have grown more deeply into nearby tissue. They may have also spread to lymph nodes but not to other parts of the body.
- Stage 4
Also called advanced or metastatic cancer, stage 4 cancers have spread to the lymph nodes and throughout the body.
Like many aggressive cancers, mesothelioma does not present symptoms in most patients until it has progressed into what is often considered Stage 3 or 4. However, patients and their families can take comfort in knowing that their specialty mesothelioma cancer care team (doctors, surgeons, and oncologists) are extremely well-versed in treating late-stage diseases. Your team of experts will be able to develop a customized treatment plan, typically including surgery, chemotherapy, radiation, and immunotherapy.
Mesothelioma Life Expectancy by Cell Type
Additionally, histology can greatly affect a mesothelioma patient’s life expectancy. Mesothelioma tumors occur in two cell types: epithelioid, sarcomatoid, or a combination of the two, referred to as biphasic. Epithelioid tumors begin in the cells that line an organ, whereas sarcomatoid tumors begin in the bone or soft tissues. Epithelioid tumors are generally associated with a better prognosis than sarcomatoid or biphasic tumors because they don’t spread as quickly and tend to respond better to treatment.
Mesothelioma Tumor Location in the Body
The location of mesothelioma in the body can also affect a patient’s life expectancy. Patients with peritoneal mesothelioma tend to have a longer life expectancy than those with pleural mesothelioma. This is mainly due to the treatment types available to peritoneal mesothelioma patients, as well as the fact that the peritoneal form affects the abdomen and not the chest where most of the vital organs are housed.
Interestingly, peritoneal mesothelioma is more often associated with non-occupational exposure than pleural mesothelioma. It tends to have a shorter latency period than occupational exposure cases and is predominantly found in women and diagnosed at a younger age.
Mesothelioma Treatment and Life Expectancy
Treatment plays an essential role in determining the life expectancy of a person facing a mesothelioma diagnosis. Treatment options have significantly improved over the years, as researchers and doctors race to understand more about the disease. Location and tumor type, stage and extent of spreading, and even overall health tie into the treatment options that will be available to a mesothelioma patient.
Patients diagnosed at stage 1 or 2 are usually stronger candidates for potentially curative treatment than those diagnosed at stage 3 or 4 when treatment options shift to focus on palliative care.
Peritoneal mesothelioma also tends to carry a stronger prognosis than pleural mesothelioma — primarily due to the location and treatment options available for this form of the disease. Therapeutic advances, such as HIPEC (hyperthermic intraperitoneal chemotherapy) and cytoreductive surgery, offer peritoneal patients an improved chance of survival. Combining the two in a multimodal treatment plan has historically offered patients a median life expectancy of 34 to 92 months. More recent studies have shown a potential increase in that range, closer to 53 to 92 months.
Patients with early-stage pleural mesothelioma may undergo surgery, chemotherapy, radiation, or a combination of some or all of these treatments in an effort to eradicate the cancer. Treatment options may include a pleurectomy/decortication procedure or extrapleural pneumonectomy — resective operations that aim to completely remove tumors. Palliative treatment, which focuses on symptom relief and pain management, is also an option often deployed to keep patients comfortable.
Patients may also be eligible for clinical trials, which aim to better understand and treat the progressive disease.
Research reveals that those exposed to asbestos at an early age and for an extended period of time are at higher risk of developing mesothelioma than those exposed later in life. About 65 percent of all mesothelioma cases are diagnosed at age 65 or older. Only about 4 percent of cases are diagnosed under the age of 45. Younger patients generally have a longer life expectancy than older patients, since younger patients tend to be healthier overall and better able to weather the treatment process.
According to the World Health Organization, approximately half of all deaths from occupational cancer can be attributed to asbestos. Because of this, the vast majority of mesothelioma diagnoses are among men who were exposed to asbestos in their workplace. Women make up a much smaller percentage of diagnoses, likely coming into contact with dangerous asbestos in the home or even indirectly through the transfer of asbestos dust from an exposed loved one who may have carried it home on their body or clothing.
Men have an average survival rate of 4.5 percent, as opposed to an average 13.4 percent for female mesothelioma patients.
If you or a loved one are living with mesothelioma, it’s important to seek out quality treatment and focus on your health. Mesothelioma is an aggressive disease — acting quickly can significantly impact your overall prognosis and increase your life expectancy.