Mesothelioma Prognosis | Factors & Life Expectancy


Mesothelioma prognosis is generally poor, as most patients are around one year old. The latency period of aggressive cancer does not affect the prognosis, but the later onset of the symptoms delays the effective treatment. Patients in the early stages live on the average of 22.2 months, while patients in the late stages live about 14.9 months.

The prognosis for mesothelioma is poor, most patients live less than a year. The type of mesothelioma, the stage of cancer and the health of the patient are the three most important factors used to determine the prognosis. The prognosis of mesothelioma can be improved if you receive treatment as soon as possible and lead a healthy lifestyle.
Mesothelioma Prognosis
Malignant mesothelioma is extremely aggressive and has a long latency period, meaning it usually goes undetected until cancer has reached an advanced stage. There is no cure for mesothelioma, although the prognosis has slowly improved over the years. This improvement in prognosis is due to the development of experimental treatments, new detection and diagnostic methods, and other research areas in clinical trials.

Coping with Your Mesothelioma Prognosis

After receiving a mesothelioma diagnosis, you will need to answer a few questions and make decisions:
  • Do I want to seek treatment?
  • If so, what are the good treatment options for me?
  • What are the side effects of the treatment?
  • How do I deal with side effects and take care of myself?
  • How do I pay for the treatment?
Finding a mesothelioma specialist who can guide you through your treatment options is one of the most important decisions you can make. You will be able to answer your questions, evaluate your individual case and discuss the best treatment options available to you. Conventional mesothelioma treatments such as surgery, chemotherapy, and radiation have been shown to positively affect prognosis, with mesothelioma survival rates even improving when these treatments are combined.

For qualified individuals, joining a clinical trial may be another way to improve your life expectancy. Clinical trials are research studies in which people voluntarily test new treatments, interventions or tests as a means of preventing, detecting, treating or treating various diseases or disorders. Many patients have benefited from the types of experimental treatments explored in these studies, such as gene therapy and immunotherapy. Talk to your doctor if you want to learn more about clinical trials that may be available to you.

Mesothelioma Prognosis by Type

There are four types of mesothelioma affect your body in different ways. The exact type plays an important role in deciding whether your prognosis is good or bad. The type of mesothelioma, which is determined by the place where it first develops, can have a major impact on the prognosis of the disease.

Pleural Mesothelioma

The pleural mesothelioma affects the lung lining and is the most common type of cancer with 80-90% of all diagnoses. The treatment is usually multimodal and, on average, pleural mesothelioma patients who receive some form of treatment live 6 - 12 months after diagnosis. Some treatments have been associated with slightly longer survival times, for example with chemotherapy using pemetrexed (Alimta) and cisplatin.

The prognosis of patients with pleural mesothelioma - the most common type - is not favorable. Research shows that about 40 percent of patients survive one year after diagnosis. As cancer forms in the lungs, tumors exert pressure on the chest cavity. This makes breathing difficult and can lead to pneumonia or heart failure.

Peritoneal Mesothelioma

Peritoneal mesothelioma affects the lining of the abdomen and is the second most common cancer with 15 - 20% of cases. Common treatments often include surgery, chemo and/or radiation. The median survival for patients with peritoneal mesothelioma is one year. Patients who are healthy enough to undergo surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) were able to improve the prognosis with a 5-year survival rate of up to 67%.

Patients with peritoneal mesothelioma have a much better prognosis. New treatments for stomach cancer, such as heated chemo, have improved the chance of long-term survival. About 50 percent of patients who undergo surgery with heated chemotherapy live longer than five years.

Pericardial Mesothelioma

Pericardial mesothelioma occurs in the lining of the heart and is one of the rarest forms of the disease, which occurs in 1 - 2% of mesothelioma diagnoses. This type has a very poor prognosis of about six months, with many cases being correctly diagnosed only after autopsy. In early detection, treatment is usually palliative to improve symptoms and quality of life.

The prognosis for pericardial mesotheliomas is generally poor. About half of the patients survive six months. Rare cases of five-year survival have been reported, usually involving treatment including surgery and chemotherapy.

Testicular Mesothelioma

The testicular mesothelioma occurs in the testes and, with only 1% of all diagnosed cases, is the rarest of the four types. The prognosis for patients with testicular mesothelioma is usually 20 to 23 months, although some have lived much longer. Treatment includes a multimodal approach to surgery, chemo and radiation therapy.

Although testicular mesothelioma is the rarest type, its prognosis is usually the best. The average survival time is about two years and some patients live more than a decade.

Which Factors Influence The Mesothelioma Prognosis?

There are five main factors that doctors consider when determining a prognosis for mesothelioma patients. Although these factors can help physicians to give a prognosis to patients, the progression of the disease differs from case to case.


The stage is the most important factor in determining the prognosis of a patient. Patients diagnosed at an early stage of mesothelioma have more treatment options and a better prognosis than patients diagnosed at a later date. Life expectancy for stage 1 mesothelioma patients is typically 21 months or longer and 19 months for stage 2 patients. 

In levels 3 and 4, patients generally only have palliative care options available to relieve pain and discomfort. On average, patients in stage 3 have a life expectancy of 16 months, while patients in stage 4 survive about 12 months after diagnosis.

Cell Type

Of the three primary mesothelioma cell types, epithelioid mesothelioma is the most common and has the best prognosis, as epithelial cells spread more slowly and respond to treatment. Biphasic mesothelioma has a poorer prognosis due to the presence of sarcomatoid cells. 

Sarcomatoid mesothelioma has the most unfavorable prognosis of these cell types as these cells spread aggressively and are less responsive to cancer treatments. In some cases, patients may be diagnosed with other rare cell types whose prognoses vary from a few months to 10 years or more.


Average life expectancy varies in patients diagnosed with pleural, peritoneal, pericardial and testicular mesothelioma. Testicular patients have a favorable prognosis with a mean survival time of about 20 - 23 months.
Peritoneal patients usually survive one year or longer, and patients with pleural mesothelioma have an average prognosis of about six months to a year. Pericardium patients have the most unfavorable prognosis of this type, with many diagnosed posthumously.


If the mesothelioma has spread to other parts of the body from which it originates, the prognosis is much worse. Once the disease spreads, it is much more difficult to surgically remove cancer or kill the cancer cells with chemotherapy. Typically, localized tumors can be surgically removed through targeted, aggressive treatments, leading to better prognosis and longer mesothelioma lifetimes.

General Health

Patients who are relatively young and healthy have a better prognosis because their bodies can handle aggressive treatments better. Elderly patients may not be able to survive the side effects of surgery, chemo, or radiotherapy, and are prone to have other conditions that can worsen the disease or limit treatment options.

In general, overall health will limit treatment options and reduce the life expectancy of patients who are diagnosed with mesothelioma.

Improvement Of a Mesothelioma Prognosis

In recent years, research has developed new diagnostic techniques and treatments for mesotheliomas that have helped improve the prognosis.

Improvement Of The Prognosis Before The Diagnosis

The best way to improve the prognosis of mesothelioma is the early diagnosis of the disease. By using blood tests to identify specific biomarkers (high levels of specific substances in the blood), researchers have been able to find new ways to detect mesothelioma at an early stage.

The first thing an individual can do is to understand the relationship between mesothelioma and asbestos exposure. If you have been exposed to asbestos in the past or have symptoms of mesothelioma, you should consult a doctor immediately.

Improvement Of Prognosis After Diagnosis

After a diagnosis of mesothelioma, the improvement in prognosis depends on the cell type, the location, and metastasis of the tumors, as well as the age, sex, and general health of the patient. While some of these factors can not be changed, patients should be confident that they are pursuing a healthy lifestyle by eating properly and exercising regularly. Holistic practices such as meditation, massage, and yoga can also alleviate mental and physical strain, which can also improve prognosis.

Apart from early detection, treatment is the best way to improve survival. Some treatments have proven to be more effective than others in improving prognosis. For example, surgery with HIPEC has significantly improved the prognosis for some patients with peritoneal mesothelioma. At least half of the patients undergoing this treatment survive for five years or more. Patients with tumors that can not be surgically removed may benefit from chemotherapy with pemetrexed, cisplatin, and bevacizumab. Radiation therapy can also be used in a multimodal treatment plan.

Clinical trials may provide some patients with definite hope of improving prognosis. These studies offer promising experimental treatments such as immunotherapy, gene therapy and photodynamic therapy, which in some cases have a longer life expectancy.

Mesothelioma Prognosis Through Stage

The size of the tumors and the spread (metastasis) of their place of origin influence the prognosis. Physicians typically discuss the tumor size and extent of cancer spread in levels from grade 1 to grade 4 by severity. Patients with stage 1 or stage 2 (early stage) typically have a better prognosis than patients with stage 3 or stage 4 (advanced stage).
Mesothelioma Prognosis
For the pleural mesothelioma, more prognosis data is available for the individual stages than for the peritoneal. The reason is twofold. First, the type of pleura is significantly more common, meaning that more patients need to collect data. Second, there is no formally administered staging system for peritoneal mesothelioma. This prevents researchers from collecting data on peritoneal survival after the stage.

Mesothelioma Prognosis in Stage 1

The patients diagnosed at stage 1 have the best prognosis. Cancer does not cause any symptoms at this stage. Aggressive treatments are recommended for people who are otherwise in good health.
Survival rates vary for pleural mesotheliomas of stages 1A and 1B
  • Stage 1A: The biennial survival rate is 46 percent and the five-year survival rate is 16 percent.
  • Stage 1B: The two-year survival rate is 41 percent and the five-year survival rate is 13 percent.
  • Median overall survival in stage 1 is 22.2 months after surgery.

Mesothelioma Prognosis in Stage 2

Patients diagnosed at stage 2 have a better prognosis than patients at the advanced stage. Cancer rarely causes symptoms at this stage, but patients may experience shortness of breath during exercise. Aggressive treatment plans are also recommended at this time.
  • There is a two-year survival rate for pleural mesothelioma is 38 percent and the five-year survival rate is 10 percent.
  • Median overall survival in Stage 2 is 20 months after surgery.

Mesothelioma Prognosis in Stage 3

The prognosis will be less favorable for patients diagnosed at stage 3. Cancer begins to cause symptoms at this stage, including chest pain, respiratory distress, and weight loss. Some Level 3 patients are eligible for aggressive treatment plans.
Survival rates vary for pleural mesotheliomas of stages 3A and 3B.
  • Stage 3A: There are the two-year survival rate is 30 percent and the five-year survival rate is 8 percent.
  • Stage 3B: There are the two-year survival rate is 26 percent and the five-year survival rate is 5 percent.
  • The mean survival time in stage 3 is 17.9 months.

Mesothelioma Prognosis in Stage 4

The forecast at level 4 is generally poor. At this stage, the symptoms worsen slowly and patients may develop fever, night sweats, and dysphagia. Palliative treatments are recommended in this phase to control the symptoms and prolong survival as long as possible.
  • The biennial survival for pleural mesothelioma is 17 percent and the five-year survival rate is less than 1 percent.
  • The mean survival time in stage 4 is 14.9 months.

Treatment Options For Mesothelioma

Mesothelioma is primarily treated with surgery and chemo. Radiation therapy and immunotherapy play a role in multimodal therapies or clinical trials. Most patients are diagnosed too late to qualify for surgery and undergo only chemotherapy. The people diagnosed in Stage 1, 2, or 3 may qualify for aggressive surgery. Tumor-removing surgery offers the best chance for long-term survival. The surgery may involve the removal of an entire lung, part of the lung, or only the removal of the lung lining, the so-called pleura.

Many people wonder if a person can live with a lung and the answer is "yes". Surgery is regularly combined with chemotherapy and sometimes radiotherapy or immunotherapy. Chemotherapy, radiotherapy, and immunotherapy are available to patients at all stages. The response rate of chemotherapy is nearly 50 percent. 
This means that in about half of the mesothelioma patients tumor shrinkage or no new tumor growth occurs over a certain period of time. A 2016 study published in the journal Clinical Epidemiology found that patients who received chemotherapy lived on average for 12 months, while those who did not receive treatment lived on average for four months. Palliative care aims to control the symptoms and improve quality of life. It is also available at any time.

Patients with peritoneal mesothelioma may improve their prognosis through a combination of surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). For this purpose, chemotherapeutic agents are added to a heated saline solution and pumped directly into the patient's abdomen. Research has shown that about half of the patients who have undergone this procedure have survived for more than five years.

Mesothelioma Remission and Recurrence

Despite a generally poor prognosis, some mesothelioma patients achieved remission and long-term survival. There are the two types of mesothelioma remission: partial remission and complete remission. A partial remission shows that cancer improves dramatically, reducing tumor size by at least 50%. A complete remission indicates that cancer has been completely removed or destroyed. This is most often the case in patients with early detection and aggressive treatments.

While remission is a great achievement for patients, it is important to have regular follow-up visits and checks to detect possible recurrences or the return of tumors after the remission. Early detection of recurrent tumors is important, and patients with a history of benign mesotheliomas should also be aware of the fact that tumors may recur as malignant tumors.

The repetition rates depend on a variety of factors, including cell type or previous treatments. For example, in more than half of the patients in a study of patients with cystic mesothelioma, recurrence occurred. Another study finds that recurrence may also be high in patients who undergo aggressive treatments, such as extrapleural pneumonectomy or pleurectomy decortication.

The researchers found local recurrence rates of 41 - 71% and distant recurrence rates of 10 - 65% in both operations. With different recurrence rates, all mesothelioma patients should be aware of the risks and receive professional medical care throughout the remission.



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Mesothelioma Master: Mesothelioma Prognosis | Factors & Life Expectancy
Mesothelioma Prognosis | Factors & Life Expectancy
A mesothelioma prognosis reflects how certain factors may impact your life expectancy and affect your chances of recovery.
Mesothelioma Master
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