Mesothelioma Prognosis

Mesothelioma is a serious cancer, most commonly found in the outer lining of the lungs, caused by exposure to airborne asbestos fibers. Even small amounts of asbestos and infrequent exposure can create a risk for contracting mesothelioma or other asbestos-related diseases.  Mesothelioma has an extended latency period – symptoms can sometimes take between 20-50 years to appear. Often called “asbestos cancer,” mesothelioma is highly aggressive and is resistant to many standard cancer treatments. Currently there are no known cures for mesothelioma, and the average survival time varies from 4 – 18 months after diagnosis. The overall prognosis for individuals with mesothelioma is not very good. The disease has among the lowest five year survivability rates among different cancers and remains extraordinarily difficult to treat. While research is ongoing and our knowledge of the disease is definitely increasing faster than it ever has, doctors know an actual cure is still years away.  However, large variabilities exist in many mesothelioma patients and there are people who have lived full lives after their diagnoses.
The most important disease-specific prognostic factors for patients with mesothelioma involve the form of mesothelioma as presented and the histological subtype of of the presented disease. Of the two major forms of mesothelioma,  pleural mesothelioma generally presents with a worse prognosis than peritoneal mesothelioma does. The physiological reasons for this difference are not completely understood, but a major factor is the histological aspect of the cancer. Pleural mesothelioma presents about fifty percent of the time with an epitheloid histologic subtype, twenty percent of the time with sarcomatoid subtype and the remaining thirty percent is the biphasic subtype, which is a combination of the previous two subtypes. Peritoneal mesothelioma presents in the vast majority of diagnoses with the epitheloid subtype. This is significant because epitheloid mesothelioma responds more favorably to treatment than sarcomatoid mesothelioma or biphasic mesothelioma does. Thus, with the majority of peritoneal cases featuring the most treatable histological subtype, one would expect for it to have a better overall prognosis. Conversely, with only half of pleural cases involving the most treatable subtype, one would also expect a generally worse prognosis.
Along with the biological aspects of mesothelioma as presented, another set of important prognostic factors includes the stage of the disease at diagnosis, the health of the patient and his or her age. All three will have a major impact on life expectancy and the future course of the disease. The stage of disease at diagnosis is a crucial factor in the development of the patient’s prognosis. As with all forms of cancer, early detection is important, but this is especially true of mesothelioma. Because mesothelioma generally resists curative treatment, doctors can manage the disease more efficiently if they have caught it in its early stages. The diffuse nature of the disorder means advanced tumor progression will invade large areas of tissue, making treatment even more difficult. Mesothelioma presents with symptoms shared by a number of other diseases and often goes undiagnosed because of these similarities. An early diagnosis is absolutely crucial if one hopes to control the disease.