Mesothelioma Prognosis

Prognosis by Mesothelioma Type

One of the most influential factors is mesothelioma type and cell type. Mesothelioma type is determined based on initial tumor location, usually occurring in the linings of the lungs, abdomen, heart or testicles. Pleural mesothelioma (lungs) and peritoneal mesothelioma (abdomen) are the two most common types.

In terms of cell type, mesothelioma cancer may be composed of sarcomatoid cells or epithelioid cells. If the cancer has both cell types, it’s referred to as biphasic mesothelioma.

Sarcomatoid mesothelioma usually has the worst prognosis of the cell types, as these cancer cells are aggressive and less responsive to treatment. Epithelioid mesothelioma usually has the best prognosis with slower spreading cells that are responsive to treatments. The prognosis for biphasic patients typically falls in between the two types, differing based on which cell type is dominant. In some cases, patients may be diagnosed with rare cell types, which also result in varied survival times.

Prognosis by Mesothelioma Stage

Staging can also help physicians predict how a patient’s condition may progress. Mesothelioma is typically staged using the TNM staging system, classifying the disease based on tumor location, lymph node involvement and metastasis. Metastasis references whether or not the disease has spread.

If a patient is diagnosed at stage 1 or stage 2, they are likely able to undergo multimodal treatments with radical surgeries and chemotherapy or radiation therapy to stop or slow disease progression, therefore improving prognosis. Diagnoses at stage 3 or stage 4 typically progress much quicker with lower survival rates because the mesothelioma cancer has already spread to the lymph nodes and distant organs within the body.

Other factors potentially influencing mesothelioma prognosis include patient age and overall health. Older patients may not respond as well to treatment, or may not be able to undergo aggressive treatments to slow progression. Patients with weakened immune systems or pre-existing conditions may also experience a worse prognosis.

Determining Mesothelioma Prognosis

Patients with malignant mesothelioma will typically discuss their prognosis with a specialist at the time of diagnosis. The mesothelioma doctor will review the patient’s medical records, type of cancer, stage and other characteristics to help determine a relative prognosis.

Prognosis can vary greatly from patient to patient, even if they have the same mesothelioma type and cell type and are diagnosed at the same stage. A prognosis is also not guaranteed, and survival time can vary based on how patients respond to cancer treatment and if they face any additional challenges after their original mesothelioma diagnosis.

Emerging Methods to Determine Prognosis

In an effort to provide patients with clear insight as to how their disease is likely to progress, doctors continue to develop new methods for determining prognosis. Two common studies being utilized recently include gene expression and biomarkers in the blood.

Improving Mesothelioma Prognosis

The best way to improve prognosis is through early detection. The earlier that mesothelioma cancer is detected, the more treatment options likely available to the patient. Early diagnoses can also help treat the cancer before it has spread to distant areas of the body. Due to the long latency period of mesothelioma, it can be difficult to recognize and address symptoms before stage 3. However, research continues to uncover innovative diagnostic tools, like new biomarkers in the blood or the mesothelioma breath test.

Patients can aid with early detection if they are aware of a history of asbestos exposure. If occupational exposure, secondhand exposure or other contact with asbestos is known, patients should let their doctor know and have routine checkups done to monitor for potential symptoms. Some blood tests can even reveal a history of asbestos exposure if the patient is unaware.

The Effect of Treatment on Prognosis

Once mesothelioma is diagnosed, patient survival and disease progression may differ from the original prognosis, depending on the treatment plan and response to treatment. Mesothelioma is usually treated with a multimodal approach, using a combination of surgery, chemotherapy and radiation therapy. Patients with a late-stage diagnosis may opt solely for a palliative treatment plan to improve quality of life with minimal treatment side effects.

Research continues to look at different combinations of traditional practices, such as surgery with hyperthermic intraperitoneal chemotherapy (HIPEC). HIPEC, a heated chemotherapy wash, is used to treat malignant peritoneal mesothelioma and has shown success in extending mesothelioma survival rates. Experimental treatments have also shown success in slowing disease progression and extending survival in clinical trials.

Patients and their loved ones should discuss their individual case and personal treatment options with their mesothelioma doctor to fully understand what’s available to them. Not all patients are eligible for clinical trials, though some experimental treatments, such as immunotherapy, are now becoming more widely accessible due to their success.

Mesothelioma Remission and Recurrence

Despite the statistics surrounding survival for mesothelioma patients, it is possible to achieve disease remission. Remission doesn’t indicate that the cancer has been cured, but rather that the condition has significantly improved. There are two types of remission: partial remission and complete remission.

Remission is often the result of patients undergoing aggressive multimodal treatments, as is seen with many mesothelioma survivors. Early detection can also contribute towards the possibility of remission as patients can begin treatment sooner, before the disease has spread. Whether in partial or complete remission, it’s crucial for patients to undergo frequent follow-up appointments to address potential recurrence.

Mesothelioma Recurrence

Recurrence is common for mesothelioma patients in remission. Recurrence indicates that the cancer has returned after a period of remission. Mesothelioma recurrence is usually described as local, regional or distant, depending on where the cancer has been found.

Mesothelioma patients that are experiencing a return of their cancer may not be able to undergo aggressive surgeries again. However, chemotherapy, radiation therapy and clinical trials may be viable options.

Patients in remission should discuss recurrence rates, cancer prevention techniques and continued treatment options with their specialist to fully understand their individual case.