One of the most overwhelming and potentially discouraging things about a mesothelioma diagnosis is the outlook moving forward. Many mesothelioma patients are given a rather daunting prognosis–that is, a projection of how the disease is likely to progress–especially when it comes to projected survival rates and lifespans.
What is the average prognosis of someone with mesothelioma?
When considering average prognoses, we have to remember that averages are not absolutes. Averages are just that: average, or the most common experience among a wide range of experiences. Just because an experience is average doesn’t mean that it will directly correspond to or a define each particular individual’s experience.
The average mesothelioma prognosis is a little more than one year. This time frame is based on the average survival rates from all past mesothelioma cases, taking into account potentially prognosis-improving new therapies.
However, when you get more specific, average prognoses vary depending on a number of factors, including:
- Type of Mesothelioma: Different types of mesothelioma have different average prognoses. While pleural mesothelioma, which affects the lining of the lungs, has an average prognosis of 6-12 months, peritoneal mesothelioma, which affects the lining of the abdomen, has an average prognosis of around 2-5 years.
- Cell Type: Just like there are different types of mesothelioma based on where the cancer develops, there are also different types of mesothelioma based on what types of cancer cells compose the tumor. There are three major types of mesothelioma in terms of composition of cancer cells: epithelioid, which is the most common, sarcomatoid, which is less common, and biphasic, which is a mix of epithelioid and sarcomatoid.
Generally, patients with epithelioid mesothelioma have better prognoses, as these cells are less aggressive, spread slower, and respond better to treatment. Patients with sarcomatoid tend to have worse prognoses, as these cells are more aggressive, faster spreading, and less responsive to treatment. When it comes to biphasic mesothelioma patients, prognosis will depend on relative percentages of epithelioid and sarcomatoid cells–with higher percentages of epithelioid cells meaning better prognoses.
- Stage of Cancer at Diagnosis: Cancer is diagnosed and described in terms of TNM stages, which describe the tumor location, lymph node involvement, and metastasis (or spread). Generally, the higher the stage, the more advanced the disease. Patients whose mesothelioma was diagnosed while still in early stages tend to have better prognoses, while patients with later-stage diagnoses tend to have worse prognoses.
If mesothelioma is diagnosed at Stage 1 or Stage 2, there are more treatment options, and the prognosis is therefore usually better (on average, 21 months or longer for Stage 1 diagnoses, and 19 months or longer for Stage 2 diagnoses). However, if the mesothelioma has already begun to spread, as in Stage 3 diagnoses, or has already spread to distant parts of the body, as in Stage 4 diagnoses, average prognoses are more limited (around 16 months and 12 months, respectively).
- Age: In cases of mesothelioma, as with most types of cancer, the younger a patient is, the better their prognosis tends to be. Patients who are 75 and older tend to have a shorter prognosis than those who are 50 years and younger at the time of diagnosis. Patients under 50 tend to have much better prognoses than older patients: one study suggested that patients diagnosed with mesothelioma at age 44 or younger lived almost six times as long as those diagnosed at 75 or older.
- Gender: Generally, women tend to have better average mesothelioma prognoses than men. It is not fully understood why, but one study suggested that this difference is quite significant, showing among its subjects that women lived eight months longer than men with mesothelioma on average.
- Overall Health: Fighting cancer is very taxing on the body, and patients in poorer health may have fewer viable treatment options than those in better health. As a result, those who were already in poor health or had pre-existing conditions when they got their mesothelioma diagnosis may have worse prognoses than those who are diagnosed while in otherwise good health.
- Blood Chemistry: Some characteristics of a mesothelioma patient’s blood may impact their mesothelioma prognosis. Certain blood-related biological characteristics, such as elevated white blood cell counts, high platelet counts, and low hemoglobin levels, tend to worsen
What do people who beat their prognoses have in common?
Now that we have a sense of what an average mesothelioma prognosis looks like, there’s some better news: mesothelioma patients sometimes beat their prognoses, and more and more mesothelioma patients are joining their ranks as time and medical science progress onward.
New treatments and therapies are making it possible for some people to outlive their prognoses by years, and to improve their quality of life both during and after treatment.
While there is no “magic bullet”, it is worth noting that many of the mesothelioma patients who have beaten their prognoses and surpassed the expectations of their doctors have several things in common. In addition to pursuing the course of treatment ultimately recommended by their medical team, mesothelioma patients who beat the odds often utilized the following:
- Getting a Second Opinion: As is the case for all cancers and serious conditions, it is absolutely worth it to get a second opinion after your first mesothelioma diagnosis. Don’t worry about hurting your doctor’s feelings or insulting them: no credible doctor will be offended if you seek out the opinion of a second doctor, as this is considered standard in the field.
Second opinions are so important because they give you access to more information, and potentially more options. Doctors are still human, and their opinions are subject to human error. A second opinion may reveal that your mesothelioma is not as advanced as the first doctor believed. Alternatively, your first doctor may not have offered certain treatments if they believed the risks outweighed the benefits. A second doctor may disagree, and help you get a better sense of what your treatment options actually are.
Many mesothelioma patients who beat their prognoses sought out second opinions, and in doing so learned important information that helped improve their odds.
- Finding a Mesothelioma Specialist or Specialist Cancer Center: Once you have your diagnosis, you should absolutely try to find a mesothelioma specialist or s cancer center that specializes in treating your specific type of mesothelioma. Mesothelioma is a relatively rare cancer, and general oncologists may not have the knowledge or tools to provide you with the best treatments possible.
Many mesothlioma patients who beat their prognoses sought out and received care from top mesothelioma experts or highly rated mesothelioma treatment and research hospitals. These specialists and centers/hospitals will have access to the latest information and the most cutting-edge treatments in order to give you the best shot at beating your prognosis.
- Experimental Treatments and Therapies: Many prognosis-beating mesothelioma patients utilized one or more of the standard, first-line mesothelioma treatments (surgery, chemotherapy, and radiation). Many also utilized experimental treatments, which are not considered “first-line” for several reasons, but which may work wonders on individual cases of mesothelioma. These include:
- Immunotherapy: Immonotherapy is a cancer treatment that uses the patient’s immune system to fight cancer in a targeted way. One of the most common immunotherapies for pleural mesothelioma is a combination of Opdivo (nivolumab) and Yervoy (ipilimumab). Another immunotherapy being used to treat mesothelioma is CAR T-cell therapy, which reprograms t-cells to target and attack mesothelin (a protein produced by mesothelioma cancer cells), often used in combination with Keytruda (pembrolizumab), an immunotherapy drug similar to Opdivo.
- Photodynamic Therapy (PDT): Often used in combination with other treatment methods, PDT uses light to kill cancerous cells. It works by giving the patient a photosensitizing drug that collects in cancer cells but not healthy cells, making the cancer cells vulnerable to light of specific wavelengths. Fiberoptic cables are then placed in the body to focus light in that wavelength onto the tumor, producing a toxic oxygen molecule that kills the cancer cells.
- Angiogenesis: Since cancer cells rely on a regular supply of blood, and must develop a network of adjacent capillaries and larger blood vesels in order to get enough blood (a process which is called “angiogenesis”). There is currently extensive research being done on how to slow down, reduce, or stop angiogenesis in order to cut off the tumor’s blood supply and starve cancer cells to death.
- Clinical Trials: Clinical trials are a huge boon to many mesothelioma patients, and have been shown to be helpful in a sizable amount of cases where mesothelioma patients beat their prognoses. These trials, which may give patients access to otherwise unavailable treatment options, were the lynchpin for a variety of prognosis-beating mesothelioma patients. One of the reasons why it is important to find a mesothelioma specialist or specialist treatment center is their ability to connect patients with ongoing clinical trials, and potentially with prognosis-beating treatments.
- Nutrition: Whether or not you have mesothelioma, nutrition is one of the key building blocks of health and improved health outcomes, especially when it comes to medical prognoses. Studies have shown that nutrition may help patients before, during, and after their treatment for mesothelioma. While there is no magic bullet food you can eat or not eat to shrink a tumor, maintaining a nutritious diet supports mesothelioma treatments and can therefore improve outcomes. Many cancer treatment centers and mesothelioma specialists will be able to refer mesothelioma patients to an oncology nutiritionist who can help patients make changes to their diet to facilitate treatment.
The National Cancer Institute’s Exceptional Responder’s Initiative (ERI), which studies patients who outlive their initial life expectancies, found that 50% of prognosis-beating cancer patients changed their diet after recieving a cancer diagnosis, mostly by decreasing red meat and carbohydrates and increasing fruits and vegetables.
- Exercise: While it may be difficult to maintain an exercise regimen during mesothelioma treatment, fitness training seems to be effective in helping mesothelioma patients improve their prognoses. Research shows that exercise like resistance training and aerobics may help reduce fatigue during treatment, reduce the risk of cancer returning after treatment, and improve life expectancy. 33% of ERIs interviewed by the National Cancer Institute started exercise programs or increased their exercise levels upon diagnosis.
- Complementary/Alternative Therapies and Supplements: Both complementary and alternative medicine and vitamin or mineral supplements may improve a mesothelioma prognosis in some circumstances. They may also reduce mesothelioma and treatment symptoms and improve overall quality of life. Alternative therapies like acupuncture, yoga, meditation, massage, and biofeedback are widely reported among patients who beat their mesothelioma diagnoses, with 60% of ERIs reporting that they utilized at least one of these therapies. Supplements like calcium, folic acid, magnesium, beta-carotene, amino acids, magnesium, protein, selenium, and vitamins A, B12, D and E can help ensure mesothelioma patients are getting everything their bodies need to put up the best fight possible. Over 50% of ERIs reported that they took supplements of some sort during their cancer treatment.
- Community Support: One of the most essential boons for mesothelioma patients in improving their prognoses is spiritual/communal strength and support. A diagnosis like mesothelioma can be isolating and alienating for patients, which means it’s more important than ever to strengthen and rely on community support networks to remind them that they are not alone.
Many mesothelioma patients who beat their prognosis reported that their strong network of support was pivotal in improving their outcomes. There was also a high reported rate of participation in support groups, where patients were able to touch with other people with similar prognoses. In addition, professionals like counselors/therapists and mesothelioma patient advocates can be enormously important resources for patients looking to improve their odds and their quality of life.