Mesothelioma has a poorer prognosis than other forms of cancer which may be curable. However, a doctor should give context to the prognosis based on a patient’s overall health, disease progression, and eligibility for various treatments . Many patients benefit from a second opinion to learn more about treatment options and feel assured their provider has experience in treating this rare cancer.
For all stages and types of mesothelioma combined, life expectancy is around 12-21 months. Cancer found in earlier stages tends to have a better prognosis and longer life expectancy. Treatment can help improve the overall prognosis, quality of life, and life expectancy.
What is the Prognosis for Mesothelioma?
A mesothelioma prognosis reflects how certain factors may help determine your life expectancy, affect your chances of recovery, and impact your well-being. The average life expectancy for a person diagnosed with mesothelioma ranges from 12 to 21 months depending how advanced and aggressive the disease is. Factors that affect prognosis include the cell type, stage, and location of the disease.
More and more patients are living even longer because of better treatments and advances in research. Patients can take control of their prognosis by seeking out an experienced mesothelioma specialist. Not all oncologists (cancer doctors) have treated people with mesothelioma. Many patients benefit from a second opinion to learn about more treatment options and feel confident their provider has experience with this rare disease. Get in touch with a member of our Patient Help Team to get connected with a mesothelioma expert doctor.
Important Prognostic Terms To Know
Prognosis is an overall outlook for an individual patient. While each stage and type of mesothelioma have their own survival statistics and average life expectancies, every patient is different. There are important terms for patients to understand when it comes to prognosis:
- Survival Rate - The percentage of people who survive mesothelioma compared to the general population. This rate, given as a percentage, is often referred to in two or five-year increments.
- Life Expectancy - How long a patient can expect to live with their cancer. Life expectancy is a measure of time, often expressed in total months. Remember, life expectancy can vary among different populations, such as age and gender.
- Death Rate - The ratio of deaths from mesothelioma to a specific population or period of time, often per 100,000 people per year.
Survival Rates for Mesothelioma
Survival rates are part of your prognosis, but it's important to remember that they are general statistics and not specific to you and your body. Doctors use survival rate statistics to help determine your prognosis combined with other factors.
No matter the survival rates associated with your diagnosis, mesothelioma survivors have proven that it's always possible to outlive a prognosis.
You may see mesothelioma survival rates reported as a 5-year percentage, or as a total number of years and months. Five-year rates show the percentage of patients who survived 5 years after they were diagnosed, and specific years or months reflect how long a patient survived after they were diagnosed or received treatment.
The 5 Year Survival Rates for Mesothelioma are:
- 44.2 percent for patients 45 years old or younger.
- 15.6 percent for patients between the ages 45 – 54.
- 15.9 percent for patients less than 65.
- 5.1 percent for patients over 65.
Data sourced from most recent statistics from the National Cancer Institute (NCI).
Your doctor may also relate your survival rate to the cancer stage and location of the mesothelioma. For example, Stage II mesothelioma patients have a better prognosis than Stage IV patients, and patients whose mesothelioma originates in the abdomen (peritoneal mesothelioma) often have a better prognosis than patients with pleural mesothelioma, which originates in the lung.
Early–stage mesothelioma hasn’t spread as far as advanced–stage mesothelioma and is easier to remove. The difference in stage may simply reflect the time it took to be accurately diagnosed. Because mesothelioma can initially cause symptoms similar to less serious conditions, it may not be suspected immediately. If you have a history of asbestos exposure —the only known cause of mesothelioma — of any type or amount, getting diagnosed as soon as possible may allow you more treatment options and improve your prognosis. Depending on how far the cancer has spread, doctors may have limited options for treating it with surgery, chemotherapy, or radiation therapy.
Mesothelioma survivors have often outlived their prognoses by exploring all their treatment options. Multimodal treatments and clinical trials often offer the best chances for patients to beat their prognosis.
"When hope is in the equation, anything is possible."Dr. David Sugarbaker, Leading Mesothelioma Surgeon and Specialist
Factors That Affect Your Mesothelioma Prognosis
Cancer stage, type of mesothelioma (including where cancer first developed in your body), and location of tumors all affect prognosis. Early-stage mesothelioma, for example, tends to have a better prognosis than late-stage disease. Similarly, cell type can impact prognosis, with epithelioid cells having a better prognosis than both sarcomatoid and biphasic cell types.
Lifestyle factors, such as diet and exercise, and overall health also impact how your cancer may progress. Generally, patients with good overall health have a better prognosis than patients with pre-existing conditions. Your health may determine for which treatments, especially surgery, you would be a good candidate.
Factors beyond your control:
- Stage of mesothelioma when diagnosed
- Location of the mesothelioma
- Cell type of the mesothelioma
Factors within your control:
- Treating with a mesothelioma specialist
- Getting a second opinion
- Participating in clinical trials
- Living a healthy lifestyle — including nutrition and staying active
- Maintaining a positive frame of mind
- Developing a support group of family and friends
- Accepting help when you need it
Mesothelioma Tumor Location
Mesothelioma is often categorized based on where the primary tumor is located and/or where the cancer originated. It is possible to have more than one type, or to not be able to determine where in the body it first started. There are four main types of mesothelioma, some of which occur more commonly than others:
- Pleural. Found in the lining of the lungs (pleura)
- Peritoneal. Originating in the tissue lining the abdominal wall (peritoneum)
- Pericardial. Starting in the membrane surrounding the heart
- Testicular. Found in the testes
Pleural Mesothelioma Prognosis
Pleural mesothelioma is found in the lining of the lungs (pleura). Malignant pleural mesothelioma patients have a life expectancy of around 18 months, which varies by cell type. Surgery and sometimes radiation can improve prognosis in earlier stages. In later stages, when cancer has spread to nearby lymph nodes and beyond, chemotherapy and immunotherapies can help extend and improve quality of life.
Peritoneal Mesothelioma Prognosis
Peritoneal mesothelioma originates in the tissue lining the abdominal wall (peritoneum). Life expectancy for peritoneal mesothelioma tends to be longer than for pleural, and averages around 53 months but can vary deepening on cell type and stage at diagnosis. The most common treatment for peritoneal mesothelioma is HIPEC – a specific combination of surgery and chemotherapy administered at the same time.
Pericardial and Testicular Mesothelioma Prognosis
Testicular mesothelioma is found in the testes. Life expectancy for this mesothelioma averages nearly four years. The most common treatment for this cancer is surgery, which can be used alongside chemotherapy and other therapies to improve prognosis.
Pericardial mesothelioma starts in the membrane (pericardium) surrounding the heart. Life expectancy for this cancer is about six months. Treatments including pericardiectomy, chemotherapy, and palliative care can help improve prognosis.
Mesothelioma Cell Type
Different cell types can make up your mesothelioma tumor(s). Different cell types respond to treatment in different ways, and grow at different rates. The main cell types are:
Your oncologist will conduct cell histology to understand what types of cells make up your cancer. It is possible to have a mixture of different cell types in a tumor, as well as different cell types in different areas of the lining.
Epithelioid is the most common mesothelioma cell type. These cancer cells, which are square or cubic, are mutated epithelial cells. They are less aggressive than others, grow slowly, and tend to respond well to treatment. Life expectancy for patients with epithelioid mesothelioma averages 18-23 months, but varies significantly based on treatment and the area of the body in which the cancer is located.
Sarcomatoid mesotheliomas are the most aggressive cell type. These cancer cells have a characteristic spindle shape. Patients with sarcomatoid mesothelioma have a life expectancy of fewer than four months to eight months without treatment. However, immunotherapy has been show to significantly improve the life expectancy of people with sarcomatoid pleural mesothelioma.
Biphasic mesotheliomas contain both epithelioid and sarcomatoid cells. Life expectancy for patients with biphasic mesothelioma is around 10 months without treatment. Patients with pleural mesothelioma of the biphasic type have been show to benefit significantly from immunotherapy treatment.
Mesothelioma Prognosis by Stage
Mesothelioma stage is likely the biggest factor in determining your prognosis. The stage is only a reflection of how much the mesothelioma has grown or spread by the time it is diagnosed. Some people do not have significant symptoms at earlier stages, and for some, their mesothelioma is discovered accidentally through routine imaging or other surgery. Generally, patients with early-stage mesothelioma have a better prognosis than advanced-stage patients. Early detection means more available treatment options, like surgery, that might not be options in later stages after cancer has metastasized. Staging cancer is an integral part of diagnosing your mesothelioma.
Stage I Prognosis
Patients diagnosed with Stage I mesothelioma have the best prognosis since they have the most treatment options available, including surgery. Life expectancy averages around 21 months, with much longer survivorship possible with some treatment options.
Stage II Prognosis
For patients diagnosed with Stage II mesothelioma, in which cancer has spread to nearby lymph nodes, the prognosis remains good. It is easier to diagnose mesothelioma at this stage because of larger tumor size and more physical symptoms. The median survival for this stage is around 19 months without treatment.
Stage III Prognosis
The prognosis for Stage III mesothelioma is less positive because cancer has spread throughout the affected region and treatment options may be limited now. The median life expectancy for Stage III mesothelioma is around 18 months without treatment.
Stage IV Prognosis
Given the spread of cancer to distant organs, the prognosis for Stage IV mesothelioma is poor. The average life expectancy is less than one year.
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Other factors that affect prognosis
Maintaining a balanced diet can be a challenge for mesothelioma patients, especially when experiencing a loss of appetite or abdominal bloating. However, poor nutrition can hurt their prognosis. In later cancer stages, malnutrition can increase as patients lose their appetite and miss out on key nutrients or become dehydrated. Patients who work on maintaining proper nutrition during their treatment can improve their quality of life.
Overall health of Patient and Demographics
In general, younger people diagnosed with mesothelioma survive longer than older people. While mesothelioma can occur many decades after asbestos exposure and patients are generally older when diagnosed, patients diagnosed before the age of 45 can live up to six times longer than patients diagnosed after 75.
Similarly, gender plays an important role in prognosis, as women diagnosed with mesothelioma tend to live longer than men. One NCI study on peritoneal mesothelioma found women have a five-year survival rate three times that of men. Women are also more likely to be diagnosed with the peritoneal (abdominal) form of mesothelioma.
Other conditions can also be risk factors that impact prognosis. Patients with some conditions, like COVID-19 and lung cancer, may not be able to manage the side effects of aggressive treatment. Some pre-existing conditions require daily medication that would limit a patient’s ability to receive a full dose of immunotherapy or chemotherapy.
Treatments That Can Improve Your Prognosis
Mesothelioma treatments are available for patients at every stage, but they are most effective for early-stage cancers before tumors have spread. Treatments include therapies to shrink or remove tumors, as well as palliative care options that aim to reduce symptoms and improve quality of life.
Some treatment options include:
- Multimodal therapy: This type of therapy combines several types of treatments, such as chemotherapy and radiation. Using more than one type of treatment typically depletes more mesothelioma cells than a single form of treatment.
- Surgery: Although not all patients are eligible for surgery, it offers the best chance of removing mesothelioma cells from the body.
- Clinical trials: Patients who have exhausted all of their treatment options may be able to turn to clinical trials for more options. While these treatments are considered experimental today, they could very well become standard treatment in the near future.
- Chemotherapy: Chemotherapy uses medications to kill cancer cells and shrink tumors and can be used for most stages of mesothelioma. In early stages, chemotherapy is often used after a surgical procedure to help remove additional cells and ensure clear margins.
- Immunotherapy: A newer cancer treatment option, immunotherapy stimulates the immune system to fight cancer on its own. The combination of two immunotherapy drugs, Opdivo® (nivolumab) and Yervoy® (ipilimumab), has been shown to improve survival for malignant pleural mesothelioma with fewer side effects than chemotherapy
- Radiation Therapy: Also called radiotherapy, it uses high doses of radiation to damage cancer cells, which hinders growth and helps to shrink tumors. Radiation is most effective on small targets, which is why it is a less effective treatment once cancer has spread.
Mesothelioma survivors have often outlived their prognoses by exploring all their treatment options. Multimodal treatments and clinical trials often offer the best chances for patients to beat their prognosis.
"When hope is in the equation, anything is possible."
-Dr. David Sugarbaker, Leader Mesothelioma Surgeon and Specialist
Other Ways to Improve Your Prognosis
The prognosis for mesothelioma is shorter than many other types of cancer, but every patient can take concrete actions to help them live longer. Improving your prognosis begins with accepting what you can't change and taking control of what you can change.
- Get treatment from an experienced doctor: Mesothelioma is a very rare disease, and few oncologists are truly experienced treating the disease. Specialists experienced in treating patients with mesothelioma can be a must if you wish to improve your prognosis. Seeking help from a mesothelioma specialist may be the most important step you can take to improve your prognosis. Sometimes specialists are located in other cities, but they can create a treatment plan to be administered locally.
- Seek a second opinion: Patients who take control of their diagnosis get the best treatment, and this may be accomplished by getting a second opinion. Not all doctors will perform the same procedures or offer the same treatments, and some may have a more favorable prognosis for you. Patients who get a second opinion may learn that a different doctor is more capable of treating them. Good doctors encourage their patients to seek second opinions, and are not offended by you doing so.
- Participate in clinical trials: Clinical trials play an essential role in the development of new treatments, some of which may lead to a cure in the future. Every traditional mesothelioma treatment started as a clinical trial. Participating in a clinical trial gives you access to new treatments and expands your options. Some survivors have a clinical trial to thank for their lives.
- Live a healthy lifestyle: You can help improve your prognosis by eating healthy and getting plenty of exercise. Cancer care teams often include registered dietitians and you may be prescribed supplements. The stronger your body is, the better it is equipped to fight the disease. A healthy immune system can also help you recover from side effects caused by major treatments, like surgery or chemotherapy, and improve your overall quality of life.
Understanding Your Prognosis
Your survival rate is based on statistics researchers gather from the experiences of past patients, so it is not an exact prediction of your future. Doctors use such statistics to help explain how your diagnosis may affect your health, quality of life, and treatment options. To better understand your prognosis, seek treatment from a doctor who has experience with mesothelioma patients, and specifically your type of mesothelioma. He or she will confirm your stage and cell type to create a treatment plan tailored to your needs.
Our Patient Help Team can have a conversation with you about your diagnosis and help connect you to experienced doctors—for free. Speak with a member of our team and get started on improving your prognosis.
Mesothelioma Prognosis FAQs
Is mesothelioma always fatal?
There is no cure for mesothelioma, although some patients have been able to go into short-term remission or survive years after their diagnosis. Mesothelioma caught in an early stage has a better prognosis with more treatment options available compared with later stages, leading to a better chance of long-term survival. Additionally, maintaining good overall health can improve your prognosis.
How long do you live after being diagnosed with mesothelioma?
For mesothelioma overall, life expectancy is around 12-21 months. Cancer found in earlier stages, before it spreads to other parts of the body, tends to have a better prognosis and longer life expectancy. There is also a longer life expectancy association with epithelioid mesothelioma, as well as mesothelioma located in the abdomen. Treatment can help improve the prognosis for all mesothelioma patients.
Can you live for years with mesothelioma?
Mesothelioma is not curable, but some cancer patients have lived longer than 10 years after their diagnosis. Catching cancer in its earliest stages, receiving early and aggressive treatment, and maintaining a healthy lifestyle all improve the chances of living longer. Certain types of mesothelioma, such as peritoneal, are associated with longer life expectancy. Patients who are younger at the time of diagnosis are more likely to live several years longer than others.
How quickly does mesothelioma progress?
Cancer takes decades to develop after exposure to asbestos. Late-stage (3-4) disease tends to progress quickly. Certain cell types, like sarcomatoid and biphasic mesotheliomas, are very aggressive and metastasize to other areas of the body quickly. Other cell types like epithelioid mesothelioma, spread more slowly. Immunotherapy has proven to increase survival rates for sarcomatoid and biphasic pleural mesothelioma to be closer to that of epithelioid cell tumors.
How can I help my loved one with mesothelioma?
You can support your friend or family member by helping out with everyday tasks such as laundry or yard work, offering transportation to medical appointments, managing a full calendar of doctor visits, and providing emotional support during a difficult diagnosis. You can also advocate for cancer research and encourage your loved one to take part in any available clinical trials or emerging treatments.
American Cancer Society. Survival Statistics for Mesothelioma. Accessed on 2/16/16. Retrieved from: http://www.cancer.org/cancer/malignantmesothelioma/detailedguide/malignant-mesothelioma-survival-statistics
National Cancer Institute. Malignant Mesothelioma Treatment. Accessed on 2/16/16. Retrieved from: http://www.cancer.gov/types/mesothelioma/patient/mesothelioma-treatment-pdq
Baratti, Dario, et al. "Diffuse malignant peritoneal mesothelioma: Long-term survival with complete cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (HIPEC)." European Journal of Cancer. Published online: 7/8/13
Chance, William, et al. "Hemithoracic Intensity Modulated Radiation Therapy After Pleurectomy/Decortication for Malignant Pleural Mesothelioma: Toxicity, Patterns of Failure, and a Matched Survival Analysis." International Journal of Radiation Oncology. January 1, 2015