Explaining the Factors
A few factors influence life expectancy a great deal; you can limit the influence these factors have on your life expectancy by getting specialized treatment from an experienced doctor.
The stage of your disease describes how far the mesothelioma has spread from where it originated. The farther the disease has spread, the more advanced it is and the later the stage. A patient's life expectancy is greater in the earlier stages. The patient also has more effective treatment options in the earlier stages of the disease.
Doctors diagnose the stage of a pleural mesothelioma patient's disease as stages 1-4, with stage 4 being the most advanced stage. There is currently no accepted staging system for peritoneal mesothelioma, so doctors diagnose these patients as having either localized or advanced stage mesothelioma.
The following list explains how doctors diagnose the stage of pleural mesothelioma:
- Stage 1: The cancer is localized to the point of origin.
- Stage 2: The cancer has spread to the lung itself, part of the diaphragm, and nearby lymph nodes.
- Stage 3: The cancer spread throughout one side of the chest, into the chest wall, esophagus and more lymph nodes.
- Stage 4: The cancer has spread into both sides of the chest, affecting other organs, the blood, and bone cells.
While the stage of your disease can help determine your life expectancy, it's important to remember that current statistics are based on the average life span of mesothelioma patients. These averages include patients who didn't receive treatment from a specialist; therefore, your life expectancy could be far better with the right treatment.
According to the American Cancer Society, some life expectancies based on mesothelioma stage are:
- Patients with stage 1 or 2 pleural mesothelioma have an average life expectancy of 19 to 21 months.
- Patients with stage 3 or 4 pleural mesothelioma have an average life expectancy of up to 16 months.
- Patients with peritoneal mesothelioma who receive surgical treatment often have life expectancies greater than 5 years.
Mesothelioma diagnosed at an early stage responds better to curative treatment, like surgery or chemotherapy. In fact, with the right treatment, the life expectancy of a patient diagnosed with stage 1 mesothelioma may range from 30 to 40 months — over 2 times the average life expectancy of all patients.
Mesothelioma cell type has a huge impact on your life expectancy. There are three cell types: epithelioid, sarcomatoid, and biphasic. Each cell type behaves — and responds to treatment — differently. Doctors determine the cell type of a tumor when they diagnose you. Identifying the cell type helps them create the most effective course of treatment for your diagnosis.
Epithelioid cells are egg-shaped and stick to each other as they spread. As a result, they spread slowly, making epithelioid mesothelioma the most treatable cell type with the best prognosis. The average life expectancy of a patient with epithelioid mesothelioma ranges from 12 to 27 months.
Sarcomatoid cells are spindle-shaped and spread quickly to other parts of the body — their speed makes them less responsive to treatment. The average life expectancy of a patient with sarcomatoid mesothelioma ranges from 7 to 18 months.
Biphasic tumors are made up of both epithelioid and sarcomatoid cells. The ratio of the two cell types determines the effect a biphasic mesothelioma tumor will have on your life expectancy. More epithelioid cells result in a longer life expectancy, because epithelioid cells spread slowly and respond better to treatment. The average life expectancy of a patient with biphasic mesothelioma ranges from 8 to 21 months.
The location of mesothelioma also has an effect of your life expectancy. Where the tumor originates — the lining of the lungs, abdomen, or heart — determines which treatment options are available to you.
Pleural mesothelioma originates in the lining of the lungs, the pleura. The average life expectancy for most patients with mesothelioma in this location ranges from 4 to 18 months. More life-extending treatment options are available for you if you’re diagnosed with pleural mesothelioma because doctors have more experience treating it. This type of mesothelioma accounts for 75 percent of all diagnosed cases.
Peritoneal mesothelioma originates in the lining of the lungs, the peritoneum and has the best life expectancy. The average life expectancy for patients diagnosed with peritoneal mesothelioma is 12 months, though several studies have shown that having cytoreduction with HIPEC has extended the life expectancy of some patients to 5 years and beyond.
Pericardial mesothelioma originates in the protective lining of the heart, the pericardium. It’s rare, accounting for about 1 percent of all diagnoses. The life expectancy for patients with pericardial mesothelioma is 6 months. Pericardial mesothelioma has limited treatment options because its rarity has given doctors few opportunities to develop new treatments.
Surgery is the most effective way for mesothelioma patients to extend their life expectancy. There are surgical options for pleural and peritoneal mesothelioma. If your doctor says you aren't eligible for surgical treatment, get a second opinion from another mesothelioma specialist.
There are two surgeries for patients with pleural mesothelioma are the extrapleural pneumonectomy (EPP) and the pleurectomy with decortication (P/D). A recent study reported that treatment with the EPP increased the overall survival rate of patients to about 27.5 months. The (P/D) —a less invasive procedure for patients with pleural mesothelioma — has produced results similar to the EPP, extending the survival rate of pleural mesothelioma patients to about 20 months.
Cytoreductive surgery with heated intraperitoneal chemotherapy (HIPEC) is the most effective surgical option for peritoneal mesothelioma. There are reports of patients increasing their life expectancy to greater than 7 years with this treatment.
Multimodal therapy is the combination of two or more treatment options, including surgery, chemotherapy, and radiation therapy. Overall, using more than one treatment has improved the life expectancy of patients with mesothelioma in any location, pleural or peritoneal.
According to a few recent studies, pleural mesothelioma patients who had an EPP combined with chemotherapy and radiation therapy experienced a median survival rate ranging from 13 to 23.9 months. Those who had a multimodal therapy combining P/D with chemotherapy and radiation therapy resulted in an even better survival rate of 30 months.
Cytoreduction with HIPEC is also a form of multimodal treatment. It’s a combination of surgery to remove tumors in the abdomen and heated chemotherapy applied directly to the abdominal cavity, which kills microscopic cancer cells after the procedure.
Emerging treatments are developed and tested in clinical trials by medical researchers, doctors who find better ways to treat patients. If you’ve been diagnosed with stage–three or stage–four mesothelioma, you may not qualify for traditional treatments, like the EPP or a P/D. You may, however, benefit from emerging treatments researchers are testing in clinical trials. Some of these treatments include immunotherapy, gene therapy and photodynamic therapy.
Getting Help with Treatment
No matter your diagnosis — the cancer stage, cell type, and location of the mesothelioma — getting specialized treatment from an experienced doctor will help you improve your prognosis and quality of life.
If you’d like to know more about how mesothelioma affects your life expectancy — and what you can do to improve yours — speak to a member of our Patient Help Team. We’re here to answer your questions, and can even help connect you to an experienced mesothelioma doctor. Request a call from a team member today, or get a free copy of our mesothelioma help guide.
- American Cancer Society. Survival Statistics for Mesothelioma. Accessed on 2/17/16. Retrieved from: http://www.cancer.org/cancer/malignantmesothelioma/detailedguide/malignant-mesothelioma-survival-statistics
- National Cancer Institute. Malignant Mesothelioma Treatment. Accessed on 2/17/16. Retrieved from: http://www.cancer.gov/types/mesothelioma/patient/mesothelioma-treatment-pdq
- Flores, Raja et al. The Journal of Thoracic and Cardiovascular Surgery. "Extrapleural pneumonectomy versus pleurectomy/decortication in the surgical management of malignant pleural mesothelioma: Results in 663 patients." March 2008.