Mesothelioma Prognosis

Pleural mesothelioma is a difficult cancer to treat because it can spread so extensively and it is generally not diagnosed until it is in the more advanced stages, making surgical removal of all the cancer difficult or impossible. Because it is a relatively rare cancer, mesothelioma has not been studied as much as more common forms of cancer. The stage at which treatment for mesothelioma is begun has a tremendous impact on the patient’s prospects for long-term survival.

The American Cancer Society reports that some pleural mesothelioma patients in stage I have had their mesothelioma successfully removed through an involved surgical procedure called extrapleural pneumonectomy. Extrapleural pneumonectomy is a grueling surgery only offered to patients in otherwise good health. The entire affected lung plus the pleural lining of the chest wall, diaphragm, and pericardium on the affected side are removed. Surgeons then reconstruct the diaphragm and the pericardium. This procedure works best for patients with epithelioid cell mesothelioma.

Some patients who have had a successful extrapleural pneumonectomy are now enjoying long remissions. A study of 120 patients, who underwent extrapleural pneumonectomy at the Dana-Farber Cancer Institute in Boston between the years 1980 and 1995, revealed that 22 percent of these patients survived five years or longer. The surgery for these patients had been followed by chemotherapy and radiation (Cancer Help UK, 2008).

Removing most of the mesothelioma from patients in stage II and III in a procedure called pleurectomy/decortication may also increase a patient’s life expectancy. The aim of this procedure is palliative, as it can control fluid buildup and relieve pain and pressure.

Factors Influencing the Prognosis

The patient’s overall health status and age affect the prognosis. The American Cancer Society reports that 75 percent of those diagnosed with mesothelioma are 65 years old or older. Men are five times more likely to have mesothelioma than women are.

When mesothelioma is diagnosed, the doctors look at how far the cancer has spread and several health factors. Pleural mesothelioma patients have a poorer prognosis if they are experiencing chest pain, shortness of breath, inability to perform daily tasks, weight loss, a low red blood cell count, a high white blood cell count, and high blood levels of a substance called LDH. According to the American Cancer Society, most mesothelioma patients who have all these factors present pass away within six months of their diagnosis. It is rare for these seriously ill patients to live two years after their diagnosis. Patients without these serious risk factors at the time of their diagnosis have a better outcome.