Mesothelioma Prognosis Statistics
Doctors collect statistical information about the different types of cancer and prognosis. Prognosis is the likely outcome of your disease and treatment. In other words, your chances of getting better and how long you are likely to live.Following on this page, is quite detailed information about the survival rates of different stages of mesothelioma. We have included it because many people have asked us for this. But not everyone who is diagnosed with a cancer wishes to read this type of information. If you are not sure whether you want to know at the moment or not, then perhaps you might like to skip this page for now. You can always come back to it.
Please note: There are no national statistics available for different stages of cancer or treatments that people may have received. The statistics we present here are pulled together from a variety of different sources, including the opinions and experience of the experts that check each section of CancerHelp UK. We provide statistics because people ask us for them. But they are only intended as a general guide and cannot be regarded as any more than that.
There is a section explaining more about the different types of cancer statistics in the CancerHelp UK section on cancer statistics. Unless you are very familiar with medical statistics, you may find it helpful to read this before you read the information below.
Remember - statistics are averages based on large numbers of patients. They cannot predict exactly what will happen to you. No patients are exactly alike and response to treatment also varies from one person to another.
You should feel free to ask your doctor about your prognosis, but not even your doctor can tell you for sure what will happen. You may hear your doctor use the term '5 year survival'. This relates to the proportion of people in research studies who were still alive 5 years after diagnosis. This is because doctors follow what happens to people for 5 years after treatment in any research study.
The general outlook for mesothelioma
Generally speaking, with cancer the outcome depends on how advanced your
cancer is when it is diagnosed. Usually with cancer, the statistics are given
for each stage. Stage is just as important for mesothelioma as it is for other
cancers. But finding the statistics is more difficult to do. This is because
- Mesothelioma is not all that common, (although incidence is increasing)
- It is usually diagnosed when it is advanced - people may not have symptoms early on and so don't go to the doctor
- Statistics by stage aren't readily available because most people don't have surgery and accurate staging needs an operation
There are two types of mesothelioma. Pleural mesothelioma has three staging
systems and peritoneal mesothelioma has no established staging system.
Overall, both types of mesothelioma have a poor outlook. By the time someone has
symptoms and goes to their doctor, the disease is very often advanced. Because
few people are diagnosed early, there are no reliable statistics for 5 year
survival rates for the early stages of mesothelioma.
For both types of mesothelioma, patients are often told that they may have less
than a year to live. But mesothelioma specialists, working in leading cancer
centres throughout the world, often report better statistics than this based on
clinical trials that they are carrying out. Some of these are reported below.
Generally, of all those people diagnosed with mesothelioma only about 1 in 10
(10%) will be alive 3 years later and 1 in 20 (5%) will be alive 5 years later.
For those people who have been diagnosed and treated in the earlier stages of
the disease, there is little information to draw on. But we have seen reports
that quote survival rates of up to 1 in 2 (50%) after 2 years. So the range of
survival times is very wide. Survival depends on other factors, as well as
stage.
Although there are results from quite a few trials available, they are often
quite small studies involving fewer than 20 patients or so. We have picked the
trials below to report because they are large. The larger the trial, the more
reliable the results are likely to be.
At the Dana-Farber Cancer Institute in Boston, doctors followed 120 patients,
with different types of pleural mesothelioma, from 1980-1995. All these patients
were treated with surgery to remove the lung and pleura (pleural pneumonectomy),
followed by a combination of chemotherapy and radiotherapy, with or without
immunotherapy. 54 out of the 120 (45%) patients in this trial were alive 2
years later and 26 out of the 120 (22%) patients were alive 5 years later.
Patients with sarcomatoid and mixed mesothelioma had a poorer prognosis. Of the
patients with these types of mesothelioma only 20% were alive 2 years later and
by 5 years later, all had died.
Patients with epithelioid type tumours and no cancer in the lymph nodes had a
much better outlook. Nearly 3 people out of every 4 (74%) were alive 2 years
later and more than 1 person in every 3 (39%) alive 5 years later. (The full
results of this trial are published in the February 2002 edition of the medical
magazine Seminars in Oncology, volume 29, issue 1, pages 41-50.)
Another study looked at survival with mesothelioma in an area of North West
Italy. This is called a population study. The researchers look at the records
of everyone diagnosed with the disease in a given area. This study looked at an
area with a total population of 4.5 million. Throughout the world, this is the
second largest, of 3 population based studies about mesothelioma survival. All
three studies have had similar results. One year after diagnosis, on average, 1
in every 4 people (24%) with pleural mesothelioma and 1 in every 3 people (34%)
with peritoneal mesothelioma were still alive. (The full results of this trial
are published in the July-August, 2002 edition of the Tumori Journal, volume 88,
issue 4, pages 266-9).
There are other factors that can affect your prognosis, apart from the stage
of your cancer. One is how well you are overall. Doctors have a way of
measuring this. They call it your 'performance status'. You may see this
written PS. A score of 0 means you are completely able to look after yourself.
A score of 1 means you can do most things for yourself, but need some help. The
scores continue to go up, depending on how much help you need. This is
relevant to survival because overall, the fitter people are, the better able
they are to withstand their cancer and treatment.
Other factors include
- The type of mesothelioma you have
- Your blood counts
People with normal haemoglobin levels, and normal white blood cell and
platelet counts, tend to do better. These tests are a measure of your overall
health and the effect the disease is having on you.
No statistics can tell you what will happen to you. Your cancer is unique.
The same type of cancer can grow at different rates in different people for
example.
The statistics are not detailed enough to tell you about the different
treatments people may have had. And how that treatment may have affected their
prognosis. Chemotherapy, surgery and radiotherapy may help people to live
longer as well as relieving symptoms. There are many individual factors that
will determine your treatment and prognosis. If you are fit enough to have
treatment, you are likely to do better than average, particular if your cancer
is more advanced.
People treated at centres where clinical trials are taking place tend to do
better. This is almost certainly because that is where the most expertise is
concentrated - research is more likely to take place in specialist centres. For
those in the trials, it may be partly to do with having a closer eye kept on
them by their doctors than they might if not in a trial - more scans and blood
tests for example. But it might also be something to do with morale. You may
feel more positive if you are taking part in a trial because it is more obvious
to you that something is being done to help you. There is more about
understanding clinical trials in CancerHelp UK. To search our clinical trials
database for trials that are recruiting for mesothelioma, click on the blue
'clinical trials button' to the left of your screen and pick 'lung' from the
drop down menu of cancer types.
This article comes to you from
Cancerhelp.org.uk
CancerHelp UK is not designed to provide medical advice or professional services and is intended to be for educational use only. The information provided through CancerHelp UK is not a substitute for professional care and should not be used for diagnosing or treating a health problem or a disease. If you have, or suspect you may have, a health problem you should consult your doctor.
Copyright Cancer Research UK 2002
Cancer Research UK Charity Number 1089464
Information from American Cancer Society.
Staging is the process of finding out how far a cancer has spread. Your treatment and prognosis (outlook) depend, to a large extent, on the cancer's stage.Staging is based on the results of the physical exam, biopsies, and imaging tests (CT scan, PET scan, etc.), which are described in the section, "How is malignant mesothelioma diagnosed?"
Since pleural mesothelioma occurs most frequently and has been studied the most, it is the only mesothelioma for which a staging system exists. The TNM staging system
The system most often used to describe the growth and spread of pleural mesothelioma is the American Joint Committee on Cancer (AJCC) TNM staging system. The TNM system describes 3 key pieces of information:
- T indicates the extent of spread of the main (primary) tumor.
- N describes how much the cancer has spread to nearby (regional) lymph nodes. Lymph nodes are small bean-shaped collections of immune system cells that are important in fighting infections.
- M indicates whether the cancer has spread (metastasized) to other organs of the body. (The most common sites are the pleura on the other side of the body, the lungs, and the peritoneum.)
Numbers or letters appear after T, N, and M to provide more details about
each of these factors. The numbers 0 through 4 indicate increasing severity.
Stage grouping for pleural mesothelioma
Stage grouping for pleural mesothelioma
Once the T, N, and M categories have been assigned, this information is combined
in a process called stage grouping to assign an overall stage of I, II, III, or
IV. The stages identify tumors that have a similar prognosis and thus are
treated in a similar way. Patients with lower stage numbers tend to have a
better prognosis.
See staging system
Resectable versus unresectable cancer
The TNM system divides mesotheliomas into several groups that help give
doctors an idea about a person's prognosis (outlook). But for treatment
purposes, doctors often use a simpler system based on whether these cancers are
likely to be resectable (where all visible tumor can be removed by surgery) or
unresectable.
In general terms, most stage I and some stage II and III mesotheliomas are
potentially resectable, but there are exceptions. Resectability is based not
only on the size of the tumor, but also on the subtype (most doctors believe
only epithelioid tumors are potentially resectable), where it is located, and
whether or not a person is healthy enough to have surgery.
Even for resectable mesotheliomas, in most cases there are cancer cells that
cannot be seen that are left behind after surgery. For this reason, many doctors
advise using other forms of treatment (radiation therapy and/or chemotherapy)
along with surgery when possible.
Other prognostic factors
Stage is an important factor in determining a patient's prognosis, but other
factors also play a role. Some factors linked to longer survival times include:
- good performance status (being able to perform normal tasks of daily life)
- younger age
- epithelioid subtype
- not having chest pain
- no significant weight loss
- normal levels of a substance in the blood called LDH
- normal red blood cell counts, white blood cell counts, and blood platelet counts
Survival statistics for mesothelioma
Mesothelioma is a serious disease. By the time the symptoms appear and cancer is
diagnosed, the disease is often advanced. But regardless of the extent of the
cancer, it can be very hard to treat.
In the medical literature, average survival times for people with mesothelioma
have ranged between 4 and 18 months, depending on the study. About 10% of people
with mesothelioma live at least 5 years after being diagnosed.
Because these cancers are not common, it is hard to find accurate survival rates
based on the TNM stage of the cancer. As a general rule, survival times are
likely to be higher for people with mesotheliomas that can be operated on than
for those with cancers that have metastasized. Other prognostic factors, such as
those listed above, may also affect survival.
There are some other important points to keep in mind when looking at survival
statistics such as the numbers above.
These numbers are derived from patients treated at least several years ago.
Improvements in treatment since then mean that the survival statistics for
people now being diagnosed with these cancers may be higher.
Survival statistics can sometimes be useful as a general guide, but they may not
accurately represent any one person's prognosis. A number of factors other than
the type and extent of the cancer may also affect outlook, including a person's
general health and the response of the cancer to treatment. Your doctor is
likely to be a good source as to whether the numbers above may apply to you, as
he or she is familiar with the aspects of your particular situation.
Last Medical Review: 03/17/2009
Last Revised: 03/17/2009