mesothelioma survival rate

The five-year survival rate for mesothelioma patients is approximately 12%. About 40% of mesothelioma patients survive at least one year after diagnosis. The one-year survival rate is approximately 73% for pleural mesothelioma and 92% for peritoneal mesothelioma.

What Are Mesothelioma Survival Rates?
Survival rate typically refers to the percentage of people with cancer who live one and five years after initial diagnosis. These measures are referred to as the one-year and five-year mesothelioma survival rates.

When discussing survival rates, you may hear other related terms such as life expectancy, which is the average time a person is expected to live based on birth year, current age, gender and other factors.

Mesothelioma affects life expectancy because the cancer reduces the number of years a patient is expected to live.

A 2015 meta-study published in Translational Oncology analyzed 20 years of data, collected from 1992 to 2012. The five-year survival rate for peritoneal mesothelioma patients was more than five-times higher than the rate for pleural patients.

Pleural and Peritoneal Mesothelioma Survival Rates


1 year  73%  92%
3 years  23%  74%
5 years  12%  52%
10 years  4.7%  39%


Factors Affecting Mesothelioma Survival Rates
There are several things that affect how long a person will live after a mesothelioma diagnosis.

Tumor Location
Stage of disease
Mesothelioma cell type
Age at diagnosis and overall health
A 2018 analysis of 888 cases in the National Mesothelioma Virtual Bank cohort identified median overall survival of 15 months, on average, for pleural and peritoneal patients combined.

The most important factors associated with better survival were age (less then 45), female gender, epithelioid cell type, stage 1 disease, peritoneal occurrence and treatment combining surgery with chemotherapy.

Shortness of breath (dyspnea)
Pain and tightness in the chest
Night sweats and fever
Difficulty swallowing (dysphagia)
Coughing up blood (hemoptysis)
Fluid buildup in the chest or abdomen
Abdominal pain
Severe weight loss or anorexia (lack of appetite)
General feeling of discomfort (malaise)

Late-Stage Mesothelioma by Type
Each type of mesothelioma has unique characteristics at the late stages of the cancer.

Stage 4 Pleural Mesothelioma
Stage 4 typically refers to pleural mesothelioma, the most common type of the asbestos-related cancer.

Pleural disease can take the form of epithelial or sarcomatoid cell tumors. Cell type does not affect how stage 4 disease is diagnosed, but it does affect how it can be treated at this stage.

Stage 4 Peritoneal Mesothelioma
There is no official stage 4 for peritoneal mesothelioma. This type of the cancer accounts for roughly 20% of all mesothelioma cases. It is generally accepted that peritoneal patients with extensive tumor spreading are classified as stage 4.

By this point, the cancerous tissue is more extensive and tumors have moved outside of the peritoneum. Surgery usually is not an option for end-stage peritoneal mesothelioma.

For people who can try surgery, heated intraperitoneal chemotherapy (HIPEC) is the most promising option. It combines surgery and heated chemotherapy circulated throughout the abdomen.

Stage 4 Pericardial Mesothelioma
Pericardial mesothelioma is a rare form of the cancer which develops on the lining of the heart. It is typically diagnosed in the later stages, although it may not be defined as stage 4.

Stage 4 Testicular Mesothelioma
Testicular mesothelioma is the rarest type of this cancer, with around 100 cases documented in medical literature. As with the pericardial type, testicular mesothelioma may not be defined as stage 4, but it is recognized as advanced disease in most cases.

Three systems are commonly used to define stages of pleural mesothelioma (Brigham, TNM and Butchart). They categorize stage 4 on similar cancer characteristics and tumor behaviors. The Butchart and TNM staging systems note whether the cancer has metastasized to distant organs. Brigham designates when surgery is not a viable option.
Treatment for Mesothelioma at Stage 4
Mesothelioma treatment options to extend survival are most limited at stage 4. Aggressive surgeries to remove tumors are not an option because the tumor has spread too far.

For many patients with advanced disease, chemotherapy is the best option. Even though it won’t cure the disease, this treatment can shrink tumors to improve quality and length of life.

Targeted radiation therapy also can be used in a palliative treatment plan. Radiation treatments may alleviate pain and pressure and ease breathing.

Stage 4 mesothelioma treatment options video
Watch: Mesothelioma specialist Dr. Jacques Fontaine explains what factors patients should consider when deciding treatment options for stage 4 mesothelioma.

Stage 4 Chemotherapy
Chemotherapy is one of the most common treatment options for stage 4 mesothelioma. These drugs slow tumor growth and may shrink tumors in some cases. This helps alleviate symptoms and extend survival.

A 2016 Wayne State University study out found chemotherapy more than doubles life expectancy for malignant mesothelioma patients, including those with stage 4 disease. Combining chemotherapy with surgery extended survival even longer.

Some patients’ tumors respond so well to chemotherapy that they qualify for surgery. A 2020 case report published in General Thoracic and Cardiovascular Surgery described a woman in her 60s with stage 4 pleural mesothelioma who qualified for surgery after responding well to chemotherapy. She was alive and undergoing another round of chemotherapy 30 months after surgery.

The most commonly prescribed chemotherapy regimen for pleural mesothelioma is cisplatin or carboplatin combined with pemetrexed (Alimta).

Stage 4 Surgery
Extensive tumor-removing surgeries, such as a pleurectomy/decortication (P/D) or extrapleural pneumonectomy (EPP) are not offered to patients with stage 4 disease.

Due to the extensive spread of tumors at stage 4 disease, doctors cannot remove all growths with EPP or P/D.

Still, some peritoneal mesothelioma patients can benefit from less extensive surgical procedures. Surgeons will attempt to remove as much tumor mass as possible in a procedure called debulking.

They can target tumors causing symptoms, so patients breathe more comfortably and experience less pain.

Thoracentesis: Drains fluid from the chest
Paracentesis: Drains fluid from the abdomen
Pericardiocentesis: Drains fluid from around the heart
Pleurodesis: Potential long-term solution to fluid buildup in the chest
Stage 4 Radiation Therapy
Doctors don’t always treat stage 4 mesothelioma with radiation therapy. They may recommend the procedure depending on your tumor growth and overall health.

Radiation therapy at this stage is used to reduce the size of tumors. This can lessen chest pressure, decrease pain and improve breathing.

Immunotherapy and Clinical Trials
Some stage 4 mesothelioma patients may qualify for clinical trials. Clinical trials investigate the value of various treatment combinations for late-stage mesothelioma or may test newer options such as immunotherapy.

In some cases, experimental treatments can help stage 4 patients survive far past their prognosis. These include immunotherapy, gene therapy and other emerging therapies.

A 2016 study published in The Annals of Thoracic Surgery showed photodynamic therapy may improve late-stage mesothelioma survival.

A subset of pleura mesothelioma patients with no cancer cells in their lymph nodes lived an average of 7.3 years compared with the typical one-year prognosis.

Improve Quality of Life with Palliative Care
Palliative or supportive care can relieve symptoms and improve quality of life. At stage 4, doctors may recommend pain medication, oxygen therapy and respiratory therapies. These treatments control pain and improve lung function.

Many long-term mesothelioma survivors have incorporated complementary and alternative medicine into their stage 4 mesothelioma treatment plan. Certain complementary therapies may improve survival, ease symptoms, reduce treatment side effects and enhance quality of life.

Examples include mind-body therapies, nutritional support, acupuncture, massage and herbal treatments.

*This content for education purpose, not actual 


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