Mesothelioma Survival Rate

Survival Rates of Mesothelioma

The term survival rate refers to the percentage of people who will live for a certain period of time after receiving a diagnosis. It is often measured in years, such as one-year, five-year and 10-year survival rates, but the five-year rate is the time span most commonly used by the medical community. Because of the nature of mesothelioma cancer, a rare and aggressive disease, data for 10-year survival rates is not available, and researchers tend to evaluate pleural mesothelioma patients in one-year intervals up to five years.

Survival rates for pleural mesothelioma patients are low. About 10 percent of people diagnosed with the disease live between three and five years. Only 5 percent survive five years or longer. Although mesothelioma remains an incurable cancer with a short life expectancy, some patients surpass the average mesothelioma survival rate because of their overall good health and by electing to receive specific treatments. For patients who are able to have surgery, survival rates are likely to be much higher than those of patients who aren't candidates for surgery. This is because surgery gives patients the best chance of removing as much of the cancer as possible and this slows down metastasis to extend survival.

Several factors about pleural mesothelioma cancer and the patient can affect survival rates. One of the most important factors is the stage at which the cancer was discovered. Another influential factor is the cell type of the cancer. Both the stage and the cell type of the cancer are important because they influence the type of treatments that are available and indicate how effective those treatments are likely to be. A patient's eligibility for treatment options like surgery and chemotherapy and how they react to these treatments will also affect survival rate statistics.

Staging of Pleural Mesothelioma and Survival Rate

Staging has the most significant influence on pleural mesothelioma survival rates. The earlier pleural mesothelioma is diagnosed, for instance, in Stage 1 or Stage 2 when the tumor is less likely to have spread beyond the point of origin, the more likely it can be surgically removed or controlled with other types of treatment. However, if it is detected during a later stage of development, such as Stage 3 or Stage 4, the cancer has likely spread to other areas of the body and many types of treatment are less likely to be effective in treating it. Therefore, since there are fewer effective treatments available to treat late-stage pleural mesothelioma, the expected life expectancy is much shorter and the average associated survival rate is much lower. In a 1996 study, only about one-third of patients with Stage 4 pleural mesothelioma survived one year or more. Stage 3 mesothelioma patients tend to share similar results.

There is one primary factor for why people with Stage 1 or Stage 2 pleural mesothelioma have a higher survival rate than those with a Stage 3 or Stage 4 diagnosis.  Stage 1 and 2 cases are more likely to be  candidates for surgery. Since surgery removes more cancerous cells than any other treatment, surgery is considered to be one of the most effective means of treatment.

Early detection is one of the most important factors effecting survival rate. It is possible to detect the cancer before symptoms are noticeable, but because pleural mesothelioma symptoms are normally so mild, and many people are unaware of the health risks associated with asbestos exposure, early detection often occurs unexpectedly while treating a separate condition. The best way for anyone with a history of asbestos exposure to detect pleural mesothelioma in its early stages is to have an annual screening with someone familiar with asbestos-related diseases.

Cell Types that Affect Survival Rate

Pleural mesothelioma can consist of two cell types, including epithelial and sarcomatoid cells. In some cases, mesothelioma can be made up of a combination of the two, known as biphasic mesothelioma. Although survival rate statistics are not generally kept for individual cell types, there is no doubt that a particular cell type can influence a patient's chance of surpassing the five-year survival rate.

Epithelioid mesothelioma, the most common cell type, typically responds more favorably to surgery and chemotherapy, which are two of the most effective treatment methods for pleural mesothelioma. As a result, those who reach the five-year survival rate generally have the epithelial cell type. In contrast, tumors made up of sarcomatoid cells are less responsive to most treatments; therefore, associated survival rates are lower. Tumors that are biphasic in cell make-up often have a mixed response to treatment that is dependent on the ratio of sarcomatoid to epithelial cells. The larger the ratio in favor of sarcomatoid cells the less likely the tumors are to respond favorably to treatment, and therefore they are more likely to have lower associated survival rates.  

Other Factors that Affect Survival Rate

Even though the stage of cancer at the time of diagnosis is the most important determinant of survival for mesothelioma patients, a number of other factors can also play a role. Overall health is important, and it is one element a doctor uses to determine how aggressive to be during treatment. For instance, people who are not in good overall health can be removed from consideration for surgery. Being in good health also helps patients respond better to treatments like chemotherapy and radiation.

The sooner a patient is diagnosed, the better the associated survival rates. Factors that can lower the odds of beating average survival rates and make symptoms worse include smoking, fluid in the lungs, larger tumors and built-up scar tissue. All of these can significantly limit treatment options.

How Treatment Affects Survival Rate

How well pleural mesothelioma responds to treatment is a big contributor to a patient's survival rate. Unfortunately, only a small percentage of patients benefit from surgery. When patients receive palliative treatment without surgery, average survival is about six months. Research is now showing that a multimodal approach involving surgery, chemotherapy and radiation therapy provides patients with the best chance of reaching the five-year survival rate for pleural mesothelioma. 

One study showed that a multimodal treatment plan most effectively helped patients to live longer than five years. Data showed a five-year survival rate of 46 percent in patients diagnosed with epithelioid mesothelioma, no mediastinal lymph node involvement (Stage 1) and clear resection margins (meaning these patients had the most cancer cells removed from the edges of the tumor during surgery).

Another study at Brigham and Women's reported two- and five-year survival rates of 38 percent and 15 percent in 183 patients with pleural mesothelioma who received chemotherapy or chemoradiation following an extrapleural pneumonectomy.

The standard chemotherapy regimen for pleural mesothelioma is a combination of cisplatin and pemetrexed. Such chemotherapy drugs are often prescribed after surgery to kill any remaining cancer cells. If doctors were unable to remove all of a tumor during surgery, they may use radiation therapy to shrink any remaining tumors. This kind of combination treatment can help manage pleural mesothelioma and increase associated survival rates.