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16.11.09

Mesothelioma Prognosis: A Short Review


Generally the prognosis of mesothelioma is not good and most researches report median survival of less than a year. Typically the most important variable determining the prognosis and life expectancy of a mesothelioma patient is the stage of the cancer when it is diagnosed. Unfortunately, mesothelioma is more difficult to “stage” than other cancers. Factors that affect mesothelioma prognosis include:
• Stage of the cancer
• Age of the patient
• The type of mesothelioma (pleural, peritoneal, benign, pericardial or testicular)
• The size of the tumor
• The location of the tumor and whether it can be surgically removed
• The extent of other symptoms, including fluid in the lungs or abdomen
• Whether or not the patient is a smoker
Statistically, pleural mesothelioma typically presents in an advanced stage of progression with a 10-14 month lifespan expectation from diagnosis. Peritoneal mesothelioma often presents with a slightly more optimistic lifespan expectation and patients surviving 2-5 years are not uncommon. However, after 5 years, statistics show survivability dropping to well below 30 %.
Other study said that 10 % of all people diagnosed with mesothelioma will live 3 years later and about 5 % will be live 5 years later. However, if the mesothelioma is detected in its earlier stages and treated, 50 % will survive 2 years and 20 % people will survive 5 years.
In a clinical trial involving 120 patients with different types of pleural mesothelioma, all of the patients underwent pleural pneumonectomies (removal of the lung and pleura), followed by radiotherapy and chemotherapy. 45 % live 2 years later and more than 20 % live five years later. Patients with sarcomatoid and mixed mesothelioma did not fare as well. Only 20% of these patients live two years later, and none of them survived five years. However, patients that had no cancer in the lymph nodes and epithelioid type tumors did much better. Almost 75% survived longer than two years and nearly 40% were alive after five years.
Another much broader study conducted in Italy looked at the records of 4.5 million people diagnosed with mesothelioma. The survival rates were as follows: 24% of people with pleural mesothelioma and 34% diagnosed with peritoneal mesothelioma were still alive one year after diagnosis. Two other major studies, also reviewing comparable populations, also revealed similar findings.
but there is a hope…
There was a story about Dr. Stephen J. Gould of Harvard University. He was an internationally respected paleontologist and evolutionary biologist who conducted important research in both of these fields. Dr. Gould was diagnosed with peritoneal mesothelioma in 1982.
After an initial period of depression, motivated by all of the negative statistics he read regarding his diagnosis, he became determined to not let the statistics regarding life expectancy rob him of all hope. When he died in 2002, it was from another form of cancer, totally unrelated to his mesothelioma.
Dr. Gould has written about his experience with peritoneal mesothelioma and his determination to not let simple statistics take over his reaction to his diagnosis in the essay, “The Median Isn’t the Message.” We recommend Dr. Gould’s essay for everyone who has been diagnosed with this disease, or with any other form of cancer. Dr. Gould’s experience certainly may not be standard, but his hopeful approach to his disease cannot be discounted.
Dr. Gould’s story reminds me to Victor Frankl’s story in Auswitch concentration camp. His choice to escape from his poor destiny in NAZI’s worst place has saved his life. Every one who faced the dead always also faced 2 choices: still hope or give up. Your choice will determine the final result and it means determine your destiny. You have a chance to change your destiny!
In fact, large variability exists in many mesothelioma patients and there are people who have lived full lives after their diagnoses. There are long term mesothelioma survivors (both pleural and peritoneal survivors) who have survived more than 10 years.
From a short review above, it seems that mesothelioma prognosis shall be affected by each individual condition. This fact should force us to think about non-conventional therapies together with the struggle of mesothelioma patients. These facts also tell us that although there hasn’t been any final treatment yet, we can increase the life expectancy of the patients by managing their physic and psychic life optimally. Here we encourage you to share everything about mesothelioma. For some people, mesothelioma causes their life end, but, believe me, cancer mesothelioma is not your life end.

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