Mesothelioma is a tumor of the serosal surfaces such as the pleura and peritoneum. Once in history, the occurrence of this tumor was rare, but not anymore. The number of mesothelioma diagnoses is increasing worldwide. So far, the widely accepted cause of mesothelioma is exposure to asbestos, a naturally occurring harmful mineral. Every year more than 3000 cases of pleural mesothelioma are reported due to prolonged exposure to asbestos. Because of the protracted latency period of this type of tumor, it is often found in its later stages when oncologists are left with fewer options to treat this cancer. Hence, they find it challenging to communicate the prognosis. But, knowing more about your prognosis is the first concern you might have after learning about your mesothelioma diagnosis. This is because it determines your next step for treatment.
What is meant by mesothelioma prognosis?
It is an estimate of how your mesothelioma will progress, its development over time, and the probability of survival. In mesothelioma, the prognosis has not been very favorable in the past. But with the emergence of new treatments, there has been an increase in the victims’ life expectancy. Moreover, it is often challenging for cancer specialists to provide an exact estimate and definitive mesothelioma prognosis because many factors come into play. The prognosis may differ according to different stages, type of cancer and the cells, metastasis, location, and the aggressiveness of the treatment used.
Mesothelioma prognosis determination
A doctor considers numerous factors when estimating a mesothelioma patient’s prognosis. A quick explanation of those factors is mentioned below.
Type of mesothelioma cells
Based on the tissue types, mesothelioma can be divided into three cell types: epithelial, sarcomatoid, and biphasic. The last type contains both epithelial and sarcomatoid. The most common type is epithelial mesothelioma. This type has the highest survival rate due to its higher response to cancer treatment. In contrast, sarcomatoid cells have the least favorable prognosis. In the case of Biphasic mesothelioma, the response to medication and prognosis varies on the type of cells dominant in the cell mix.
Based on location, mesothelioma has many types. Pleural mesothelioma occurs on the linings of the lungs and is diagnosed in 70-75% of mesothelioma patients. This type also has the highest survival rate. The patients can live for about 18 months following the diagnosis. Some treatments such as surgery and chemotherapy improve the prognosis further.
The second frequently occurring type of mesothelioma is peritoneal mesothelioma. It accounts for 20% of the diagnosis. It is also much more challenging to treat than the one mentioned earlier. Patients with this type of mesothelioma can live for two to six years. Some treatments like surgery and hyperthermic intraperitoneal chemotherapy lead to a better prognosis.
The other rare types of mesothelioma are pericardial mesothelioma occurring at the heart sac of the patient and testicular mesothelioma at the lining of testes, the tunica vaginalis. Generally, the rare types of mesothelioma have a less optimistic prognosis.
Stage of mesothelioma
One factor which can improve prognosis in all kinds of cancers is early diagnosis and treatment. Unfortunately, it is often not possible in the case of mesothelioma. The issue is that most of the mesothelioma symptoms, including cough and chest pain, are also found in other less severe diseases. This may result in misdiagnosis. In most cases, this cancer gets diagnosed in its later stages only. Generally, stage one mesothelioma patients have the highest life expectancy of 21 months or more. In the second stage, the person can survive for 19 months or longer. Similarly, in the third and last stage, the life expectancy decreases to 16 months or longer and 12 months or longer, respectively.
It refers to the spread of cancer inside the human body. The extent of the spread, the location of actual occurrence, and the spread determine the prognosis. The metastasis also determines the type of treatment and its efficacy.
The health of the patient
Like in other diseases, the overall health of the patient and the external environmental factors can play an important role in improving the prognosis of mesothelioma. A young and strong patient has more chances of fighting cancer than the older ones who may already be dealing with other health issues. Moreover, patients suffering from diseases like heart issues, asthma, diabetes, high blood pressure may have more chances of getting traditional mesothelioma treatments, including surgery, radiation, and chemotherapy. They may not be referred for advanced treatments and clinical trials. Furthermore, you are also less likely to have a better mesothelioma prognosis if you smoke.
Factors that can improve mesothelioma prognosis
The main factor that can improve the prognosis is the early detection of cancer in the human body because cancer detection at the later stages makes it impossible to cure. Research has been successful to some extent for ways to diagnose mesothelioma earlier. The new techniques include a simple blood test known as Mesomark® assay, which measures biomarkers released into the blood by the mesothelioma cells. This biomarker is called Soluble Mesothelin-Related Peptides (SMRP). Its levels can increase in the patient’s blood before mesothelioma symptoms appear or a person undergoes a diagnosis. The test of this biomarker at the right time can result in an early diagnosis and potentially save many people’s lives.
Development of new drugs and treatments
There has been a greater interest in developing new drugs and treatments to improve prognosis. Treatments such as immunotherapy, gene therapy, photodynamic therapy, etc., are new additions to the list of treatments available for mesothelioma. New methods of chemotherapy and radiation targeting cancer more closely have also improved the life quality and prognosis of the patients.
Multimodal treatment plans
Doctors have also been using a combination of many treatments known as multimodal treatment plans to cure patients. Some of these treatments have improved prognoses. For instance, surgery with HIPEC has shown better results in patients with peritoneal mesothelioma.
Mesothelioma is not entirely curable, but it does not mean that there is nothing to improve the prognosis and quality of a patients’ life. There is a need for better prognostic and diagnostic tools to reduce the deaths caused by this cancer. The presence of new treatments offers renewed hope to mesothelioma patients. Combination treatments and some environmental factors such as a good diet, plenty of rest, and staying away from smoke and pollution are also suitable for mesothelioma patients.
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