For many rare diseases, mesothelioma included, patients face a rather poor prognosis. This dilemma often hinges on the fact that it’s difficult to diagnose these conditions, and many times it may not be detected until it has already progressed to a later stage with fewer treatment options.
In the case of mesothelioma, the majority of patients are diagnosed at stage 3, meaning the cancer has begun to spread beyond where it originated. At this point of the disease, treatment options can be greatly limited, with many patients only able to seek palliative care to better manage their symptoms rather than attempt to cure the disease.
How Long Can You Live With Mesothelioma?
Overall, mesothelioma prognosis has remained poor for many years. Survival rates have improved slightly in recent years, but many patients still face the same grim life expectancy. On average, mesothelioma patients have a life expectancy of just 12 to 21 months. Though some patients live well beyond this average, only about 9% survive 5 years or more.
One of the biggest determinations of mesothelioma life expectancy is the stage of disease. Patients whose mesothelioma is detected earlier have more treatment options, like curative surgery with chemotherapy. This is because the cancer is more localized and the tumors are easier to remove. Complete resection, in these instances, may be possible, and chemotherapy could help kill any remaining cancer cells. Those at an advanced stage will have difficulty finding a curative treatment plan.
In addition to staging, the mesothelioma type and cell type the patient is facing also has a huge role in how long they can expect to live. For instance, though pleural mesothelioma is the most common type, it has worse survival rates than peritoneal mesothelioma. But the cell types in particular can have a huge difference for an individual patient. There are three basic cell types associated with mesothelioma: epithelioid, biphasic and sarcomatoid. These cells have vastly different growth rates, as well as likelihood of metastasis or spreading.
Epithelioid cells are fast to grow, slow to spread and respond well to treatment, so patients with this cell type generally see a longer life expectancy than with other cell types, living an average of 18 to 24 months after diagnosis. Sarcomatoid cells, on the other hand, are the most aggressive in that they can grow and spread rather quickly. Patients with this cell type have an average life expectancy of only 6 months and limited treatment options to improve it. Patients with biphasic mesothelioma can have a more varied prognosis, since this cell type is a combination of the other two cancer cells. If more epithelioid cells are present, the patient will typically see a slightly better prognosis.
For patients with any type and stage of mesothelioma, treatment is the best way to prolong survival. As more clinical trials have become available with emerging treatments like immunotherapy, some patients have started to live well beyond their expected prognosis.
Mesothelioma Life Expectancy Without Treatment
For many patients, it isn’t always a simple answer to get whatever treatment is an option for their individual case. One of the main reasons a mesothelioma patient may not have treatment is because there are no curative options left. When diagnosed at a late stage, especially stage 4 mesothelioma, surgery is not an option and the patient may not be able to tolerate aggressive chemotherapy or radiation therapy.
Many patients are left with only palliative treatments, which aren’t meant to try to cure the cancer but rather alleviate symptoms, like pain, to provide a better quality of life. Though palliative treatments may employ similar techniques as curative therapies, the dosages and types of drugs used will be much more tolerable. At the same time, researchers have found some patients who can tolerate the toxicity of chemotherapy drugs like cisplatin and other therapies still opt to forgo treatment because of the side effects or the uncertainty around whether a particular treatment will work for them. Some of these patients may seek alternative treatments instead, but cancer research has not been able to verify the validity or efficacy of such treatments.
Studies have also found that many cancer patients are opting to forgo treatment or take less than they’re supposed to because of the high cost of treatment. Chemotherapy can easily reach upwards of $50,000 per round, with many patients needing several courses of chemo for it to be successful.
New cancer drugs are even more expensive. Keytruda, a promising immunotherapy drug used to treat mesothelioma and other cancers, is estimated to cost around $156,000 for a year of treatment. For most Americans, these costs are simply out of reach, especially considering that health insurance will often not be enough to cover such high medical bills. The health care system in the United States doesn’t provide many options to make these costs more manageable, either.
But without treatment, several studies have determined that mesothelioma patients on average only survive a little over 6 months without treatment. Some older studies have seen some untreated patients live beyond a year after their cancer diagnosis, but these patients likely were diagnosed in early stages.
The Value of Treatment and Research
Overall, the value of cancer research and developing or improving cancer treatments cannot be understated. There are more treatments available than ever through clinical trials, with new therapies and combinations even being tested and providing hope for patients with advanced cancer. Mesothelioma survival rates have seen improvements recently, with even a five-year survival rate for peritoneal mesothelioma at 65%. Considering the rather bleak statistics often associated with the rare disease, this is a significant improvement.
Along with early detection, treatment is the best way to improve survival. Research in areas like immunotherapy have already shown great promise for a number of cancers, and hopefully can bring us that much closer to a cure.