Mesothelioma was a prominent disease back in the 1970s and 1990s. Today it is an uncommon disease with an occurrence of 0.3% in the United States. It accounts for 1% of all cancer cases and tends to be more common in men aged 54 to 74 years old.
Mesothelioma is a cancer of epithelial cell type, mesothelium. The mesothelium is a cell layer covering the internal organs, mainly the lungs, abdomen, testicles, and heart. Uncontrolled growth of cells in this layer results in mesothelioma. The chief cause of mesothelioma is asbestos exposure; others include genetics, smoking, and radiation exposure.
A diagnosis of mesothelioma can be frightening for many. The information that you suffer from cancer, which has a life expectancy of 1-2 years, can be worrying. Resultantly, people begin to stress about their finances and family. However, your foremost concern should be the prognosis of your cancer. By understanding the disease prognosis, you can choose the appropriate treatment and improve your survival.
Here are four things to help you understand what prognosis is and what factors influence it.
- What is the prognosis and its types:
Prognosis is a medical term that relates to the progression of a disease. It provides an estimate of patient survival and improvement by describing how an illness will develop and what will be the expected outcomes.
The basis of prognosis is the previous findings and statistics that help set an average: a patient can be above or below this average according to their condition.
A chief factor that affects the prognosis of mesothelioma is the time of diagnosis. An early-stage prognosis is very different from a late-stage prognosis.
An early-stage prognosis occurs when the patient gets diagnosed with stage 1 or 2 of cancer. As cancer detection occurs early on, the treatment options and chances of survival are more. Therefore, the average life expectancy of patients with an early-stage prognosis is 1.8 years.
A late-stage prognosis relates to diagnosis at stage three or four. By now, cancer has metastasized, meaning it has spread to other parts of the body. Cancer becomes more recognizable and symptoms severe. Treatment at this stage is more palliative than aggressive. In addition, the survival rates are low, and life expectancy is 14-16 months.
- Prognosis and type of cancer:
There are four types of mesothelioma due to its presence around different organs. These types are pleural, peritoneal, testicular, and pericardial. The prognosis of each type of mesothelioma is dissimilar.
75% of cases of mesothelioma are pleural mesothelioma. In such cases, cancer develops in the lining around the lungs. The prognosis of such patients depends on the type of cell affected, the stage of cancer, and patient factors. The average life expectancy with treatment is 18 months, and the survival rate is 73% after one year of diagnosis.
Peritoneal mesothelioma affects the peritoneum, the lining of the abdomen. Around 15-20% of all mesothelioma cases are peritoneal mesothelioma. The prognosis is convenient for the patient, meaning that the chances of improvement and survival are high. Patients without treatment can even live up to a year, and those on treatment live up to six years. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy increase the survival rate to 86% after one year of diagnosis.
Pericardial and testicular mesotheliomas are rare. Pericardial mesothelioma accounts for less than 1 % of mesothelioma cases. It is most severe, and therefore, its prognosis is the worst. The life expectancy of such patients is only six months. On the other hand, the prediction of testicular is very much favorable, and the patient can live up to ten years after diagnosis.
- Factors affecting mesothelioma prognosis:
The prognosis of every mesothelioma is not identical and varies due to the numerous factors influencing it. Cell type, nutrition, and patient characteristics are some of these factors.
Mesothelioma varies depending upon the type of cell affected. The cells affected can be epithelioid, sarcomatoid, or biphasic. Around 50% of mesothelioma cases are of epithelioid cells. Such cases have a better prognosis and respond well to treatment. Resultantly, the life expectancy of these patients is higher, 200 days or more. On the other hand, sarcomatoid cells are hard to treat, and cancer spreads quickly. Therefore, the prognosis of this type is unfavorable.
In the case of Biphasic cells, a mixture of epithelioid and sarcomatoid cells is present. Whichever cell is dominant, the prognosis will change accordingly.
Nutrition is a strong determinant of a patient’s survival and prognosis. A healthy diet can provide the body with energy to stand the treatment and fight off cancer. On the other hand, an imbalanced diet cannot provide the fundamental nutrients needed for growth and maintenance. As a result, cancer worsens. Therefore, the patient should form a nutritional plan and strategize on obtaining maximum nutrition. Smoothies, meat, whole grains, and dairy should be the top choice of mesothelioma patients in terms of food.
Like many other cancers, mesothelioma is more prevalent in men than women. Nearly 75% of cases are of men, and only 25% of women. The reason for this contrast is the extent of asbestos exposure. Men are more prone to asbestos exposure in comparison to females. Therefore, they mainly tend to develop pleural mesothelioma, which has a poor prognosis, and women develop peritoneal mesothelioma, which has the most favorable prognosis. Resultantly, 38% of men and 45% of women survive after one year.
- Treatment and prognosis:
The type of treatment that the patient undergoes affects their prognosis. Commonly, most patients receive surgery, radiotherapy, chemotherapy, and immunotherapy. However, surgery and chemotherapy tend to be the most beneficial.
Patients on chemotherapy have a better survival rate than those on no treatment. Their life expectancy is also high: 14 months. Chemotherapy is preferred for stages 3 and 4 when surgery is not possible.
Surgery in combination with chemotherapy is very effective for stage 1 and 2 patients in whom cancer has yet to spread. It increases the life expectancy, and the patient can live up to six years.
Radiation and immunotherapy are mainly adjunctive therapies that help keep the tumor in check. They aid in survival, and a patient on a multimodal plan may live up to a year or two.
Understanding disease progression can help in management and treatment. Progression is, however, only an estimate, and it differs for everyone. Therefore, consulting with the doctors and following through with treatment is essential.