Life Expectancy of Pleural Mesothelioma Patients
Life expectancy refers to the projected months or years someone might live at a given age. Researchers and specialists who study and treat pleural mesothelioma hope to drive its life expectancy number increasingly higher in the near future. Statistics show about 38 percent of people who have this rare cancer can expect to live one year or longer following diagnosis.
Despite the difficult prognosis, some patients can live for five years or longer after tests confirm the existence of malignant pleural mesothelioma (MPM). These patients usually undergo heavy-duty treatments that may include a combination of surgery, radiation therapy and/or chemotherapy.
Doctors say one overriding factor in how long someone can live with this cancer is catching it before it spreads (early detection) and treating aggressively as soon they give a diagnosis.
Other factors that help to increase someone's life expectancy include:
- An epithelial tumor cell type
- Good overall health
- Younger age
Pleural Tumor Factors Can Affect Survival Time
The status and nature of the pleural tumor can impact life expectancy significantly. The stage of the cancer, the tumor's cell type, and biomarkers associated with the tumor can affect how long someone lives with pleural mesothelioma.
Stage of Tumor
Early-stage patients usually live longer than late-stage patients. The later the cancer is diagnosed, the farther the disease has spread from its point of origin. Spreading inhibits the effectiveness of treatments. Someone diagnosed with an early stage cancer - Stage I or Stage II - is more likely to qualify for potentially curative treatment options.
A 1996 study reported the following median survival times among 131 pleural mesothelioma cases:
|Stage||Median Survival in Months|
Tumor Cell Type
The epithelial tumor type is one of the three most common pleural mesothelioma cell types. It also has the longest associated survival rate. The sarcomatoid cell type has the shortest associated survival, and survival associated with the biphasic cell type falls between the other two. Studies show the difference in life expectancy among cell types span more than 200 days.
In one study, epithelial patients survived 15 months and non-epithelial patients survived six months. In another study, Japanese pleural mesothelioma patients with epithelial, biphasic and sarcomatoid cell types had median survival of 427, 319 and 183 days, respectively.
Biological markers such as chromosomes, tumor suppressor genes, proteins and simian virus 40 (SV 40) may play a role in pleural mesothelioma and can help doctors better predict life expectancy. One study shows longer survival among pleural patients who tested negative for SV 40.
In a 2011 Japanese study, lower levels of a protein known as C-reactive protein (CRP), a byproduct of inflammation, was associated with longer survival. Patients with low, medium and high CRP levels had a median survival of 569, 314 and 201 days, respectively.
How Patient-Related Factors Make a Difference
Factors unique to each patient - such as overall health, age and gender - also can play a role in their projected life expectancy.
Performance Status and Overall Health
A medical term for overall health, performance status (PS) is a measurement of a patient's general health. Performance status scores range from zero to five, with higher scores indicating poorer health. Numerous studies report that pleural mesothelioma patients with lower PS scores tend to live longer. One 1996 study found the risk of death for patients with PS scores of one or two was 1.65 and 2.71 greater, respectively, than for patients with a PS score of zero.
Age - Younger Is Better
Most studies on pleural mesothelioma show that younger age is associated with longer survival. Studies report that survival time is shorter in patients older than 75, while other studies have reported a negative survival impact that starts at age 50. Researchers believe older patients are more likely to have accompanying ailments, known as comorbidities, that affect overall life expectancy.
Sex - Women Live Longer than Men
Women with pleural mesothelioma tend to live longer with the disease than men, but this trend isn't confirmed in all studies that analyze sex as a prognostic factor. Researchers suspect that men don't live as long because they typically endured higher levels of occupational asbestos exposure during the 20th century. Elevated exposure levels are associated with more aggressive cases of pleural mesothelioma and a subsequent shorter life expectancy.
Weight Loss Is Bad
Weight loss is a poor prognostic factor in several pleural mesothelioma studies. Patients with weight loss who underwent chemotherapy in one study had poorer responses to radiation therapy and a shorter overall survival. In another study, patients who didn't lose weight showed the most symptomatic benefit from palliative surgery.
The types of treatments that patients elect to have can impact life expectancy. A 2009 study analyzed the overall survival of 456 malignant pleural mesothelioma patients. Groups of patients were separated based on the types of cell structure that made up their tumors as well as which surgical treatments they elected to receive.
Pleurectomy/decortication (P/D), which removes cancerous areas of the lining of the lung, was performed on more than half of the patients. Pleurodesis/biopsy, which is used to drain fluid and reduce future buildup, was also a common choice. Extrapleural pneumonectomy (EPP), in which the diseased lung is removed, was the least-favored option because of the severity of the procedure. All three types of surgery were associated with an improved average survival.
After surgery, some patients underwent radiation therapy and/or chemotherapy. These additional treatments made a notable difference in life expectancy and offered patients a higher chance of living for 18 or more months. Of the 456 patients, 127 of them (28 percent) lived 18 months or longer.
Patients may also choose alternative and complementary treatment options such as acupuncture, massage and yoga. Like palliative treatments, alternative treatments tend to focus on improving quality of life and boosting overall health. There is limited clinical testing on the efficacy of these options, but many patients find that these therapies provide significant relief from symptoms.