A mesothelioma prognosis is a patient’s outlook with the cancer. Mesothelioma is considered terminal, but treatment can improve prognosis. The 2-year survival rate of patients treated with chemotherapy is 19%, and the 5-year survival rate is 4%. The average 2-year survival rate of patients treated with surgery is 39%, and the 5-year survival rate is 11%.

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Last Updated on February 12, 2020.

A mesothelioma prognosis is a doctor’s estimation of the likely course the cancer will take for a specific patient. Prognosis includes life expectancy, but it also lets a patient know what mesothelioma symptoms to expect. A patient’s prognosis helps determine their treatment options.

Pleural Mesothelioma Prognosis by Stage

Doctors describe how far the cancer has spread in terms of mesothelioma stages, ranging from stage 1 to stage 4. A higher stage number means cancer cells have spread further throughout the body. This leads to a worse mesothelioma prognosis.

Researchers have studied how long past pleural mesothelioma patients have lived to calculate their median overall survival. This is typically measured in months.

The median is the number in the middle of a data set. Half of patients lived longer than the median, and half of patients lived shorter than the median. Recent median overall survival statistics for pleural mesothelioma come from a 2016 Journal of Thoracic Oncology article.

Median life expectancy by mesothelioma stage
The average pleural mesothelioma prognosis based on early versus late stages.

Stage 1

Stage 1 pleural mesothelioma usually does not cause symptoms and carries the best prognosis. Patients in strong health are eligible for aggressive cancer treatments such as surgery.

With surgery, stage 1 patients have a median overall survival of 22.2 months.

Stage 2

Stage 2 patients may begin to experience shortness of breath as the tumor grows around their lung. This is still an early cancer stage, and aggressive treatment plans are recommended.

With surgery, stage 2 patients have a median overall survival of 20 months.

Stage 3

Stage 3 is when most patients start to experience chest pain, breathing difficulty and weight loss. When a patient is diagnosed in stage 3, mesothelioma specialists must evaluate them carefully. Aggressive treatment could do more harm than good.

With surgery, stage 3 patients have a median overall survival of 17.9 months.

Stage 4

Stage 4 pleural mesothelioma usually carries a poor prognosis, with worsening chest pain, breathing difficulty and fatigue. Patients may also experience fever, night sweats and difficulty swallowing. At this stage, doctors usually recommend palliative treatments, which control symptoms.

With treatment, stage 4 patients have a median overall survival of 14.9 months.

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Mesothelioma specialists play critical roles in improving prognosis

Biological Factors That Affect Mesothelioma Prognosis

A pleural mesothelioma prognosis is heavily influenced by biological factors aside from the cancer stage. The most important of these factors are the cancer cell type and the patient’s age.

Cell Type

Mesothelioma cells can form in different patterns, which determine the cell type of the tumor. Epithelioid mesothelioma is the most common type as well as the easiest to treat. Sarcomatoid and biphasic mesothelioma are more resistant to treatment.


Younger patients usually have a better mesothelioma prognosis. Their bodies have stronger immune systems and a better ability to recover from surgery. More than half of patients under 50 live at least one year after a mesothelioma diagnosis, compared to less than a third of patients over 75.

Steps You Can Take to Improve Your Prognosis

While you can’t control your age, cell type or cancer stage, there are other factors you can take charge of to improve your prognosis. Taking action to optimize your lifestyle and health care team can help you beat the odds and live longer with mesothelioma.

Seek Guidance from Specialists

Working with a mesothelioma expert at a specialized treatment center is the best step you can take to improve your prognosis.

Pleural mesothelioma is rare compared to other cancers. Few doctors have the necessary tools or experience to diagnose and treat it effectively. Mesothelioma specialists understand the intricacies involved in ensuring you have the best possible care.

Learn About Established Treatments

People with early stage tumors and the epithelial cell type can benefit from a combination of surgery, chemotherapy and other treatments such as radiation or immunotherapy. This is called a multimodal approach. It is considered the gold standard for pleural mesothelioma treatment.

Median Survival of Pleural Mesothelioma Patients According to a 2011 Study
With Surgical Treatment 710 days
Without Surgical Treatment288 days
Source: Japanese Journal of Clinical Oncology

Patients with late-stage pleural mesothelioma usually benefit the most from palliative treatments. These focus on improving quality of life. Though palliative treatments aim to reduce pain and discomfort, they can also extend survival.

Consider Participating in a Clinical Trial

Clinical trials test new and emerging treatment options. The National Institutes of Health maintains a list of clinical trials for pleural mesothelioma in various phases and in multiple trial sites across the U.S.

Many clinical trials test new chemotherapy drugs, new combinations of drugs or new pairings of drugs with other types of treatments. Other clinical trials test the effectiveness of experimental techniques such as immunotherapy, photodynamic therapy and gene therapy.

Take Care of Your Overall Health

The healthier you are, the better your body can fight cancer. Having good overall health and physical fitness will also help you endure the side effects of treatments.

  • To boost your immune system, eat a balanced, nutritious diet rich in vegetables and fruit and low in sugar and fat.
  • Drink plenty of water to stay hydrated.
  • Talk to an oncology nutritionist who can recommend specific dietary changes that will strengthen your body.

Other lifestyle changes that can improve your prognosis include being more active when you are up and getting better rest when you are down.

  • Find simple ways to get regular, light exercise. Do things you enjoy to keep your mind engaged.
  • Get quality sleep — and plenty of it — to help your body recover from treatment.
  • If you’re a smoker, you can especially improve your lung function and overall health by quitting immediately.

Reduce Your Stress

Leading a low-stress lifestyle can improve how your body responds to cancer treatment. Take a look at the stressors in your life and see what you can do to manage them and reduce the frustration and anxiety you experience.

  • Take responsibilities off your plate, spend time with loved ones and do activities you enjoy.
  • Get the emotional support you need by reaching out to loved ones, joining a support group or meeting with a mental health counselor.
  • Your quality of life may be further improved with complementary and alternative medicine practices such as massage, acupuncture and meditation.

Complementary and alternative therapies come in a wide variety. Some are as simple as working with a personal trainer to create a special diet and exercise plan. Others are based on mystical belief systems that deal with energy fields and the mind-body connection.

Whatever therapy you choose, always be open and honest with your doctors to ensure it won’t interfere with your medical treatment.

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Understanding Mesothelioma Survival Rates and Life Expectancy

The one-year survival rate for pleural mesothelioma is about 40 percent. Less than half of patients live longer than one year after diagnosis. This is because most cases of mesothelioma are caught too late for patients to be eligible for aggressive cancer treatment.

Mesothelioma survival rates show you what percentage of past patients lived beyond certain milestones after they were diagnosed.

Median Survival of Pleural Mesothelioma Patients According to a 2011 Study
Stage at Diagnosis Two-Year Survival Rate Five-Year Survival Rate
1A 46% 16%
1B 41% 13%
2 38% 10%
3A 30% 8%
3B 26% 5%
4 17% Less than 1%
Source: American Cancer Society

Estimating life expectancy with mesothelioma is complicated. Mesothelioma statistics can only give you a general picture. How long you live with mesothelioma depends on your cancer stage and how well you respond to treatment.

People diagnosed in stage 1 or 2 often qualify for tumor-removing surgery, which offers the best chance of long-term survival. About one-fifth of all patients with pleural mesothelioma qualify for surgery.

Mesothelioma Life Expectancy Without Treatment

A 2016 Clinical Epidemiology study found mesothelioma patients who received no treatment lived an average of four months. In contrast, those who received chemotherapy lived an average of 12 months.

Pleural Mesothelioma Remission and Recurrence

Remission is when a tumor shrinks or disappears from the body. Surgery, chemotherapy, radiation therapy and immunotherapy can send mesothelioma into partial or complete remission.

Partial remission is when tumor size is reduced by at least 50 percent. Complete remission is rare with mesothelioma, but some pleural mesothelioma patients have lived for years in partial remission.

Unfortunately, sooner or later, mesothelioma usually comes back. This is called cancer recurrence. Certain clinical trials specifically look for patients with a mesothelioma recurrence to test innovative new therapies.

Is Mesothelioma Curable?

Currently, no pleural mesothelioma prognosis includes the possibility of a cure.

As with any type of cancer, the best doctors can hope for is long-term remission. Pleural mesothelioma is a difficult cancer to treat, especially because it is usually caught in a late stage.

However, you can take inspiration from the stories of mesothelioma survivors who defied the generally poor prognosis for this disease.

  • Emily Ward has gone into remission twice with pleural mesothelioma thanks to tumor-removing surgery and a heavy chemotherapy regimen. These treatments have helped her remain active in her community years after her diagnosis.
  • Randy Boudreaux was not eligible for surgery when he was diagnosed, and he did not respond well to chemotherapy. But then his wife found a specialist who prescribed him a new immunotherapy treatment, which restored much of his quality of life.
  • Kay Kilpatrick-Simmons was determined to see her first granddaughter graduate high school, but it meant living with mesothelioma for six years after diagnosis. With a positive attitude, plus surgery, chemotherapy, radiation and cryoablation, she achieved her goal.
  • Rich DeLisle sought out a mesothelioma expert for his treatment because he did not just want to live longer — he wanted to have the energy to travel the world. His insistence gave him the opportunity to make treasured memories with his family over the following years.