Prognosis and survival for mesothelioma
If you have mesothelioma, you may have questions about your prognosis. A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type, stage and characteristics of your cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to make a prognosis.
A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. The following are prognostic factors for mesothelioma.
The cell subtype is an important prognostic factor for mesothelioma. Epithelioid subtype is the most common subtype of mesothelioma and has a better prognosis than sarcomatoid or mixed types. Mixed tumours that have more epithelioid cells have a better prognosis than tumours with more sarcomatoid cells. The sarcomatoid subtype has the least favourable prognosis no matter what treatment is given.
Stage plays a role in prognosis for people who are going to have surgery. Generally, people with stage 1 or stage 2 mesothelioma have a better prognosis than people with stage 3.
Mesothelioma that has spread to the lymph nodes (stage 3or 4) has a less favourable prognosis.
Surgical removal and surgical margins
Mesothelioma that can be completely removed with surgery has a more favourable prognosis than mesothelioma that can’t be completely removed.
A negative surgical margin means that there are no cancer cells at the edges of the tissue removed during surgery. A positive surgical margin means that cancer cells are found in the edges. Positive surgical margins have a higher risk of recurrence and a less favourable prognosis than negative surgical margins.
People who have chest pain and a diagnosis of pleural mesothelioma have a poor prognosis. This is because the chest pain may mean the cancer has advanced past the point where it can be removed with surgery.
Performance status is the measure of how well a person can do ordinary tasks and carry out daily activities. People with a poor performance status have a less favourable prognosis than people with a good or fair performance status.
People who have lost a lot of weight before their diagnosis have a less favourable prognosis than people who have not lost much weight.
People older than 60 who are diagnosed with mesothelioma do not survive as long as younger people with the same diagnosis.
Men diagnosed with mesothelioma have a poorer prognosis than women diagnosed with mesothelioma.
Increased numbers of platelets and white blood cells
People with mesothelioma who have a higher than normal platelet count (thrombocytosis) have a less favourable prognosis than people with a normal platelet count.
People with higher white blood cell counts (leukocytosis) also have a less favourable prognosis than people with normal white blood cell counts.
Higher than normal lactate dehydrogenase (LDH) levels
LDH is an enzyme that is found in almost all of the body’s cells. When cells are damaged or destroyed, LDH is released into the blood. A higher than normal level of LDH means that there is tissue or cell damage somewhere in the body.
People with mesothelioma who have a higher than normal LDH level have a less favourable prognosis than people who have normal or low LDH levels.