What is a Pleural Mesothelioma Prognosis?

Pleural mesothelioma prognosis refers to the severity of the pleural mesothelioma discovered in a patient and the outlook of the condition as it relates to the effectiveness of treatments, the health and wellbeing of the patient, and the proposed survival rate of the patient. A prognosis may be either positive or negative. Pleural mesothelioma begins in the lining of the lungs, can severely debilitate the patient’s ability to breath, and makes up approximately 75% of all known mesothelioma patients.

A positive prognosis is one in which an oncologist determines that a course of treatments will ultimately lead to a full or partial recovery of a condition. In the case of pleural mesothelioma, patients often remain undiagnosed for many years because mesothelioma takes many years to produce symptoms that indicate its presence. This period of time between onset of the disease and presenting symptoms is known as a “latency period”. Many mesothelioma patients receive a poor prognosis because later stages of mesothelioma are much more difficult to effectively treat.

A pleural mesothelioma prognosis is ultimately defined based on the several factors surround the patient’s entire medical picture at the time of diagnosis, including the following factors.

•  Overall health of the patient; patients with other conditions such as diabetes or heart disease do not fare well during surgery. Since surgery is the most commonly prescribed and most effective treatment for cancer, the pleural mesothelioma prognosis will be adversely affected by the presence of these conditions.
•  Pleural mesothelioma stage; the stage of cancer helps oncologists determine how severe the condition of the patient.
•  Type of cancer cells that are present in the pleura, the lining of the lungs; certain cancer cells are more aggressive or less responsive to treatments than others.
•  Exact location of tumors and cancer cells; pleural mesothelioma in the chest wall is less difficult to treat than that which is found on the lung and therefore, behind the rib cage.
•  Potential response to treatments; pleural mesothelioma prognosis in late stages receive a more negative prognosis because treatment is less effective.
•  Life Expectancy\Survival Rate; the amount of time that oncologists think will pass before death occurs in the absence of effective treatment.

How is a Pleural Mesothelioma Prognosis Determined?

The first step to gaining an accurate pleural mesothelioma prognosis is an accurate diagnosis. Doctors perform a series of scans, x-rays, and a biopsy the cells found within a tumor in the body. Images and blood tests provide a clear picture of whether or not things seem to be normal around the lungs. A biopsy determines the type of cells that are present in any abnormality the images show. When combined, all of these procedures will provide enough information to determine a pleural mesothelioma prognosis.

Images and Biopsies

Images may show a growth of tissue that normally wouldn’t exist in the mesothelium surrounding the lungs – the pleura. A biopsy of the abnormality will yield information that indicates whether the cancer is malignant (cancerous) or benign (not cancerous). Benign tumors in the pleura are rare. Malignant tumors in the pleura are further analyzed to determine the type of cancer cells that are present.

A special doctor, called a histopathologist, will determine which of the following types of tumors or cancer cells exist in the pleura.

•  Epithelioid cancer cells are the most common among pleural mesothelioma patients and are easily confused with other conditions, such as adenocarcinoma. Therefore, the location of the cancer (the pleura) and any history with exposure to asbestos is heavily considered by the oncologist.
• Sarcomatoid cancer cells are present in only twenty percent of mesothelioma cases, making pleural mesothelioma prognosis (and diagnosis) easier to conclude. Sarcomatoid cells may also appear with other conditions and sometimes manifest as a sub-type known as desmoplastic sarcomatoid, which make pleural mesothelioma prognosis easier to obtain.
• Biphasic cancer cells is a term that refers to the discover of both sarcomatoid and epithelioid cancer cells present in a single tumor on the pleura. Biphasic conditions are rare and much easier to identify and diagnose than a tumor with a single type of cell present.

Pleural Mesothelioma Prognosis and Treatments

After obtaining as much information as possible, the oncologist will determine the pleural mesothelioma prognosis by comparing the patient’s information to the historical facts of other pleural mesothelioma cases including:

•  Response to Treatment
•  Survival Rates
•  Treatment Complications

Applying a prognosis to a group of individuals through statistics can be completely inaccurate to the individual case under consideration. Therefore, determining the pleural mesothelioma prognosis must also be concluded by heavily considering the individual patient’s situation.

Pleural Mesothelioma Prognosis and Staging

As it is often the case, the oncologist will develop several prognosis based on which groups the patient will likely fall into both in the current situation and in the future during and after treatment. For this purpose, oncologists use a scoring system that assists in determining the stage of cancer. The stage of cancer helps to determine the likely outcome of treatments on a patient.

There are up to three staging guides, but the most commonly employed is the TNM staging system. Others include the Brigham Staging System and the Butchart Staging System, which is the earliest system employed by oncologist and is no longer in general use.

Once stage is determined, potential pleural mesothelioma prognosis can be determined, as outlined in the table below.

Stage I cancers are more responsive to treatment because they are localized to one area and have not yet manifested into deeper layers of tissue. Pleural mesothelioma prognosis for early stage cancer is often positive, though there is no complete cure for mesothelioma. The survival rate in early stages may be more than five years. Stage IV cancers are less responsive to treatment because there are more cancer cells present and cancer cells multiply into deeper tissues or even into the lung itself, making it more difficult to safely remove them. Pleural mesothelioma prognosis for late stage cancer is almost always negative, with a survival rate of three months to one year.

Pleural Mesothelioma Prognosis and Survival Rates

The survival rate (life expectancy) associated with pleural mesothelioma prognosis is often poor because of the extended latency period involved. The latency period allows for unchecked multiplication of cancer cells, which work their way into major arteries, nerves, and organs. Late stage cancers detected well after the mesothelioma has begun to develop is often difficult, if not impossible, to effectively treat.

Because of the heavy damage present at this point in the development, pleural mesothelioma prognosis often carries a short life expectancy.

Statistically, survival rates for late diagnosis are very short; less than one year. However, some patients who are diagnosed earlier are provided a pleural mesothelioma prognosis that exceeds five years. Additionally, younger patients with fewer health conditions fare better than elder patients with conditions that may complicate or prevent treatment.