Typically the most important variable determining the prognosis and life expectancy of a mesothelioma patient is the stage of the cancer when it is diagnosed. Unfortunately, mesothelioma is more difficult to "stage" than other cancers. This is true for a couple of reasons:
1) because its somewhat rare, and
2) because its initial symptoms are subtle it is usually advanced when diagnosed, making it difficult to stage.
Peritoneal mesothelioma in particular can be difficult to stage because, while pleural mesothelioma has multiple staging systems, pathologists still haven't developed a staging system for peritoneal mesothelioma. Both pleural and peritoneal types of mesothelioma are very serious conditions and neither have a good outlook.
Since mesothelioma is usually diagnosed at an advanced stage, the statistics for five year survival for early stage mesothelioma are usually unreliable. It also can not be said with certainty which of the two types is a worse diagnosis; peritoneal mesothelioma or pleural mesothelioma. Many studies show that peritoneal is a more deadly, and rapidly spreading mesothelioma than pleural mesothelioma, but these studies are often contradicted by specialists who argue pleural mesothelioma is the more dangerous and more difficult to treat of the two. Usually patients diagnosed with either peritoneal or pleural mesothelioma are told that they may have less than a year to live. However, according to researchers in leading research centers around the world this is not necessarily the case. More recent studies indicate that patients with mesothelioma might, in some instances, have a better out look than originally believed.
According to these studies about 10% of all people diagnosed with mesothelioma will be alive 3 years later and about 5% will be alive 5 years later. However, if the mesothelioma is detected in its earlier stages and treated, 50% will survive 2 years and 20% people will survive 5 years.
In one clinical trial involving 120 patients with different types of pleural mesothelioma, all of the patients underwent pleural pneumonectomies (removal of the lung and pleura), followed by radiotherapy and chemotherapy. 45 % were alive two years later and more than 20% were alive five years later.
In the same study, patients with sarcomatoid and mixed mesothelioma did not fare as well. Only 20% of these patients were alive two years later, and none of them survived five years.
However, patients that had no cancer in the lymph nodes and epithelioid type tumors did much better. Almost 75% survived longer than two years and nearly 40% were alive after five years.
Another much broader study conducted in Italy looked at the records of 4.5 million people diagnosed with mesothelioma. The survival rates were as follows: 24% of people with pleural mesothelioma and 34% diagnosed with peritoneal mesothelioma were still alive one year after diagnosis. Two other major studies, also reviewing comparable populations, also revealed similar findings.
Another variable that is extremely important to a patients out look is his or her overall health at the time of diagnosis. Generally the healthier a patient is, the better he or she will react to cancer treatments, and the greater the chances of longer survival. Doctor's have a method of grading a patients health and give each patient a score at the time of diagnosis. This method of grading is referred to as a patient's "performance status" (PS). The best score is 0 and indicates a patient can basically take care of him or herself with out assistance. A performance status of 1 indicates that a patient can do most things, but may need some assistance. The more deteriorated the patient's health, the higher the number.
The patient should always bear in mind that statistics such as the ones mentioned here are in no way definitive. Survivability has a lot to do with a number of different factors including health, type of mesothelioma, treatment choice, and even a patient's morale. The statistics listed here are too general for individual patients to get an exact idea of their own out look.
Patients should consider taking part in clinical trials. Though no one can say exactly why; patients who are treated in clinic trials fare better on average than those who are treated conventionally. Perhaps with all the tests and monitoring that is done, patients become more confident that all that can possibly be done, is being done.
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