Written By: Camryn Keeble

Pleural Mesothelioma Prognosis

A pleural mesothelioma prognosis is the result of a doctor evaluating a patient’s life expectancy. Your prognosis is dependent on many factors, which means each patient’s prognosis can be different. The main factor affecting pleural mesothelioma prognosis is the stage of the cancer.

Karen Ritter, RN BSN

Medically Reviewed By

Karen Ritter, RN BSN

Registered Nurse

Karen Ritter, RN BSN

Medically Reviewed By

Karen Ritter, RN BSN

Registered Nurse


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Important Facts About Pleural Mesothelioma Prognosis

  • The average prognosis for pleural mesothelioma patients is 8-19 months. If the patient receives treatment, their prognosis usually improves versus if they do not. Patients who have surgery typically have a prognosis of at least two years.
  • Several factors can affect a patient’s pleural mesothelioma prognosis, such as age, gender, lifestyle, diet, and overall health.
  • There are ways to improve, or beat the original prognosis, such as considering all available treatment options, connecting with a premier mesothelioma specialist, increasing overall health and finding a mesothelioma specialist for a second opinion to compare treatment options.
  • Pleural mesothelioma forms in the lining of the lungs (the pleura). Pleural mesothelioma is an aggressive form of cancer and can grow and spread quickly. The lungs are a vital organ to the human body. If one or both become affected, it can have severe effects on the body and is a reason why the average prognosis is 1-2 years.

What Is a Pleural Mesothelioma Prognosis?

A pleural mesothelioma prognosis is the medical prediction of the cancer’s outcome. This prediction comes after the patient has been officially diagnosed with pleural mesothelioma. In most pleural mesothelioma cases, prognosis is measured by length of survival for the patient.

The patient’s prognosis is a medical prediction based on historical pleural mesothelioma survival rates, which is a percentage indicating how many patients survive over a certain amount of time. For instance, the 5-year survival rate for pleural mesothelioma is less than 5%. Mesothelioma specialists analyze pleural mesothelioma survival rates to determine a prognosis.

A pleural mesothelioma prognosis typically includes a life expectancy for the patient, along with chances of remission (cancer shrinking) or recurrence (cancer returning after treatment ends). This type of medical forecast may also include quality of life predictions. Quality of life is defined as your physical and mental health, ability to enjoy life events, and overall comfort. For instance, a mesothelioma specialist will indicate whether or not the patient will have difficulty breathing, exercising or enjoying their usual lifestyle.

Patients may receive multiple prognoses throughout their pleural mesothelioma journey, especially if they undergo aggressive surgery or a new treatment. A mesothelioma specialist may provide the patient with a prognosis for each available pleural mesothelioma treatment option. For example, chemotherapy may provide patients with a different life expectancy than pleural mesothelioma surgery.

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Early Stage Pleural Mesothelioma

Early stage (stage 1 and stage 2) pleural mesothelioma patients often have the best prognosis. According to Dr. David Sugarbaker, the late mesothelioma expert, patients diagnosed with stage 1 pleural mesothelioma have an average life expectancy of 22 months.

Patients diagnosed with stage 2 pleural mesothelioma have a life expectancy of 19 months.

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Late-Stage Pleural Mesothelioma

Late-stage pleural mesothelioma patients do not have as hopeful of a life expectancy as early stage pleural mesothelioma patients. The average prognosis for stage 3 patients is approximately 15 months. The average prognosis for stage 4 pleural mesothelioma patients is around 1 year.

Unfortunately, most mesothelioma patients – regardless of the type – are diagnosed in late stages. This occurs because the cancer can hide in the chest lining for years or decades before presenting symptoms. Patients may also mistake these symptoms with a less-serious condition, such as pneumonia. By the time the patient is able to see their doctor, share their concerns, and get a biopsy, the patient’s mesothelioma often has spread in the chest cavity.

What Factors Affect a Pleural Mesothelioma Prognosis?

Each patient’s prognosis is unique to their diagnosis and personal circumstances. There are several factors doctors consider when providing a pleural mesothelioma prognosis:

  • Age and gender
  • Mesothelioma cell type
  • Stage of mesothelioma
  • Treatment options
  • Lifestyle and diet
  • Survival rates
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Age and Gender

Younger patients often have a more hopeful pleural mesothelioma life expectancy due to their overall health status. Younger patients are more likely to have stronger physical health, which makes them better candidates for surgery.

Women with mesothelioma are also in the more positive prognosis group because they are more likely to recognize and react to symptoms sooner, which can lead to an earlier diagnosis. Women are also known to be more consistent with committing to receiving chemotherapy and immunotherapy and attending doctor appointments.

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Mesothelioma Cell Type

There are three mesothelioma cell types, and each can have a different effect on the patient’s prognosis:

  • Epithelioid cells usually lead to the longest life expectancy of two years, as they are easier to identify and remove during surgery. This cell type accounts for the majority of all mesothelioma cases.
  • Sarcomatoid cells usually cause the worst prognosis, often 8-12 months, as they grow significantly faster than epithelioid cells and are harder to treat.
  • Biphasic cells typically have a life expectancy of 13 months. This type of cell is a mixture of epithelioid and sarcomatoid cells. The patient’s prognosis depends on which cell type their body has the most of.
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Treatment Options

Pleural mesothelioma treatment options also affect life expectancy for patients. Different treatment options can have different effects on the patient and their cancer.

Pleural Mesothelioma Surgery

Pleural mesothelioma surgery often leads to improved survival, although not all mesothelioma patients are eligible for surgery.

Patients who undergo pleurectomy/decortication (P/D) surgery for pleural mesothelioma have a hopeful prognosis due to the surgical removal of most, if not all, visible tumors. The life expectancy for patients who receive P/D is 23-32 months.

Extrapleural pneumonectomy (EPP) for pleural mesothelioma removes the affected lung. The patient’s prognosis depends on their overall health, specifically if they are strong enough to survive surgery and the recovery phase. The life expectancy for patients undergoing EPP is around 20 months.

Pleural Mesothelioma Therapies

Pleural mesothelioma chemotherapy was for a long time the default treatment method for patients ineligible for surgery. The life expectancy for patients receiving chemotherapy is 12-14 months.

Pleural mesothelioma immunotherapy is becoming more common, giving people an alternative to chemotherapy, and improving life expectancies. Nivolumab (Opdivo) and ipilimumab (Yervoy) for pleural mesothelioma are FDA-approved immunotherapy drugs. They are approved to be used together. The average life expectancy for patients receiving Opdivo and Yervoy is 18 months.

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Lifestyle and Diet

The patient’s lifestyle and diet can affect life expectancy. Patients who regularly exercise and eat a nutritious diet can have a slightly improved prognosis due to their overall health.

How to Improve Prognosis for Mesothelioma

Although there are several factors affecting a patient’s prognosis, there are also ways to improve a pleural mesothelioma prognosis.

Steps to Improving Your Prognosis

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Evaluate Your Treatment Options

Pleural mesothelioma treatment options may seem limited, but research and development continues to expand and create more treatment options.

Surgery is often the treatment method with the best chance to extend a patient’s life expectancy. However, some patients are not surgical candidates and will need other options, such as immunotherapy or chemotherapy. Mesothelioma treatment is also the focus of many clinical trials. Participating in clinical trials can improve the patient’s prognosis and even lead to improvements in the overall landscape of mesothelioma treatment.

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Connect With an Experienced Mesothelioma Specialist

Seeing an experienced mesothelioma specialist is one of the most important things to do as a pleural mesothelioma patient. This will ensure a proper diagnosis, access to all possible treatment options, and a higher chance of improving the prognosis.

Mesothelioma specialists have dedicated their careers to better understanding and treatment of mesothelioma. Non-specialized doctors usually do not have the expertise required to effectively treat this complicated cancer.

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Improve Your Overall Health

A healthy patient is often eligible for more treatment options as they can typically withstand more aggressive treatment methods, such as surgery. The healthier the patient, the healthier their immune system, which means it can properly identify and fight off cancer cells. Even if the patient was not at peak health at the time of diagnosis, it’s never too late to improve. Patients can boost their health by maintaining a healthy sleep schedule, exercising regularly, and eating a nutritious diet.

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Get a Second Opinion

Second opinions are extremely important after receiving a pleural mesothelioma diagnosis. Mesothelioma can be challenging to diagnose and is often misdiagnosed. The stage of pleural mesothelioma is important for the prognosis, so a second opinion can change the stage and treatment options. Getting a second opinion can often mean gaining access to treatments not previously available.

Frequently Asked Questions About Pleural Mesothelioma Prognosis

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How Long Do People Live with Pleural Mesothelioma?

People with pleural mesothelioma typically live for 1-2 years but can live longer. It depends on the stage of diagnosis, the patient’s overall health, and the treatment plan.

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What Is the Average Prognosis for Pleural Mesothelioma?

The average prognosis for pleural mesothelioma is 8-19 months. Pleural mesothelioma forms in the lining of the lung and can easily spread to the lungs and lymph nodes, causing severe health issues.

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What Factors Can Affect Pleural Mesothelioma Prognosis?

There are several factors affecting a patient’s pleural mesothelioma prognosis, such as:

  • Age and gender
  • Treatment options
  • Stage of mesothelioma
  • Mesothelioma cell type
  • Survival rates
  • Lifestyle and diet

Some of these factors are within the patient’s control, so focusing on some of these factors can improve the prognosis.

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How Can I Improve My Pleural Mesothelioma Prognosis?

Improving your overall health can improve your mesothelioma prognosis. Healthy patients are often eligible for more treatment options and respond better to treatment. Receiving high-quality care from a mesothelioma specialist may improve your prognosis as mesothelioma specialists have the most experience with this type of cancer and have the most knowledge about treatment options.

Sources & Author

  1. Survival Rates for Mesothelioma. American Cancer Society. Retrieved from: https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/survival-statistics.html. Accessed: 11/03/2022.
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About the Writer, Camryn Keeble

Camryn Keeble is the senior content writer and editor for Mesothelioma Guide. She creates informative content to educate mesothelioma patients and their loved ones on news, treatments and more. She also works diligently to raise awareness of the dangers of asbestos exposure and the effects of mesothelioma.