Written By: David Statman
The goal of treating mesothelioma is achieving long-term remission. Despite being disease-free for an extended period of time, many specialists are reluctant to consider patients with mesothelioma “cured.” This page delves into what remission from mesothelioma means, the factors contributing to remission, and when, if ever, patients are considered cured.
Medically reviewed for accuracy by
Dr. Stephen Williams
Precision Oncology Scientist
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The term “remission” refers to the reduction or absence of signs and symptoms of a disease. For mesothelioma and other forms of cancer, remission means the disease is under control or undetectable but not necessarily cured. Remission can be partial or complete:
It is essential for patients in remission to stay diligent by attending regular follow-up appointments and continue to be closely monitored by their doctors due to the risk of recurrence or new tumor development. The duration of remission can vary greatly depending on the type and stage of mesothelioma, as well as the effectiveness of the treatment received.
Long-term remission is possible and some patients may ultimately live for as long as people who never develop mesothelioma. Regardless of this possibility, doctors are reluctant to use the word “cured” for anyone with this cancer. In clinical settings, patients who remain disease-free for 5 or more years are often designated as “survivors” rather than active cancer patients.
Here’s what that means:
Even for patients who achieve complete remission or extended disease-free intervals, close medical surveillance is essential due to the high incidence of mesothelioma recurrences. While difficult to achieve, there is still hope for long-term remission.
The goal for all mesothelioma patients is to achieve long-term remission of their disease. Although mesothelioma typically has a short prognosis compared to other types of cancer, many patients have beat the odds and achieved disease-free remission. Read some of the stories of how mesothelioma survivors have reached the goal of remission in our mesothelioma survivors section.
Mesothelioma treatment has improved over the years, and patients who are able to achieve long-term remission credit a combination of therapies for their progress. Treatments range from standard options like surgery, chemotherapy, immunotherapy, and radiation to newer therapies and new treatment combinations being tested in clinical trials.
Surgery can remove the largest amount of mesothelioma tumors or tissue in the quickest time. However, many patients are unable to have surgery due to either their overall physical health or their cancer being too advanced.
Extrapleural pneumonectomy (EPP) and pleurectomy with decortication (P/D) are the two surgeries for pleural mesothelioma. For peritoneal mesothelioma, cytoreductive surgery combined with HIPEC (heated intraperitoneal chemotherapy) is the surgery of choice.
The overall median survival for mesothelioma is often in the range of 12-18 months for non-surgical cases and 20-36 months, or more, for patients who have a successful surgery.
Chemotherapy remains a primary treatment option for mesothelioma. Over the past two decades, chemotherapy regimens have improved, and ongoing research continues to optimize drug combinations and timing. However, chemotherapy alone is unlikely to give patients a full remission or lead to 5 years of survival.
The FDA approved chemotherapy to treat malignant pleural mesothelioma when surgery is unavailable. The current standard chemotherapy treatment uses a combination of pemetrexed and a platinum-based drug (such as cisplatin or carboplatin). This pairing can shrink tumors, slow disease progression, and improve survival for many mesothelioma patients. Alternative or second-line agents may include gemcitabine, vinorelbine, or bevacizumab.
One important advancement in the treatment of mesothelioma is the addition of intraoperative chemotherapy. This process allows a liquid chemotherapy solution to be put directly into the abdominal cavity before the incision is completely closed. When intraoperative chemotherapy (HIPEC) was combined with cytoreductive surgery for peritoneal mesothelioma, it led to significantly improved survival and, in some cases, long-term remission. A similar process is used for pleural mesothelioma where a cancer-fighting solution is put into the chest cavity to kill microscopic cancer cells that may remain after visible tumors are removed.
Immunotherapy has become a critical treatment choice for mesothelioma, especially for patients who are not candidates for surgery. The FDA has approved immunotherapy for many cases of malignant pleural mesothelioma.
Nivolumab (Opdivo) and ipilimumab (Yervoy) was approved by the FDA in combination with chemotherapy for unresectable malignant pleural mesothelioma.
Immunotherapy, like chemotherapy, is unlikely to give patients a full remission or long-term survival as a stand alone treatment. In the CheckMate 743 clinical trial for mesothelioma, Opdivo and Yervoy provided a median overall survival (OS) of 18.1 months compared to 14.1 months with standard chemotherapy.
Radiation therapy is a traditional treatment method used to fight many types of cancer. Unfortunately, on its own, radiation is unlikely to lead to mesothelioma remission. However, multimodal therapy that combines radiation therapy with surgery, chemotherapy, or immunotherapy has shown significant strides toward reaching remission in mesothelioma patients.
Oncolytic virus therapy – Oncolytic virus therapy uses engineered viruses to infect and kill cancer cells. The viruses are programmed to ignore healthy cells, which prevents patients from getting sicker. This type of cancer treatment is in clinical trial testing for mesothelioma.
CAR T-cell therapy – CAR T-cell therapy, a type of immunotherapy called cell and gene therapy, engineers the patient’s immune system to find and attack cancer cells. An immune system cell called the T cell can be programmed to search for mesothelioma cells based on a specific protein they carry. CAR T-cell therapy is FDA-approved for types of blood cancer. It’s being tested in clinical trials for mesothelioma.
Gene therapy – Gene therapy adds, edits, or deletes genes in the patient’s body to either kill cancer cells or help the immune system detect and attack the disease. There are several types of gene therapy. This experimental treatment is in clinical testing for mesothelioma.
These novel therapies offer hope for longer remission and perhaps eventual cures when integrated into a multimodal strategy. CAR T-cell therapy has been so successful for blood cancers that some patients have been considered “cured” from their leukemia and lymphoma.
Mesothelioma survivor Kendra Ferreira attributes her remission to the treatment opportunities she received through participating in a clinical trial. If you have been diagnosed with mesothelioma and are exploring your treatment options, a clinical trial may offer access to therapies that could improve outcomes or, in some cases, lead to remission.
The recurrence of mesothelioma remains a significant concern. Despite successful treatments and extended periods of undetectable disease, mesothelioma may reappear due to microscopic cancer cells remaining hidden following treatment. These hidden cancer cells can remain dormant and later become active again.
Mesothelioma patients need to remain diligent about recognizing new or worsening symptoms and continue to attend follow-up appointments with their doctors. If a relapse occurs, this doesn’t mean all hope is gone. Patients who achieved remission have a good chance of doing it again with the help of experienced mesothelioma specialists.
Contact our team for help finding a mesothelioma specialist or cancer center to learn more about mesothelioma, treatment options, and remission. We are also available to help if you are experiencing a recurrence. Reach out to registered nurse Karen Ritter by email at karen@mesotheliomaguide.com. You can also contact her with this link to send a message directly to her or another patient advocate.
Sources & Author
Mesothelioma remission refers to a state where the signs of cancer, such as tumors and symptoms, are no longer detectable through medical testing. It is important to understand that achieving remission does not mean the disease is completely cured or that it will never return. When a person with mesothelioma remains free of detectable cancer for several years, they are considered survivors. Long-term remission provides hope for improved quality of life and a more positive outlook; however, ongoing medical checkups and regular monitoring remain essential due to the risk of recurrence.
Remission can be classified as partial or complete. Partial remission indicates that tumors have significantly shrunk, symptoms have improved, and the remaining cancer cells are no longer spreading. Complete remission means that all signs of the disease have disappeared, with no detectable tumors on scans or physical examinations. Despite these positive outcomes, it is crucial for patients to keep attending follow-up appointments and stay vigilant for potential signs of returning cancer. The duration of remission varies depending on the stage at diagnosis, the effectiveness of treatment, and the individual’s overall health.
While long-term remission is possible, doctors are cautious about declaring that a person with mesothelioma is truly cured. This is because mesothelioma can spread microscopically within tissue linings, often remaining undetectable for years. Even after successful treatments such as surgery, chemotherapy, and immunotherapy, microscopic cancer cells may still linger in the body. Factors like early detection, favorable cell types, and comprehensive treatment plans influence chances for extended remission and survival. Patients in remission should remain under medical supervision, as close follow-up helps catch any signs of the disease returning early, which can improve treatment options and outcomes.
Advances in treatment have increased the likelihood of reaching remission, with various options playing a role in the process. Surgery, chemotherapy, immunotherapy, and radiation therapy can be used in combination to improve prognosis. For some patients, newer therapies—like targeted immunotherapy, gene therapy, and experimental treatments in clinical trials—offer additional hope. A small number of patients have achieved such significant progress that they are considered cured, although this remains rare. Patients and their families should maintain hope and work closely with medical teams to explore all available treatment options, including clinical trials, to maximize the chances of remission and long-term health.
