Mesothelioma Cancer & Cells – Types, Treatments, Prognosis, Survival Rate.

Mesothelioma Cancer, types of mesothelioma cancer, prognosis, treatment options, survival rate

Do You Know About Mesothelioma Cancer:

Mesothelioma cancer is a type of cancer that develops from the thin layer of tissue that covers many of the internal organs (known as the mesothelium). The most common area involved is the lining of the lungs and the chest wall.

Less commonly, the lining of the abdomen may be affected and rarely the sac that surrounds the heart or sac that surrounds the testicle. Signs and symptoms of mesothelioma can include wheezing due to fluid around the lung, swollen abdomen, pain in the chest wall, coughing, feeling tired and losing weight. These symptoms occur slowly.

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Over 80% of mesothelioma cases are caused by exposure to asbestos. If the exposure is higher then the risk of cancer is greater. Since 2013, around 125 million people worldwide have been exposed to asbestos at work. High disease rates occur in people who extract asbestos, produce asbestos products, work with asbestos products, live with asbestos workers or work in buildings containing asbestos.

Exposure to asbestos and cancer onset has generally been separated for about 40 years. Washing the clothes of someone who has worked with asbestos also increases the risk. Other risk factors include genetics and infection with the simian 40 viruses. The diagnosis can be suspected based on the results of chest radiographs and CT scans and is confirmed by examination of the fluid produced by cancer or by a tissue biopsy of cancer.

Prevention focuses on reducing exposure to asbestos. Treatment often includes surgery, radiotherapy, and chemotherapy. A procedure known as pleurodesis, which involves the use of substances such as talc to heal the pleura, can be used to prevent the accumulation of more fluid around the lungs. Chemotherapy often includes cisplatin and pemetrexed drugs. The percentage of people who survive five years after diagnosis is on average 8% in the United States.

In 2015, approximately 60,800 people had mesothelioma and 32,000 died due to the disease. The percentages of mesothelioma vary in different areas of the world.

Rates of mesothelioma cancer are higher in the United Kingdom and Australia but lower in Japan. It occurs in around 3,000 people a year in the United States. It occurs more often in males than in females.

Disease rates have increased since the 1950s. The diagnosis usually occurs after the age of 65 and most deaths occur around the age of 70. The disease was rare before the commercial use of asbestos.

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Types of Mesothelioma By Location & Sort of Cells:

The types of mesothelioma are based on the position in which cancer develops and on its type of cell. For example, when it forms in the pleural lining around the lungs, the cancer is called pleural mesothelioma.

Any type of mesothelioma can lead to different symptoms. The treatment is personalized based on the cellular variety. The prognosis also varies depending on the location of the mesothelioma tumor.

Primary types of mesothelioma by location and cell type:

  • Pleural mesothelioma (lungs)
  • Peritoneal mesothelioma (abdomen)
  • Pericardial mesothelioma (heart)
  • Testicular mesothelioma (testicles)
  • Epithelioid mesothelioma (epithelioid cells)
  • Sarcomatoid mesothelioma (sarcomatoid cells)
  • Biphasic mesothelioma (epithelioid and sarcomatoid cells)
  • Other types of rare cells.

Pleural Mesothelioma:

The pleural effusion is the most common mesothelioma. About 70-75% of cases occur in the pleura. More research has been conducted on this mesothelioma cancer than any other.

Most patients qualify for chemotherapy, radiotherapy. Some may qualify for immunotherapy. These therapies can add months or years to life expectancy.

Characteristics of pleural mesothelioma

  • Position: pleural lining (chest)
  • Symptoms: shortness of breath, chest pain, weight loss, fever, and fatigue
  • Prognosis: with treatment, 3+ years in stage 1 against 12 months in stage 4

Peritoneal Mesothelioma:

Peritoneal tumor accounts for 10% to 20% of mesothelioma cases. Less research is available on peritoneal compared to pleural. However, the prognosis for this type of cancer is better.

According to the research, about half of patients with peritoneal mesothelioma undergoing surgery and Hyperthermic intraperitoneal chemotherapy (HIPEC) live five or more years after diagnosis.

Characteristics of peritoneal mesothelioma:

  • Position: abdominal lining (peritoneum)
  • Symptoms: abdominal pain and swelling, swelling, loss of appetite and intestinal changes
  • Prognosis: 52% live at least five years after HIPEC surgery

Pericardial Mesothelioma:

The type of pericardial tumor is extremely rare. About 200 cases are reported in the medical literature. With surgery, some patients live for years beyond the average life expectancy of six months.

Characteristics of pericardial mesothelioma:

  • Position: The lining of the heart (pericardium)
  • Symptoms: irregular heartbeat, chest pain, difficulty breathing, and cough
  • Prognosis: generally varies from six weeks to 15 months

Testicular Mesothelioma:

Testicular mesothelioma develops in the lining of the testicles. This form of mesothelioma cancer is the rarest. Less than 100 cases are reported in the medical literature.

Treatment options include surgery and chemotherapy, which can help people live more than two years after diagnosis, on average.

Characteristics of testicular mesothelioma:

Position: it is formed in the vaginal tunic, which is the covering that covers the testicles
Symptoms: scrotal swelling, painless testicular lumps
Prognosis: 2 years

Types of Mesothelioma Cells

The three varieties of mesothelioma cells are epithelial, sarcomatoid and biphasic. Biphasic is a mix of the first two types of cells.

Mesothelioma doctors can tell the difference between cells based on their appearance under the microscope.

  • Epithelial
  • Sarcomatoid
  • Biphasic

Several mesothelioma cancers respond differently to a treatment. Epithelial or epithelioid cells respond better and sarcomatoid cells are more resistant to treatment.

Cancer doctors take these differences into account when planning mesothelioma treatment. The incidence of these cell types varies depending on the location of cancer.

Epithelial cell mesothelioma:

Epithelioid mesothelioma constitutes approximately 70% to 75% of all cases of asbestos-related mesothelioma tumors.

The epithelioid cell has the best prognosis. It tends to be less aggressive and does not spread as rapidly as sarcomatoid and biphasic cell disease.

About 50% of pleural disease is epithelioid. About 75% of peritoneal tumors are epithelioid cells.

Sarcomatoid cell mesothelioma:

Sarcomatoid mesothelioma is the less common mesothelioma cell category. It is the most aggressive and difficult to treat. Represents about 10-20% of all mesothelioma diagnoses.

You may hear sarcomatoid mesothelioma referred to as malignant, fused or diffuse fibrous mesothelioma.

About 20% of pleural tumors are sarcomatoid, while only 1% of peritoneal mesothelioma is sarcomatoid.

Biphasic Cell Mesothelioma:

Biphasic mesothelioma refers to tumors that contain epithelial and sarcomatoid cells. Life expectancy after the diagnosis of biphasic mesothelioma depends on which cell predominates in the tumor.

More epithelioid cells generally mean a better prognosis. If the tumor is mostly aromatic, it is more difficult to treat and life expectancy is shorter.

About 30% of pleural tumors and 25% of peritoneal tumors are biphasic cells.

Prevalence of Pleural Mesothelioma Tumors by Cell Type

Cell TypePercent
Epithelioid50%
Biphasic30%
Sarcomatoid20%

Prevalence of Peritoneal Mesothelioma Tumors by Cell Type

Cell TypePercent
Epithelioid75%
Biphasic24%
Sarcomatoid1%

Based on the limited number of cases reported in the medical literature, pericardial mesothelioma shows an approximately equal distribution of the three types of mesothelioma cells.

About two-thirds of cases of testicular mesothelioma are epithelioid cells. The rest of the testicular cases is biphasic. Only one case of purely sarcomatoid cell disease is reported for testicular mesothelioma.

Types of Rare Mesothelioma Cells:

There are some subtypes of rare cells. They may have slightly different characteristics and affect prognosis.

For example, patients with sarcomatoid tumors tend to have the shortest survival, but some patients with lymphohistiocytic subtypes of the sarcomatoid cell have survived for up to six years.

Well-differentiated papillary cells commonly occur in peritoneal mesothelioma. Only a handful of cases have been reported in subjects with other sites of mesothelioma carcinoma.

Small cell mesothelioma is another type of cell that occurs most commonly in the abdomen.

Just over half of the cases of deciduous mesothelioma occur in the abdomen. Just under half is present in the lung lining.

Cystic and papillary cells are more common in peritoneal mesothelioma.

Desmoplastic and lymphohistiocytoids are more common in pleural mesothelioma.

Adenomatous cells can occur in both malignant mesothelioma and benign mesothelioma cancer.

Heterologous cells are found in tumors that may also contain bones, cartilage, and soft tissues.

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Mesothelioma Treatment for Cancer & Cell Type:

The specific diagnosis of mesothelioma will affect Mesothelioma treatment options. Different treatments may be available, depending on the location of the tumor and possibly the cell type.

Surgery:

Surgical procedures for the treatment of pleural mesothelioma include:

  • Extrapleural pneumonectomy
  • Pleurectomy / decortication
  • Simple pneumonectomy

Peritoneal tumors are removed by peritonectomy. Pericardial tumors are removed with a pericardiectomy. Testicular tumors are removed with an inguinal osteectomy.

Chemotherapy:

A combination of cisplatin and Alimta (pemetrexed) is the most effective regimen against pleural mesothelioma.

The combinations of gemcitabine, Alimta, mitomycin and carboplatin are the most effective against peritoneal mesothelioma.

No special chemotherapy regimen is constantly effective for pericardial or testicular mesothelioma. The last two types of mesothelioma are so rare that they have not been studied enough to know which treatment is best.

In these rare situations, an experienced mesothelioma oncologist can work out the best treatment plan based on their experience and your general health.

Radiotherapy:

In pleural mesothelioma, radiation therapy is used with and without surgery. Radiation therapy is generally not a typical treatment for peritoneal mesothelioma but has been used successfully for the treatment of pericardial and testicular mesothelioma.

Palliative Treatment:

The goal of palliative therapy is to relieve pain and other symptoms of the disease. Palliative care can significantly improve the quality of life and well-being of patients with mesothelioma cancer.

For example, thoracentesis can be used to drain fluid from the lungs and paracentesis is used to remove fluid from the abdomen. These procedures can relieve pain and pressure and facilitate breathing and eating.

Selection of The Right Treatment:

To find the right treatment for mesothelioma patients, doctors consider many factors. This includes the stage of cancer, the age of the patient and the general health, as well as the wishes and needs of the patients who go into treatment.

Surgery can be recommended for patients in the early stages who are younger and in good health. Chemotherapy, radiotherapy, and immunotherapy are available for each patient regardless of stage or age.

What Is The Prognosis For Mesothelioma?

The prognosis for mesothelioma is generally poor because there is no cure for this cancer.

The prognosis is often measured in terms of “good”, “favorable”, “bad” or “poor” based on how cancer should progress. It includes the prospect of recovery and helps determine what treatment options might be available.

When patients ask about their prognosis, what they usually want to know is how long they will live.

How long do you live after being diagnosed with mesothelioma?

Most patients live about a year after being diagnosed with mesothelioma.

How long you live with mesothelioma depends on the stage in which you are diagnosed and how well you respond to mesothelioma treatments.

Early Stage Prognosis:

People with early-stage diagnosis, in phase 1 or phase 2, often qualify for surgery, which offers the best chance of long-term survival. About 20 percent of patients with pleural mesothelioma is diagnosed early enough to qualify for surgery. Stage 1 patients undergoing surgery have an average life expectancy of 22.2 months.

Prognosis In Advanced Stage:

Most patients are diagnosed late, stage 3 or 4, and do not qualify for surgery. The patients in stage 4 undergoing treatment have an average life expectancy of 14.9 months.

Although statistics play a role in determining prognosis, each case of mesothelioma is unique.

Some patients with mesothelioma are beating the typical prospects thanks to advances in treatment and care. Survivors increase lifespan for multimodal treatment, improvements in diet and complementary therapies.

Improving a Mesothelioma Prognosis

You can choose to be proactive and take steps to improve your prognosis. You cannot change important prognostic factors like your age, the type of mesothelioma cancer or the stage of cancer. But you can improve your overall health and elect an anti-cancer treatment such as chemotherapy.

In addition to undergoing treatments that control cancer, it is necessary to follow a healthy nutritional plan with a well-balanced diet. Good nutrition can also alleviate treatment side effects and cancer symptoms.

Eating properly and balancing the diet during mesothelioma treatment can help alleviate symptoms.

Treatment Options For Mesothelioma:

The most effective treatments for mesothelioma include surgery and chemotherapy. Radiotherapy and immunotherapy play a role in multimodal therapy and clinical studies.

Most patients are diagnosed too late to qualify for surgery and only undergo chemotherapy. Chemotherapy, radiotherapy, and immunotherapy are available to patients at all stages.

Cancer therapies are expensive, but many patients are eligible for financial compensation to cover the costs of mesothelioma treatment. Veterans can benefit from free or low-cost treatment.

A lawyer specialized in mesothelioma can advise patients on other possible sources of compensation.

Mesothelioma prognosis after chemotherapy:

The response rate to chemotherapy is almost 50 percent. This means that about half of patients with mesothelioma experience a tumor shrinkage or no new tumor growth over a period of time.

A 2016 study published in the journal Clinical Epidemiology found that patients receiving chemotherapy lived on average 12 months, while those who had not chosen any treatment lived on average four months.

Mesothelioma Prognosis After Surgery:

People diagnosed in phases 1, 2 or 3 can benefit from aggressive surgery. Tumor removal surgery offers the greatest opportunities for long-term survival. Surgery can involve the removal of an entire lung, part of the lung or just the removal of the lining of the lung, known as the pleura.

Many people wonder if a person can live with only one lung and the answer is yes. Surgery is regularly combined with chemotherapy and sometimes radiotherapy or immunotherapy. It can improve the survival of years in some patients.

Mesothelioma Prognosis After Radiotherapy:

Radiation therapy alone is used to reduce the painful tumors that grow in the chest wall. This application does not directly affect prognosis.

In combination with other therapies, such as surgery, radiation therapy can help delay or prevent the recurrence of local cancer.

Experimental Therapies:

Experimental therapies, such as immunotherapy and photodynamic therapy, are available through clinical trials and compassionate use programs.

Prognosis By Type of Mesothelioma:

Prognosis of Pleural Mesothelioma:

The prognosis for patients with pleural mesothelioma is the most common type but not favorable. Research shows that about 40 percent of patients survive at least a year after diagnosis.

Some patients undergoing multimodal treatment and complementary therapies survive several years after diagnosis. About 9 percent of patients with pleural mesothelioma survive for more than five years.

Prognosis of Peritoneal Mesothelioma:

Patients with peritoneal mesothelioma have a much better prognosis. New treatments for abdominal cancer, such as heated chemotherapy, have improved the chances of long-term survival.

About 50 percent of patients undergoing surgery with heated chemotherapy live for more than five years.

Prognosis of Pericardial Mesothelioma:

The prognosis for pericardial mesothelioma is generally poor. About half of the patients survive for six months. Rare cases of five-year survival have been reported and usually involve treatment including surgery and chemotherapy.

Prognosis of Testicular Mesothelioma:

Although testicular mesothelioma is the rarest type, its prognosis is generally the best. The average survival is about two years and some patients live more than a decade.

Prognosis By Stage of Mesothelioma:

Mesothelioma Prognosis In Phase 1:

Patients diagnosed in phase 1 have the best prognosis. Aggressive treatments are recommended for healthy people.

Survival rates for Stage 1A and Stage 1B:

Phase 1A: The two-year survival rate is 46% and the five-year survival rate is 16%.

Phase 1B: The two-year survival rate is 41 percent and the five-year survival rate is 13 percent.

The median overall survival at stage 1 is 22.2 months with surgery.

Prognosis of Mesothelioma in Phase 2:

Patients diagnosed in phase 2 have a better prognosis than patients in the advanced phase. In this phase, aggressive treatment plans are also recommended.

The two-year survival rate for pleural mesothelioma cancer is 38 percent and the five-year survival rate is 10 percent.

The median overall survival in phase 2 is 20 months with surgery.

Mesothelioma Prognosis in Phase 3:

The prognosis becomes more unfavorable for patients diagnosed in phase 3. Some phase 3 patients qualify for aggressive treatment plans.

Survival rates for Stage 3A and Stage 3B:

Phase 3A: The two-year survival rate is 30 percent and the five-year survival rate is 8 percent.

Phase 3B: The two-year survival rate is 26 percent and the five-year survival rate is 5 percent.

The median overall survival at stage 3 is 17.9 months with surgery.

Prognosis of Mesothelioma in Phase 4:

Stage 4 prognosis is generally poor. At this stage, palliative treatments are recommended to control symptoms and prolong survival for as long as possible.

The two-year survival rate for pleural mesothelioma is 17 percent and the five-year survival rate is less than 1 percent.

The median overall survival at stage 4 is 14.9 months with treatment.

Other Factors That Influence The Prognosis of Mesothelioma Cancer:

Type of cell:

The types of cells that make up the tumor can affect prognosis.

Epithelioid cells: patients with this type of cell tend to live longer than those with other cell types. People with epithelioid tumors live an average of 200 days longer.

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Sarcomatoid cells: these cells are associated with the poorest prognosis because they are considered more aggressive and more difficult to treat.

Biphasic cells: the prognosis for this type depends on the relationship between sarcomatoid cells and epithelial cells. The more epithelial cells, the better the prognosis.

Age:

Young people have a better prognosis with mesothelioma than older people. More than half of patients diagnosed under the age of 50 live at least one year with mesothelioma. Less than a third of patients diagnosed over the age of 75 live so long.

Gender:

The genus has a significant impact on the prognosis of mesothelioma. Women with mesothelioma tumors live longer than men.

Race:

The breed plays a role in the prognosis of mesothelioma. In 2013, the five-year survival rate was 8.7 percent for whites and 10 percent for blacks.

Black women tend to live longer with mesothelioma. In 2013, the five-year survival rate was 13.6 percent for white women and 30.1 percent for black women.

Remission & Recurrence of Mesothelioma:

The cancer prognosis includes the possibilities of healing, which is called remission. It involves a measurable reduction in the size of the tumor, which can be described as partial or complete.

  • Remission is partial when the tumor shrinks in size. Partial remission usually involves at least a 50% reduction in tumor size.
  • Remission is complete when cancer completely disappears.

Complete remission is rare with mesothelioma. Partial remission is more common. Patients can live for years in partial remission.

Unfortunately, mesothelioma tends to recur if partial or complete remission is achieved. When mesothelioma comes back, it usually occurs locally or regionally rather than distantly.

Clinical Tests:

Many clinical studies are seeking patients with recurrent mesotheliomacancer to test new and innovative therapies. Test second-line therapies to control cancer when it returns.

The goal of these studies is to find other ways to keep mesothelioma in check once back. Researchers need a wide range of participants. Patients with previous treatment who are now living with advanced disease are ideal candidates for clinical trials.

Understanding prognostic terms

Life expectation:

The term “life expectancy” refers to the average age that a person or population should live based on his position and other demographic data. Mesothelioma can reduce a person’s life expectancy by several years or decades. It all depends on their age at diagnosis and how long they live with mesothelioma.

For example, a healthy 70-year-old man has a life expectancy of 14 years. If he was diagnosed with stage 4 mesothelioma, his life expectancy is reduced to two years.

Survival Rates:

Survival rates measure how long most people live with mesothelioma. Your prognosis is mainly based on average cancer survival rates.

The National Cancer Institute states that the five-year survival rate for mesothelioma was 9% between 2007 and 2013.

Death rates

The cancer mortality rate, also called the mortality rate, describes how many people die from cancer. It has a role when doctors estimate a patient’s prognosis.

The mortality rates of mesothelioma are often defined in relation to the patient’s age, sex, race, and state of residence.

Survivors who have passed their prognosis:

Although recurrence is common, people diagnosed with mesothelioma are overcoming their initial prognosis.

Whether it is because of their particular type of mesothelioma, specialized treatments, genetics or simply changing the way they live their lives through better nutrition and exercise, it is important to keep hope alive.

Some survivors live years or even a decade or more after their initial prognosis.

Chris Gibney, pleural mesothelioma survivor

Diagnosis in 2005, Chris Gibney far surpassed his diagnosis of pleural mesothelioma cancer. In March 2017, he and his wife welcomed a group of exchange students from Germany to their home. Gibney thanks his excellent medical team and a family support group for surviving more than a decade after his prognosis.

Beth Mixon, a survivor of peritoneal mesothelioma

At the time of Beth Mixon’s peritoneal mesothelioma cancer diagnosis in 2000, most patients lived less than two years after treatment. Despite a severe prognosis, Mixon is still going strong 17 years after an aggressive cytoreductive intervention.

Kasie Coleman, a survivor of peritoneal mesothelioma

Diagnosis of peritoneal mesothelioma in 2010, Kasie Coleman underwent several cycles of chemotherapy and HIPEC treatments. His cancer went into remission in 2012.

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Source: Asbestos.com

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