Mesothelioma

Mesothelioma Prognosis

Following a mesothelioma diagnosis, a doctor will discuss the patient's prognosis, or the doctor's prediction of how a patient's health will be affected by a disease and whether a chance for recovery exists. In most mesothelioma cases, a patient is not diagnosed with the cancer until it has progressed to later stages of development. Unfortunately a late diagnosis can often negatively affect a patient's prognosis, but patients and doctors may work together to detail a treatment plan to try and combat future growth.

Prognostic Factors

A number of factors influence a mesothelioma patient's prognosis. As no two patients are alike, a mesothelioma prognosis is different for every person. Perhaps the greatest influence on a patient's prognosis is the stage at which diagnosis occurs. Since symptoms of mesothelioma often do not surface for 20 to 50 years, the cancer often goes undetected until it has greatly progressed. Doctors often refer to mesothelioma development in terms of stages ranging from one to four, with stage four indicating the greatest level of progression. Patients diagnosed with the cancer in stage three or four may not have the same amount of treatment options available to a patient with stage one or two mesothelioma.

In addition to the patient's stage of mesothelioma, overall health and age play a large part in a patient's prognosis. If a patient's general health is quite poor, various treatment options such as surgery may not be a possibility which may negatively affect prognosis. Mesothelioma is typically diagnosed in patients over 55 years old, and many patients may have other medical issues.

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Additional factors that may affect a patient's prognosis include: type of mesothelioma (pleural, peritoneal, pericardial or testicular), smoking habits, location and size of tumor and additional symptoms.

Mesothelioma Studies

Mesothelioma patients have entered into large cooperative group trials and the data from collected from these patients has resulted in the development of two prognostic scoring systems: the Cancer and Leukemia Group B (CALGB) and the European Organization for Research and Treatment of Cancer (EORTC). The Cancer and Leukemia Group B have identified several prognostic factors for patients with mesothelioma such as: poor Eastern Cooperative Oncology Group performance status, chest pain, dyspnea (shortness of breath), platelet count > 400,000/uL, weight loss, serum lactate dehydrogenase level > 500 IU/L, pleural involvement, low hemoglobin level, high white blood cell count, and age greater than 75 years.

Of these factors, pleural involvement, lactate dehydrogenase level, poor performance status, chest pain, platelet count, and age greater than 75 years were indicators of a poor prognosis or reduced survival time. Survival times in this group ranged from 1.4 to 13.9 months. A similar study was conducted by the European Organization for Research and Treatment of Cancer (EORTC). This study reported poor prognoses in patients with: poor performance status, a high white blood cell count, a probable diagnosis of mesothelioma, and male gender. Patients were subdivided into two groups: a good prognosis group and a poor prognosis group. The good prognosis group (1-year survival of 40%) had two or fewer of the poor prognostic factors while the poor prognosis group (1-year survival of 12%) had three or more of the prognostic factors.

 

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