Mesothelioma natural history
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2], Sujit Routray, M.D. [3]
Overview
Natural History
- Malignant mesothelioma is usually an aggressive disease.[1]
Complications
- Blood clots in the veins, which may cause thrombophlebitis
- Disseminated intravascular coagulation, a disorder causing severe bleeding in many body organs
- Pulmonary emboli, or blood clots in the arteries of the lungs
- Severe ascites
Prognosis
- The prognostic factors for mesothelioma include:[2]
- Cell subtype: Epithelioid mesothelioma is the most common subtype of mesothelioma and has a better prognosis than sarcomatoid or mixed (biphasic) types. Sarcomatoid subtype has the least favorable prognosis.
- Location of mesothelioma: Pericardial mesothelioma is usually associated with a poorer prognosis than the other types of mesothelioma.
- Surgical removal: Mesothelioma that can be resected has a more favorable prognosis than mesothelioma that has spread too far and is unresectable. Clear surgical margins improve prognosis. Mesothelioma is often a diffuse disease and doesn’t stay localized. This makes it difficult to get clear surgical margins.
- Stage: Stage plays a role in prognosis for people who have surgery. The stage of mesothelioma does not impact survival for people who do not have surgery. Generally, early stage mesothelioma has a better prognosis than more advanced stages. If mesothelioma has spread to the lymph nodes, it is usually associated with a less favorable prognosis.
- Symptoms: The presence of chest pain with pleural mesothelioma or excessive weight loss is associated with a poorer prognosis. Chest pain suggests there may advanced disease that is unresectable.
- Thrombocytosis: Thrombocytosis is associated with a poorer prognosis.
- Leukocytosis: Leukocytosis is associated with a poorer prognosis.
- Performance status: People with a good performance status have a better prognosis than those with a poor performance status.
- Age: Younger people have a better prognosis than older people.
- Sex: Females seem to have a better prognosis than men.
- Lactate dehydrogenase (LDH) level: People with increased LDH blood levels tend to have a less favorable prognosis than those with normal LDH levels. LDH is an enzyme in the blood that can be increased when there is damage to certain tissue or cancer.
A mesothelioma is a highly aggressive tumor that is generally deadly. Current treatment of malignant mesothelioma is designed to make the person with cancer comfortable. Although long-term survival cannot usually be expected, the case of famed paleontologist Stephen Jay Gould is a noted exception.
Mesothelioma is not contagious and cannot be passed from one person to another. The exposure to the asbestos that caused the cancer occurred many years to several decades before the disease appeared. People who live with asbestos workers have a higher risk of getting this cancer.
Although mesothelioma is very unpleasant it's still important for person after treatment is over to keep up all follow-up appointments and that's vital because further testing is always needed to check whether cancer is coming back or to examine possible side effects that could be rather unpleasant and what's even worse permanent.
As discussed earlier, the prognosis of mesothelioma depends on the cell subtype. The median survival time of various subtypes of mesothelioma are tabulated below.
| Location of mesothelioma | Approximate median survival |
|---|---|
| Pleural | 4-18 months |
| Peritoneal | 5-12 months |
| Pericardial | 6 months |
| Tunica vaginalis testis | 23 months |
References
- ↑ Survival statistics for mesothelioma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/prognosis-and-survival/survival-statistics/?region=on. Accessed on February 10, 2016
- ↑ Prognosis and survival for mesothelioma. Cancer canadian society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/prognosis-and-survival/?region=on. Accessed on February 8, 2016