Prognosticating mesothelioma remains difficult, with rapid rates of mortality. The median survival of patients diagnosed with malignant mesothelioma from time of first diagnosis is one year; in male patients or those with elevated white-cell counts, thrombocytosis or anemia, the prognosis is far worse. The presence of certain biochemical markers, as well increased vascularity or the presence of the SV40 virus in the tumor, are other indicators that the prognosis would be more serious.
A variety of factors affect a patient’s prognosis. The most important iinclude the site where the cancer has developed, the stage or extent of cancer (has the cancer metastasized to elsewhere in the body, and the histology of the cancer (epithelial, sarcomatoid, or bi-phasic). Other factors such as the patient’s general health, age and response to treatment can also affect prognosis.
Studies indicate the epithelial cell type have been associated more often with a favorable prognosis. The fibrosarcomatus type carries the worst prognosis, while the mixed (a combination of both kinds) comes in between them. The younger the age of the person diagnosed, the better the prognosis. There has not been, to this point, a study showing a difference between the survival rates for men and women diagnosed with malignant mesothelioma.
There were several other indicators that leaned toward a more favorable prognosis. An absence of weight loss and a lack of involvement of the visceral pleura were found in clinical studies to indicate the cancer was not as extensive.
To this point, no biomarker has been developed to serve as a consistent predictive or prognostic method to indicate the presence of malignant mesothelioma. However, a four-gene grouping has been identified which correctly classified a training sample into good and poor prognostic groups. The gene signature was subsequently tested on 29 sample and it correctly predicted the correct outcome in a notable number of cases.
A second study found that the signature was indeed accurate. This supports the identification of disease-specific and treatment-specific molecular marker candidates. A third study used two different kinds of microarray analysis to identify a common subset of 27 genes that could be used to predict both the progression and survivability of malignant mesothelioma. Significant questions remain, however, as to whether this new find can be clinically applicable.
Does it help to be aware of the prognosis?
Mesothelioma patients, along with their loved ones, have to face up to many unknown situations. Understanding the disease and its expected course can help both patients and their loved ones in planning treatment, making lifestyle changes, and make critical decisions related to their finances and quality of life. Many individuals diagnosed with cancer generally want doctors to tell them their prognosis. These individuals find it easier to deal with their specific situation when they are aware of the statistics. Patients can ask their doctors for statistics such as survival rates or they can search for these on their own. On the other hand, some people consider statistical information as frightening and confusing, and they feel that such data is too impersonal to be of any significant use to them.
The doctor who may be most familiar with the specific situation of a patient is the right person to discuss the prognosis and also to describe what exactly the statistics imply. Again, it is important to be aware of the fact that even the doctor may not be able to tell what exactly to expect. In reality, an individual’s prognosis may change in case the cancer progresses or if the disease responds to treatment. More on mesothelioma survival rates.
It is a personal decision to seek information about the prognosis. It is for the patient to decide what details he/she would want to know and how to deal with that information. More on understanding survival statistics and using them to make a prognosis.