Mesothelioma

Mesothelioma 

Malignant mesothelioma is a rare, asbestos-related cancer that forms on the thin protective tissues that cover the lungs and abdomen. A combined approach to treatment is helping people improve their survival and ease symptoms.

Did you know that doctors diagnose an estimated 3,000 cases of mesothelioma annually in the U.S.? The majority of those are traced to job-related exposures to asbestos. Most people have the pleural type, which forms on the lining of the lungs, but the cancer can also form around the lining of the abdomen or heart.
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Although asbestos use in this country has dropped in recent decades, a steady number of people are still getting mesothelioma. That's because this cancer can take anywhere from 20 to 50 years after asbestos exposure before symptoms appear, and an oncologist can make a definitive diagnosis.

While there's no cure for mesothelioma and the outlook is generally poor, researchers have made significant progress in understanding the cancer and developing new treatment options and alternative therapies.

How Does Asbestos Cause Cancer?

Mesothelioma typically develops after people are exposed to asbestos in the workplace – in industrial settings, shipyards, auto repair shops, old houses, schools and public buildings. While it usually takes long-term exposure to put someone at risk, short-term and one-time exposures are also known to cause this cancer.

Body Inhaling Asbestos
Asbestos inhalation occurs
Asbestos Fibers lodging in the mesothelial tissue
Fibers lodge in mesothelial tissue
 Asbestos Fibers in the mesothelial tissue
Fibers cause cellular damage, resulting in tumor growth
Fast Fact: 70-80 percent of people with mesothelioma were exposed to asbestos at work.

Asbestos can cause health complications when work duties or other activities disturb asbestos-containing materials and release fibers into the air. When we inhale or swallow these microscopic fibers, our bodies struggle to get rid of them. Over decades, the trapped fibers trigger biological changes that can cause inflammation, scarring and genetic damage that sometimes leads to cancer. The lengthy gap between asbestos exposure and diagnosis is called the latency period.

Asbestos fibers most often become trapped in the lining of the lungs, called the pleura. They also can collect in the lining of the abdominal cavity (peritoneum) or heart (pericardium). Once fibers cause biological damage, the stage is set for the decades-long latency period for the development of malignant mesothelioma.

Learn More about How Asbestos Causes Cancer
Why Is Cancer Stage Important?

Although several factors help determine your prognosis, or survival outlook, it is most affected by the stage of your cancer. Your doctors will perform tests to determine your cancer stage, typically a number I-IV that describes the seriousness of your diagnosis. Your cancer stage helps doctors determine the treatment options likely to work best for you.

Understand What Your Prognosis Means
Factors That Affect Prognosis Include:
Type/stage of mesothelioma
Tumor cell type
Overall health
Gender
Size and location of tumor
Blood characteristics
What Are the Different Types of Mesothelioma?

Pleural mesothelioma is the most common type of the disease, representing about 75 percent of all diagnoses. Peritoneal is the second most common type, accounting for 10 to 20 percent of diagnoses. Approximately 1 percent of cases are of the pericardial variety. Another rare type known as testicular mesothelioma represents less than 1 percent of all mesotheliomas.

Pleural Mesothelioma - Cancer of the Lung Lining
Pleural

It forms on the lining of the lungs, and current studies are leading to improved treatment and survival rates.

Learn about pleural mesothelioma
Peritoneal Mesothelioma - Cancer of the Abdomen Lining
Peritoneal

It affects the lining of the abdominal cavity and responds best to a combination of surgery and heated chemotherapy.

Learn about peritoneal mesothelioma
Pericardial Mesothelioma - Cancer of the Heart Lining
Pericardial

Emerging from the lining of the heart, it's the most challenging to treat because of the sensitive location.

Learn about pericardial mesothelioma
What Are the Common Symptoms of Mesothelioma?

Mesothelioma symptoms can be so mild that few people notice or recognize them, and many don't experience any of them until later stages of the cancer. Fatigue and slight pain around the tumor may surface in early stages. Late-stage symptoms are more noticeable and commonly provoke people to visit the doctor.

These late-onset signs can include shortness of breath, chronic pain near the tumor, weight loss, fluid buildup or bowel obstruction. Effective therapies can relieve symptoms, and some treatments, like talc pleurodesis, can even prevent symptom recurrence.

Symptoms you may experience include:
Fatigue
Pain near tumor
Shortness of breath
Dry cough
Weight loss
Fluid buildup
Bowel obstruction
Difficulty swallowing
Detailed Information About Your Symptoms
How Is Mesothelioma Diagnosed?

Doctors use several tests to diagnose malignant mesothelioma. Everyone has a unique path to a diagnosis, but the most important tests needed for an accurate diagnosis are imaging scans and biopsies. Doctors use several tests to diagnose malignant mesothelioma.

Mesothelioma Imaging Scan
Imaging Scans
Most people initially undergo a basic chest X-ray to check for any abnormalities. If an abnormal growth is detected, doctors will recommend a more detailed imaging scan such as a PET scan, CT scan or MRI.

Mesothelioma Biopsy
Biopsies
If cancer is suspected, doctors will recommend taking a sample of tissue, also knowns as a biopsy. Doctors use this tissue sample to definitively confirm the presence of mesothelioma cells.

Blod Test
Blood Tests
Blood tests are also available, but they do not confirm the presence of mesothelioma. Research and development is underway to determine if blood tests can aid in early diagnosis for at-risk former asbestos workers.

Doctor Going over mesothelioma stage with patient
Staging
There are at least five staging systems doctors use to stage pleural mesothelioma. The most widely used is the IMIG staging system. There are currently no universal staging systems for the cancer's other types.
What Treatment Options Are Available?

The leading treatment options for mesothelioma include surgery, chemotherapy and radiation therapy. Many specialists prefer to combine two or more of these treatments, an approach known as multimodal therapy. Clinical trials show this approach has improved survival rates.

Palliative treatments that ease symptoms are quite common for patients of all stages, and experimental therapies like immunotherapy show progress for the future. Additionally, many survivors tout less-traditional alternative treatments for helping them to live longer.

Surgery Icon
Surgery
Curative surgery is available for people with early stage mesothelioma, while palliative surgery is best for easing the symptoms of those diagnosed at a later stage.

Learn more about mesothelioma surgery
Chemotherapy Icon
Chemotherapy
Chemotherapy is a standard treatment to kill cancer cells, shrink tumors, prevent recurrence and relieve symptoms.

Learn more about chemotherapy
Radiation Icon
Radiation
Radiation therapy is used alone or in combination with chemotherapy or surgery to kill cancer cells, manage tumors and prevent cancer from spreading along the path of a biopsy incision.

Learn more about radiation therapy

What Legal Help Is Available?

Many people with mesothelioma seek legal help to recoup medical expenses and secure a financial future for their families. Mesothelioma and other asbestos-related diseases are entirely preventable, but the companies that mined, manufactured and sold asbestos products put profits before the health of customers and their own employees. Our legal system ensures these companies are held accountable for their negligence.

Fast Fact: A 2011 report from the Government Accountability Office reported that $36.8 billion remained in asbestos trusts. This money was set aside to help compensate victims of asbestos exposure and their families.

People who were injured by asbestos can seek legal help through an established asbestos trust fund or by filing a lawsuit against the companies responsible for their asbestos exposure. Trust fund benefits, winning legal claims or out of court settlements can help you and your family cover treatment, lost wages and other expenses.

Financial assistance
Filing a Lawsuit
Manufacturers that used asbestos could have prevented their workers and others from getting exposed to the deadly mineral. Filing a lawsuit can ensure they are held financially responsible for their negligence.

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Money awarded for asbestos lawsuit
Verdicts
The outcome of an asbestos-related lawsuit can vary because each case comes with its own set of facts, but juries have returned with verdicts of $337 million (for Alfred Todak), $30.3 million (for Susan Buttitta) and $22 million (for Eugene McCarthy and Walter Koczur).

Learn more
Signing legal document
Settlements
Most asbestos-related lawsuits are settled out of court — before they to go trial. A paper trail of occupational exposure can lead defendants to settle out of court to avoid lawsuit expenses as soon as possible. Settlements can range from moderate to large sums.

Stage IV Mesothelioma

Stage IV Mesothelioma

Stage IV Mesothelioma Locations in the Body
At stage IV, tumors have spread throughout the chest cavity and possibly to distant organs. Surgery is generally not a treatment option at stage IV, and most treatments are palliative rather than curative. The goal of treatment is to help you live longer, reduce pain and improve symptoms.

Learn About Stage IV Mesothelioma with Our Free Guide

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Most advanced stage.
Tumor growth and symptoms are intensified.
Curative surgery is ineffective.
Doctors offer supportive care to help with symptoms.
Stage IV is the most advanced stage of mesothelioma. By stage IV, cancer has spread to one or both sides of the body. It may have also spread to lymph nodes and several organs of the body, including the brain, prostate, spine or the lining of the heart.

For people diagnosed at this stage, doctors offer treatments that relieve symptoms and prolong life. Your outlook depends largely on the extent of cancer spread and how well you respond to treatment.

Symptoms

Symptoms of stage IV affect the lungs and possibly other parts of the body because of tumor spreading. Stage IV mesothelioma may cause fever, night sweats, chest-wall pain, shortness of breath, tightness in the chest, fluid retention in the abdomen, abdominal pain, fatigue, anorexia and malaise (a generalized feeling of illness).

Fever
Night sweats
Chest pain
Shortness of breath
m
Tightness of chest
Fluid buildup in chest or abdomen
Abdominal pain
Fatigue
Weight loss
Anorexia and Malaise
Some patients suffer from cachexia, a syndrome involving weight loss, muscle atrophy, weakness, fatigue and appetite loss. Stage IV cancer can also cause problems with the blood, including thrombocytosis (high platelet count) and anemia (low red blood cell count).

 Learn more about symptoms
Treatment

Stage IV tumors have spread to the degree that complete removal with surgery is usually not possible. For this reason, chemotherapy and radiation therapy are used to slow cancer growth and reduce symptoms. Stage IV treatment aims to alleviate symptoms and extend life span. Traditional cancer treatments and supportive care help to prolong survival and improve quality of life.

Surgery Icon
Surgery

The spread of tumors is usually too vast at stage IV for doctors to remove all growths, so they typically do not recommend curative surgery. Some patients, however, can benefit from less extensive surgical procedures. Surgeons can attempt to remove as much tumor mass as possible or target only problematic tumors to help patients breathe more comfortably and decrease pain.

Chemotherapy Icon
Chemotherapy

Doctors often treat stage IV cases with chemotherapy. First, they typically perform a PET scan, which produces images that clearly show where the cancer has spread. Chemotherapy drugs can slow tumor growth and might shrink tumors in some cases. These results can alleviate symptoms and extend survival.

Radiation Therapy Icon
Radiation Therapy

Doctors don't always treat stage IV mesothelioma with radiation therapy, but they may recommend the procedure depending upon your tumor growth and overall health. Radiation therapy at this stage might be able to reduce the size of tumors, which can lessen chest pressure, decrease pain and improve breathing.

Supportive Care Icon
Supportive Care

Supportive care helps to relieve symptoms and improve quality of life. At stage IV, doctors may recommend pain medication, oxygen therapy and respiratory therapies to control pain and improve lung function. Supportive care that aims to relieve symptoms is called palliative care.

 Learn more about treatment options
Palliative Treatments for Mesothelioma

Even though aggressive surgery is ineffective against a stage IV diagnosis, a variety of treatments can help keep mesothelioma in check or relieve pain and other symptoms.

Many people benefit from procedures that remove fluid buildup near the main tumor, which can cause pain, breathing difficulty and other problems. The name of this procedure depends on the location of your cancer:

Thoracentesis drains fluid from the chest
Paracentesis drains fluid from the abdomen
Pericardiocentesis drains fluid from around the heart
For these procedures, a doctor numbs your skin and inserts a thin, hollow needle into the area where fluid is collecting. Sometimes an X-ray or another imaging scan is used to pinpoint the best place to insert the needle. Once the needle is inserted, the doctor uses a syringe to draw out some or all of the fluid.

Draining the fluid often alleviates some bothersome symptoms, but the results are usually temporary. The procedure does not stop the buildup of fluid, so you may need to repeat the procedure again if symptoms return.

For people with pleural mesothelioma, a palliative treatment called pleurodesis may provide a long-term solution to fluid buildup. In this procedure, a doctor inserts a tube into the chest to drain the fluid. Next, the doctor puts chemicals into the chest tube, such as talc, the antibiotic doxycycline or a chemotherapy drug called bleomycin.

These substances irritate the linings of the lung and chest wall, causing the space between them — where the fluid collects — to seal together and prevent future buildup. Doctors typically leave the chest tube in place for several days after the procedure to drain any remaining fluid.

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Chemotherapy Options for Stage IV

The most commonly used chemotherapy regimen for stage IV mesothelioma combines two drugs: Cisplatin and pemetrexed. A landmark 2003 study confirmed this combination can help people achieve a median survival of 12.1 months — a marked improvement over the 9.3 month survival observed with cisplatin alone.

The drug combination also had a high response rate, with 41.3 percent of patients responding to treatment. Patients treated with cisplatin alone experienced a response rate of only 16.7 percent. The promising results from this study played a key part in making cisplatin and pemetrexed the gold standard of chemotherapy plans for pleural mesothelioma.

Although smaller studies have explored the effectiveness of other drug combinations, no randomized studies directly compare cisplatin and pemetrexed with other platinum-based chemotherapy regimens.

Other chemotherapy drugs used to treat stage IV mesothelioma include:

Carboplatin
Cyclophosphamide
Doxorubicin
Gemcitabine
Methotrexate
Mitomycin
Mitoxantrone
Oxaliplatin
Raltitrexed
Vinorelbine
Certain people in stage IV may qualify for mesothelioma clinical trials. Some clinical trials investigate the value of various treatment combinations for late-stage mesothelioma.

Some of the more successful drug combinations explored in clinical trials include:

Cisplatin and gemcitabine followed by mitoxantrone, methotrexate and mitomycin (median survival of 13 months)
Cisplatin and raltitrexed (median survival of 11.4 months)
Cisplatin and gemcitabine (median survival of 10 months)
Vinorelbine and oxaliplatin (overall survival of 8.8 months)
Ask your doctor if you might qualify for any mesothelioma clinical trials.

Get more information on clinical trials that are testing out cutting edge treatments that could improve a patient's life span.

 Learn more about clinical trials
Complementary and Alternative Treatments

Many people with stage IV mesothelioma consider complementary and alternative medicine (CAM). Numerous long-term mesothelioma survivors have incorporated CAM therapies into their treatment plan. Certain complementary therapies are known to improve survival, ease symptoms, reduce treatment side effects and enhance quality of life.

Diagnosis

Diagnosed with stage IV mesothelioma? Consider the following:

Get a second opinion from a mesothelioma specialist. Not all oncologists are experienced in treating mesothelioma. Work with a doctor who is.
Consider alternative and complementary treatment options. Make sure to discuss alternative therapies with your doctor first.
Your lifestyle choices and overall health can impact quality of life and how well you respond to treatment. Make healthy lifestyle choices and eat a diet high in vegetables and immune-boosting foods.
Take care of your mental and emotional health. Many cancer centers offer counseling to cancer patients for free.
Connect with other people facing mesothelioma. Patients and their caregivers are welcome to join the Asbestos.com online monthly support group. It meets the second Wednesday of every month.
Resources are available to help people with late-stage mesothelioma. Reach out to a patient advocate now if you need assistance.
Make time for hobbies and activities that bring you joy or encourage relaxation.
Spend time with family and friends, and express your appreciation for their support.
Your treatment team will use one of three staging systems to confirm a stage IV diagnosis. According to the Butchart system, the oldest of the three, a mesothelioma enters stage IV when it spreads through the blood to distant organs such as the brain, bones or liver.

The Brigham staging system, a newer system that focuses on lymph node involvement and whether the cancer can be removed by surgery, uses the same criteria for a stage IV diagnosis.

But the most widely used system is the TNM staging system. It is much more specific than the other systems, describing several diagnoses doctors classify as stage IV. Like the Brigham and Butchart systems, the TNM system considers any cancer that has spread to distant organs stage IV.

The TNM system also classifies some mesotheliomas as stage IV even if cancer has not spread to distant sites. These diagnoses typically involve extensive local spread or spread to lymph nodes near the tumor or on the opposite side of the chest.

The TNM system classifies the following as Stage IV:

Mesothelioma that has spread to distant sites
Mesothelioma that has spread to the lining that coats the lung, diaphragm and mediastinum, as well as to at least one of the following:
More than one place in the chest wall, including the muscle or ribs
Through the diaphragm and into the lining of the abdomen
Mediastinal organs like the esophagus, trachea, thymus and blood vessels
The spine
The lining on the other side of the chest
Through the heart lining or into the heart
Mesothelioma that has spread to lymph nodes near the collar bone on either side of the chest or to the hilar or mediastinal lymph nodes on the side of the chest opposite the main tumor.
Despite minor differences between these staging systems, they all serve the same purpose: Predicting life expectancy and guiding treatment decisions.

Prognosis & Life Expectancy

At stage IV the cancer is likely to continue to spread, which can lead to respiratory failure or heart failure if tumors spread to the heart.

The median survival for stage IV mesothelioma is 12 months. A positive response to treatment can extend survival, and patients with good prognostic factors often live longer than average.

Mesothelioma is considered a heterogeneous cancer, meaning no two cases are the same. For this reason, survival statistics cannot predict how long someone with mesothelioma will live. Some people have particularly slow-developing mesothelioma, and some respond surprisingly well to treatment. People in otherwise good health regularly outlive the average prognosis.

Prognostic factors associated with better survival include:

Epithelial cell type
Good overall health
Younger age
Female gender
No signs of blood disorders

Stage III Mesothelioma

Stage III Mesothelioma

Where Stage III Mesothelioma is Located
At stage III, the cancer has spread throughout the lung lining and chest on one side of the body. Curative surgery is usually still an option, if the cancer is resectable, along with other treatments such as radiation and chemotherapy.

Learn About Stage III Mesothelioma

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Treatment with surgery is recommended to patients in good health.
Frequent chest pain is a typical symptom.
Treatment focuses on pain relief and extending life expectancy.
Stage III is a progressed stage of mesothelioma that responds to surgery and traditional cancer treatment. Prognosis depends on response to treatment and the extent of lymph node involvement.

In this stage, tumors have spread throughout the lining of the lungs and chest cavity on one side of the body. The diaphragm and lining of the heart may be affected, as well as the chest wall or nearby fatty tissue. Cancer cells have spread to lymph nodes near the main tumor, but not to the lining of the opposite lung, distant lymph nodes or other organs in the body.

Mesothelioma can progress to this point in several ways. As the main tumor grows and puts pressure on nearby tissues and organs, it can grow directly into these structures. This is called local spread.

Cancer cells also can break off of the tumor and attach to the walls of lymph vessels, which transport immune cells to lymph nodes throughout the body. Once the cancer invades the lymph system or enters the bloodstream, there is a chance it may later spread to distant organs. This is called distant spread, and when it occurs the cancer advances to stage IV.

To detect whether mesothelioma has spread, doctors use imaging tests like MRIs and PET/CT scans. These tests will show the size and location of the main tumor and will display any locations in the body where the cancer has spread.

Symptoms

Symptoms of stage III may be mistaken for a lung infection like bronchitis or pneumonia. Shortness of breath, dry coughs, chest pain, tightness in the chest, and fever may be noticeable at stage III. The symptoms of stage III mesothelioma are caused by tumors growing on the affected lung lining and throughout the chest cavity. Symptoms may vary from patient to patient depending on how the cancer is spreading. A tumor invading the chest wall may cause increased chest pain, while tumors forming around the lung may cause breathing difficulties.

Fever
Weight loss
Shortness of breath
Tightness of chest
Dry cough
Chest pain
Treatment

Stage III tumors are considered locally advanced, but surgical removal is possible with extensive surgery. Chemotherapy and radiation therapy are used to further rid the body of cancer cells following surgery. A treatment plan using curative surgery, chemotherapy and radiation therapy has produced the best survival rates for people with stage III mesothelioma. Multimodal therapy is recommended to stage III patients who are in good enough health to handle the aggressive treatment approach.

Extrapleural Pneumonectomy

At stage III, tumor spreading to surrounding tissue and lymph nodes requires an extrapleural pneumonectomy surgery (EPP) to remove all the cancer. The affected lung and its lining are removed during surgery. The lining of the heart and half of the diaphragm are removed, as well as affected lymph nodes. Recovery usually requires a two-week hospital stay.

Surgery Icon
Chemotherapy

Once recovered from surgery, chemotherapy can begin. Most patients receive systemic chemotherapy through an intravenous drip. Less commonly, heated chemotherapy is circulated through the chest cavity during surgery. Chemotherapy drugs like cisplatin, carboplatin, pemetrexed and gemcitabine are most often used to treat mesothelioma.

Chemotherapy Icon
Radiation Therapy

Radiation therapy is also administered after surgery. However, new research has found an increased survival rate when radiation therapy is applied before surgery to shrink tumors. If the cancer returns, radiation therapy might be recommended to keep the tumor in control. Chemotherapy may be recommended again if the cancer returns.

Radiation Therapy Icon
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Palliative Care

Most stage III patients can improve their quality of life with palliative therapies, which aim to relieve troublesome symptoms. While these treatments aren't expected to cure your cancer, they usually can help you feel better. Palliative chemotherapy and radiation, for example, might be used to lessen cancer-related pain.

One palliative therapy involves draining excess fluid buildup around the tumor, a common problem with several types of mesothelioma. The name of this procedure depends on the location where it is performed.

Thoracentesis, for pleural mesothelioma, drains fluid from the chest
Paracentesis, for peritoneal mesothelioma, drains fluid from the abdomen
Pericardiocentesis, for pericardial mesothelioma, drains fluid from around the heart
Draining the excess fluid often helps with pain and difficulty breathing, but the results will likely be temporary. Because the procedure does not stop fluid production, you may need to get it again if symptoms return.

Alternative and Complementary Therapies

Numerous long-term mesothelioma survivors added alternative and complementary therapies to their traditional treatment plan. Some complementary therapies improve overall health or boost the immune system, such as dietary therapy and yoga. Certain ones may help cancer symptoms or reduce side effects caused by cancer treatments. And others, like certain herbs, are proven to improve survival rates when combined with chemotherapy.

Diagnosed with Stage III Mesothelioma? Consider the Following:

Unlike stage IV, stage III is still surgically treatable. If you qualify for surgery, it could significantly extend how long you live.
Get a second opinion from a mesothelioma specialist. Not all oncologists have experience treating mesothelioma. Work with a doctor who specializes in the type of cancer you are facing.
Think about joining an online mesothelioma support group. It meets on the second Wednesday of every month at 8 p.m. EST. Connecting with other people who have mesothelioma, especially people who’ve lived with the cancer longer than expected, is comforting and supportive.
Mental and emotional health is just as important as physical health. A stage III mesothelioma diagnosis is difficult to process and accept. It is common for people facing mesothelioma (and their caregivers) to feel sad or anxious. Reach out for help when you need it. Counseling is often available to cancer patients for free at cancer centers.
Lifestyle and overall health can affect survival. Take good care of your health with a nutritious diet and gentle exercise (such as walking or tai chi). Don’t smoke and make sure to get plenty of sleep.
Prognosis

The prognosis of stage III is significantly better than stage IV, but depends on how a person responds to treatment. If surgery is successful and a patient responds well to post-surgery therapies, they can surpass the average one-year survival. People with stage III mesothelioma who have curative surgery usually live longer than 16 months. Certain stage III patients respond well to treatment and live years past the average prognosis.

Pleural mesothelioma expert Dr. David Sugarbaker helped conduct a phase II clinical trial that reported a median survival of 19.3 months for stage III/IV patients who had an extrapleural pneumonectomy surgery.

David Sugarbaker M.D.
David Sugarbaker, M.D.
Thoracic Surgery
Baylor College of Medicine
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Other studies find that the extent of lymph node involvement has a small impact on survival. Patients with minor lymph node involvement often live longer than 17 months. Patients with more extensive involvement of nearby lymph nodes live at least 13 months.

It is important to emphasize that survival statistics cannot predict how long any one person with mesothelioma will live. Certain patients respond particularly well to treatment and end up outliving their prognosis by years.

Stage II Mesothelioma

Stage II Mesothelioma

Where Mesothelioma is Located in Stage II
At stage II, the cancer has not spread far from its origin, and treatments to remove it from the body are more effective. Symptoms could be mild and resemble less serious pulmonary diseases. Prognosis is not as good as in stage I, but it's better than in late-stage cancer.

Learn About Stage II Mesothelioma in Our Free Guide

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Cancer is not too far from initial site.
Small tumors begin spreading to thin tissue beneath the lung.
Surgical options are effective and can extend survival.
Stage II is a designation of an early stage of cancer that responds well to surgery and traditional treatment. This stage has the second-best prognosis of all the stages.

In this stage, small tumors are growing on the lining of one lung and starting to spread to the underlying lung tissue or the diaphragm. The lymph nodes are free of cancer cells. The cancer remains localized within the chest.

Symptoms

Symptoms of stage II may be mild and often resemble those of less serious lung illnesses like pneumonia. Shortness of breath, coughing, difficulty breathing and chest pain are sometimes felt at stage II. Pleural mesothelioma originates in the pleural lining, which is composed of two layers: One layer covers the lungs and one layer covers the chest wall. Symptoms are caused by the tumors that form on the pleural lining. Symptoms are also caused by the accumulation of fluid in the space between the two layers of the lining; this is called pleural effusion.

At stage II, tumors growing on the layers of the pleural lining thicken, and the space between the layers begins to disappear. A patient may feel chest pain or have difficulty breathing as a result of tumor growth or trapped pleural fluid.

Fever
Weight loss
Shortness of breath
Difficulty breathing
Cough or chest pain
Treatment

A treatment plan using curative surgery, chemotherapy and radiation therapy has produced the best survival rates for people with stage II mesothelioma. Multimodal therapy is recommended to stage II patients who are in good enough health to handle the aggressive treatment approach.

Extrapleural Pneumonectomy

At stage II, tumor spreading to the lung tissue or diaphragm may call for an extrapleural pneumonectomy surgery. During this surgery, the affected lung and its lining are removed. Half of the diaphragm, nearby lymph nodes and the heart lining may also be removed.

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Chemotherapy

Chemotherapy is most often given after surgery. Clinical trials are investigating the value of circulating chemotherapy drugs throughout the pleural space during surgery. This procedure is known as heated chemotherapy and is more commonly given to people with peritoneal mesothelioma.

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Radiation Therapy

Radiation therapy is most often given after surgery to reduce the risk of the cancer returning. New research suggests that applying radiation therapy before surgery might drastically improve survival rates for many patients. Radiation therapy has also helped to manage recurring mesothelioma tumors over extended periods of time. If the cancer returns, your doctor might recommend radiation therapy to keep the tumor under control.

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HIPEC for Peritoneal Mesothelioma

People with stage II peritoneal mesothelioma may greatly improve their long-term survival by opting for cytoreduction with HIPEC, an aggressive treatment option that combines surgery with heated chemotherapy.

For this procedure, doctors first perform surgery to remove as much visible tumor growth as possible, and then bathe the abdominal cavity with high-dose chemotherapy that is heated to improve its ability to kill cancer. A 2009 study involving more than 400 peritoneal patients treated with HIPEC reported a median survival of more than four years, with one patient surviving 19 years after the procedure.

Chemotherapy Drugs for Stage II

For the majority of people with stage II mesothelioma, doctors recommend first-line chemotherapy with the drugs cisplatin and pemetrexed. A key study found this treatment combination offers a median survival of 12.1 months, compared to only 9.3 months with cisplatin alone.

However, cisplatin-based regimens won't work for people with impaired kidney function or several other serious health conditions unrelated to mesothelioma. If you have one of these conditions, your doctor may suggest a cisplatin alternative to be given with pemetrexed.

Other first-line chemotherapy regimens for mesothelioma include:

Carboplatin and pemetrexed
Gemcitabine and cisplatin
Pemetrexed alone
Vinorelbine alone
Clinical trials have shown that carboplatin and pemetrexed appears equivalent to the standard cisplatin-pemetrexed regimen. Doctors also may recommend this combination to people with poor overall health that have trouble performing daily activities.

Complementary and Alternative Therapies

In addition to traditional cancer treatments, many long-term mesothelioma survivors used alternative and complementary therapies. Certain complementary therapies may help reduce symptoms or ease the side effects of cancer treatments, and some are even clinically proven to improve survival rates when combined with traditional cancer treatments.

Diagnosed with Stage II Mesothelioma? Consider the Following:

Few people are diagnosed as early as stage II. You may qualify for an aggressive treatment approach that could greatly improve survival.
Your overall health and lifestyle choices can impact survival. Take steps to improve or maintain good health. If you smoke, quitting will improve your lung function. Healthy lifestyle choices may also enhance your quality of life, such as improving your diet.
Be open to emotional support. Find a counselor or join the monthly online mesothelioma support group. It takes place on the second Wednesday of every month.
Helpful resources are available to anyone diagnosed with mesothelioma. Patient advocates are available to connect patients with resources.
Take time to relax and spend time with your family and friends. Travel, if possible, and make time for hobbies that bring you joy.
Remember that every case of mesothelioma is unique. Statistical averages cannot predict how long any person will live. People diagnosed at stage II respond better to treatment than most people diagnosed at a later stage. You could be one of the people who far outlive the average survival rate.
Prognosis

Stage II has the second-best prognosis of all the stages. Stage I and stage II patients who undergo curative surgery usually live longer than three years, according to research done by mesothelioma experts Dr. Raja Flores and Dr. Valeria Rusch.

Patients who qualify for surgery with a curative intent live longer than 22 months on average. About 28 percent of people diagnosed at stage II live longer than three years. Around 15 percent live beyond five years.

Stage 2 Prognosis Pie Chart
The survival difference between stage I and stage II isn't as significant as the difference between stage II and stages III and IV. Stage II is still considered an early stage cancer that responds much better to multimodal treatment than late-stage cancer. Additionally, mesothelioma is called a heterogeneous disease because every case is unique. Certain patients respond better to treatment and far surpass the average survival rates. Catching the cancer early is a major factor that helps people with stage II live much longer than people with late-stage mesothelioma.

Stage I Mesothelioma

Stage I Mesothelioma

Stage I mesothelioma icon
At stage I, tumors remain within the lining of the lung, stomach or heart. You have several treatment options at this stage and are likely to live longer than late-stage patients.

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A few tumors or none are visible.
Can be treated with therapies like surgery and chemotherapy.
Life expectancy upwards of 40 months.
Stage I is the earliest and most treatable stage of mesothelioma. This stage has the best prognosis and longest survival rate.

In this stage, the cancer has just begun to form. Tiny tumors develop along the lining of one lung. The lungs and lymph nodes do not have cancer cells. The cancer has not spread at this point.

Asbestos-related cancer is rarely diagnosed at this stage because symptoms seldom arise that would prompt someone to get medical attention. Stage I cases often are discovered accidentally.

If your symptoms or test results suggest mesothelioma, your doctor will need to take fluid or tissue samples and test them in the lab to confirm the diagnosis. This procedure is called a biopsy, and it's the most accurate method for diagnosing mesothelioma.

Treatment Options

Because stage I tumors exist only in the lining of the lung, treatments are more effective. A combination of aggressive treatments, known as multimodal therapy, is recommended to people with stage I cancer. Cytoreductive surgery is used to remove the tumors. Chemotherapy is used to kill remaining cancer cells after surgery. Radiation therapy may be used before surgery to shrink tumors, or after surgery to reduce the risk of recurrence.

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Prognosis

Stage I has the best prognosis. Patients who undergo multimodal therapy may live for years beyond the average mesothelioma prognosis. Studies using aggressive multimodal therapy on stage I cases report survival rates around three years. A number of people diagnosed in stage I have lived far beyond three years. Each case of asbestos-related cancer is unique, and the treatments used to manage the cancer are becoming increasingly effective.

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Stage Ia and Ib

Stage I is the only mesothelioma stage that is divided into two categories, Ia and Ib. There are two layers that make up the lining that surrounds the lungs and chest wall. The inner layer that lines the lungs is called the visceral pleura. The outer layer that lines the chest wall is called the parietal pleura. Together they are called the pleural lining.

Tumors most often arise as separate, small nodules across the pleural lining. This scattered pattern of tumor growth is called diffuse mesothelioma.

In imaging scans, indications of stage I cancer include slight thickening of the pleural lining as well as pleural effusion (the accumulation of fluid between the pleural layers). Staging is usually estimated with a CT scan. An MRI may be used to check for local tumor spread, which helps distinguish stage I from other stages. Surgery is the most accurate tool to assess stage, but is also the most invasive.

Stage 1a Stage 1b Diagram
When tumors form on the outer layer closest to the chest wall, a diagnosis of stage Ia is given. When tumors have spread to the inner layer closest to the lung, a diagnosis of stage Ib is given.

If you've been diagnosed with stage I mesothelioma, consider the following:

Lifestyle choices and overall health can affect how long you live. Take care of your health, and lead a healthy lifestyle.
Survivors often say that adopting an optimistic outlook helped them cope with the diagnosis and treatment process. You may not be able to feel optimistic every day or at every moment, but striving for a positive perspective is a healthy goal to work toward.
Emotional support can relieve stress for patients and their caregivers. An online support group for mesothelioma patients and caregivers meets on the second Wednesday of every month. Sign up here
You are fortunate. Few people are diagnosed so early. This qualifies you for more aggressive treatment options that could significantly extend survival.
Resources are available to people with asbestos-related diseases. Reach out to a patient advocate for more information on available resources.
Every case is unique. Statistics on survival cannot predict how long an individual may live or how well they may respond to treatment. People diagnosed at stage I often respond best to aggressive treatment. You have reasons to remain hopeful.
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Symptoms of Stage I

The symptoms of mesothelioma are caused by the tumors developing on the pleural lining and by the buildup of fluid between the pleural layers. The tumors are so small during stage I that they rarely cause symptoms. Pleural effusion may place pressure on the chest wall and lungs, causing chest pain or coughing.

Fever
Body Aches
Chest Pain and Cough
Treatment of Stage I

The treatment options recommended to stage I mesothelioma patients usually have a curative intent, so they are aggressive, but offer the greatest chance of long-term survival. A combination of surgery, chemotherapy and radiation therapy is usually recommended at stage I.

Since tumors are localized during stage I, surgical removal is possible. A pleurectomy and decortication surgery removes the lung lining and any visible tumor growth within the chest, and leaves both lungs intact. An extrapleural pneumonectomy surgery goes several steps further by removing one lung, the heart lining, nearby lymph nodes and half of the diaphragm. The recommended surgery will depend on extent of disease spread, overall health of the patient and physician's medical opinion.

Surgery Icon
Chemotherapy is most often given after a patient recovers from surgery to kill any remaining cancer cells. However, heating chemotherapy and circulating it throughout the pleural space during surgery is a new approach that could become more common if proven effective through further research. The most common chemotherapy drugs for mesothelioma include cisplatin, carboplatin, pemetrexed, doxorubicin and gemcitabine.

Chemotherapy Icon
Radiation therapy has traditionally been used after surgery to prevent local recurrence. Recently, researchers started administering radiation therapy before surgery to shrink tumors and prevent tumor seeding (the spread of cancer cells to surgical incisions). This may not be recommended to stage I patients because their tumors are already small. Months or years after surgical procedures, radiation therapy may be used to shrink mesothelioma tumors that return.

In a phase II trial, Dr. Valerie Rusch et al. followed 88 pleural mesothelioma patients of all stages who received surgery and post-surgery radiation therapy. The majority of the patients underwent extrapleural pneumonectomy surgery, but five who were ineligible received a pleurectomy/decortication instead.

The researchers estimated survival for the patients who underwent extrapleural pneumonectomy. Survival was best among stage I and II patients, who experienced a median survival of 33.8 months. Patients with stage III and IV tumors had a median survival of only 10 months.

Radiation Therapy Icon
Alternative Therapies

Alternative and complementary therapies are often utilized by long-term cancer survivors. Complementary therapies like acupuncture, nutritional therapy, herbal supplementation, yoga and meditation are known to ease side effects caused by the aggressive treatments for stage I mesothelioma.

Prognosis for Stage I

Stage I has the best prognosis of all the stages. A median survival of 40 months is reported when stage I tumors are removed by extrapleural pneumonectomy surgery.

People diagnosed at stage Ia may live around two years without any treatment. Stage Ia and Ib patients who undergo aggressive surgery usually live more than three years.

Mesothelioma is considered a heterogeneous disease, meaning no two cases are alike. Certain patients respond better to treatment and will far surpass the average survival statistics. Some people have lived for two decades with mesothelioma, and several cases of spontaneous remission are documented. New treatment approaches aim to manage the cancer in ways that allow people to live for years beyond the average survival time.

Mesothelioma Staging

Mesothelioma Staging

There are four primary stages of mesothelioma doctors use to identify the seriousness of a mesothelioma diagnosis, labeled stage I, II, III or IV. The lower the number, the more treatment options you have, and the better your chances are for long-term survival.

Karen Selby, Patient Advocate
Patient Advocate Karen Selby talks about the differences found among the stages of mesothelioma.

Staging is an accepted way for cancer doctors to describe to patients – and to one another – how advanced the disease is, how prevalent tumors are and how far the cancer has spread. Given the aggressive nature of the cancer, mesothelioma staging is a key part of proper diagnosis and treatment.

Why is mesothelioma staging important? Because knowing where a cancer is in its development sets the table for treatment, which treatment options are available and which are not. For example, doctors use cancer stage as a guideline when deciding whether a patient is likely to benefit from surgery.

If a patient is healthy enough for aggressive treatment and doctors believe that all visible signs of cancer can be completely removed, they say the cancer is resectable and will likely recommend a treatment plan involving surgery. If the spread of cancer is too advanced, however, and can't be removed completely, the cancer is unresectable. In this situation, doctors will recommend other treatment options, including chemotherapy and experimental treatments.

Stage I pleural mesotheliomas are generally resectable, as well as some diagnosed at stage II and III. But by stage IV, the cancer can't be removed completely with surgery. The cancer's subtype can also affect treatment options because most doctors agree surgery doesn't help with sarcomatoid mesotheliomas.

When peritoneal mesotheliomas have spread beyond the abdomen, surgery likely is not helpful. Doctors consider peritoneal mesothelioma unresectable when it has invaded certain areas within the abdomen, including:

The hepatoduodenal ligament
The retroperitoneal region
Root of the mesentery
If the cancer has spread to these locations, doctors typically deliver chemotherapy to the entire body or directly to the abdomen.

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Why Is Early Detection Vital?

The stage of cancer is vital information for oncologists (cancer doctors) who treat mesothelioma, but all experts agree universally on one principle: It's preferable to catch cancer, specifically mesothelioma, in the earliest stage possible.

Staging Methods Vary

Many specialists who treat these cancers — even some of the most respected ones in the field — don't agree on one staging system. Although many doctors agree that staging is a strong predictor of lifespan, not all do.

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Getting a Second Opinion

If you are diagnosed with mesothelioma, you should seek a second opinion. Oncologists treat a variety of cancers, but they may not have experience with staging asbestos-related cancers. Always find a doctor who does.

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Stages of Cancer and What They Mean

Dr. Fontaine Video Thumbnail
Dr. Fontaine explains how does the stage of mesothelioma affect the treatment options

Using one of three systems, doctors will assign your cancer a stage of I through IV. The stage varies depending on several factors, including the size and location of your tumor and whether it has spread to lymph nodes or distant organs.

There Are Three Main Staging Systems

Brigham
TNM
Butchart
Doctors use three primary systems for mesothelioma staging: Brigham, TNM, and Butchart. These systems are used primarily for pleural mesothelioma staging because there are currently no formal staging systems for the other types. TNM and Brigham are the most-used by mesothelioma specialists, although some doctors believe that none are accurate enough.

Stage I Is the Least Serious

Stage I typically offers the best chance for survival because of the potentially curative surgical treatments available for patients. Most stage I patients qualify for extrapleural pneumonectomy, an aggressive surgery that attempts to remove as much of the tumor growth as possible. Surgeons take out an entire diseased lung and other tissues, including the diaphragm, nearby lymph nodes and the linings of the chest and heart.

Stage IV Is the Most Serious

At this stage of progression, most doctors only recommend palliative treatments because the cancer has spread to many parts of the body. Trying to remove all the tumors is too difficult, and many patients are too weak to withstand aggressive treatments. Palliative treatments, which focus on symptoms rather than curing the disease, can ease pain and suffering and improve quality of life.

Because of the nature of mesothelioma and the way the cancer grows and spreads, most people are not diagnosed until stage III or IV. Doctors usually treat asbestos-related cancers with a combination of chemotherapy, radiotherapy and surgery. Depending on the progression and location of cancer cells, they may recommend different options.

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Characteristics of the four primary stages of mesothelioma include:

Stage I
Stage II
Stage III
Stage IV
Stage I

At this point of early development, tumors are close to the original tumor, having only grown in one layer of the lining of the lungs (pleura). The cancer may also have grown into the covering of the heart and the diaphragm on the same side as it first formed.

The life expectancy for someone with stage I mesothelioma is significantly better that those with later stages, and these patients may live three years or longer. However, it is difficult to catch the cancer this early because people with this stage do not usually have symptoms.

Curative surgery to remove the tumor is considered the first line of treatment, and doctors usually recommend aggressive treatment that includes chemotherapy and radiotherapy.

Median life expectancy at stage I is 21 months.

Stage I Mesothelioma
The cancer is localized and surgery is most effective.
The survival rate is highest at stage I.

Stage II

Stage II symptoms are vague and mild. Patients — and even doctors — sometimes mistake them for signs of other illnesses like the flu. Patients with peritoneal mesothelioma may lose weight and yet feel bloated.

Several treatment options are available, and doctors can usually offer curative surgery to remove tumors. In studies, some patients diagnosed at this point survive for years.

Median life expectancy at stage II is 19 months.

Stage II mesothelioma
The cancer has started to spread. Surgery is still an option and the survival rate is close to that of stage I.

Stage III

Once the cancer progresses to stage III, it may have spread to several locations on the same side of the body as it formed. These areas may include the lymph nodes, esophagus, muscles, ribs, heart and the chest wall.

Pleural mesothelioma patients may suffer from more difficulty breathing and intense chest pain even when resting. Peritoneal mesothelioma usually involves some type of bowel obstruction and pain. Because the tumors have now spread to multiple areas of the body, discomfort may be felt in other parts of the body as well.

Tumors typically do not respond to potentially curative treatment, and some stage III cancer patients will find themselves ineligible for surgery. At that point, doctors offer palliative options.

Median life expectancy at stage III is 16 months.

Stage III mesothelioma
The cancer has progressed to an advanced stage of spreading. Surgery may still be an option and chemotherapy can extend survival.

Stage IV

About 30 percent of mesothelioma patients are not diagnosed until this stage. By stage IV, tumors have metastasized (spread) throughout the body via the bloodstream and could be present on the liver, in the brain, bones or elsewhere.

Patients experience extreme difficulty breathing and suffer from severe chest pain. Tumors can spread to the esophagus or stomach, causing digestive problems and difficulty swallowing or eating.

Doctor's don't recommend aggressive surgeries. Instead, they fall back on palliative treatments designed to ease pain and control symptoms.

Median life expectancy at stage IV is 12 months or less.

Stage IV mesothelioma
The cancer has spread extensively and surgery is usually not effective. Chemotherapy, radiation therapy and palliative treatments can extend survival and provide symptom relief.

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Medical Definitions
Parietal pleura: The lining of the chest cavity
Visceral pleura: The lining of the lungs
Lung parenchyma: Any form of lung tissue, including the bronchioles, bronchi, alveoli, interstitium and blood vessels
Mediastinal: Affecting the mediastinum, the area between the lungs containing the heart, aorta, trachea esophagus and thymus
Diaphragmatic pleura: The lining of the diaphragm, a primary breathing muscle
Peritoneum: The lining of the abdominal cavity
Endothoracic fascia: A layer of connective tissue that separates the ribs from the pleura
Pericardium: The lining of the heart
Myocardium: The muscle tissue of the heart
Diffuse: Spread across a wide area
Multifocal: Occurring in more than one location
Unresectable: Not capable of being removed with surgery
Nontransmural: Occurring not completely, but partially across the wall of an organ
Ipsilateral: On the same side of the chest as where the cancer formed
Contralateral: On the opposite side of the chest as where the cancer formed
Brigham Staging System

The Brigham staging system was created by Dr. David Sugarbaker at the Brigham and Women’s Hospital in Boston. With this system, doctors examine organs, tissues and other structures to learn how far the cancer has advanced.

Brigham System
Stage I

Tumors are confined to the lining of the lungs and cancer has not spread to the lymph nodes.

Stage II

Tumors are confined to the lining of the lungs. Either the intraparenchymal or mediastinal lymph nodes are cancerous.

Stage III

Aggressive and unresectable tumors in the lining of the lungs have spread into the mediastinum or invaded the chest wall, diaphragm or contralateral lymph nodes.

Stage IV

Cancer has spread to other parts of the body and is unresectable.

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TNM Staging System

Doctors use the TNM system to stage many different types of cancer. In 1995, the International Mesothelioma Interest Group (IMIG) modified this system specifically for asbestos-related cancers because of the lack of a universally accepted staging system.

Microscope Icon
Also called the IMIG Staging System, this is the most widely used system for someone with pleural cancer. Doctors sometimes use it for other types as well. Earlier staging systems like the Butchart system and Brigham system were based largely on studies of patients who underwent extrapleural pneumonectomy.

The abbreviation TNM signifies three different parts of a diagnosis:
(T) describes tumor size and location.
(N) describes whether lymph nodes are affected.
(M) describes whether the tumors metastasized, or spread, to other parts of the body.

Doctors add a number after each letter to describe how far the cancer has advanced. As tumor size increases and the cancer invades more structures, the number increases.

TNM Specifics
Tumor
Nodes
Metastasis
TNM Stage Grouping
Specifics of the TNM System

After evaluating your case, doctors assign a value to each part of the TNM system. Next, they use this information to give your cancer a stage. For example, TNM staging guidelines say that a T1N1M0 mesothelioma is an example of stage III cancer.

 Mesothelioma TNM Staging I-IV
Tumor

T describes the size and location of the tumor:

TX:

The primary tumor cannot be assessed.

T0:

There is no evidence of a primary tumor.

T1a:

The tumor is limited to the ipsilateral parietal pleura as well as the mediastinal and diaphragmatic pleura. There is no involvement of the visceral pleura.

T1b:

The tumor has spread to the ipsilateral parietal and visceral pleura, along with the mediastinal and diaphragmatic pleura.

T2:

The ipsilateral pleural surfaces, which include the parietal, mediastinal, diaphragmatic and visceral pleura, have been invaded by tumors. At least one of the following features is also included in this stage:

Involvement of the diaphragm
Tumor has spread to the visceral pleura and underlying parenchyma of the lung
T3:

The tumor has expanded locally, but can potentially be removed with surgery. It has invaded all of the ipsilateral pleural surfaces, which include the parietal, mediastinal, diaphragmatic and visceral pleura. One or more of the following features will be displayed:

Cancer has spread to the endothoracic fascia
Cancer has spread to mediastinal fat
Cancer has spread to the soft tissues of the chest wall
Nontransmural cancer spread to the pericardium
T4:

The tumor is locally advanced and is unresectable. It has spread to all of the ipsilateral pleural surfaces including the parietal, mediastinal, diaphragmatic and visceral pleura. These tumors will also display at least one of the following features:

Diffuse cancer spread or multifocal masses on the chest wall, with or without rib destruction
Cancer has spread to the peritoneum through the diaphragm
Cancer has spread to the contralateral pleura
Cancer has spread to one or more organs of the mediastinum
Cancer has spread to the spine
Cancer has spread through the internal surface of the pericardium, with or without pericardial effusion
Cancer has spread to the myocardium
Nodes

N describes whether the cancer has spread to glands of the immune system called lymph nodes:

Node Classification Description
NX The regional lymph nodes cannot be assessed.
N0 Cancer has not spread to the regional lymph nodes.
N1 Cancer has spread to the ipsilateral bronchopulmonary or hilar lymph nodes.
N2 Cancer has spread to the subcarinal or the ipsilateral mediastinal lymph nodes, which include the ipsilateral internal mammary nodes.
N3 Cancer has spread to the contralateral mediastinal, contralateral internal mammary, ipsilateral or contralateral supraclavicular lymph nodes.
Metastasis

M indicates whether cancer has spread to other parts of the body. If the cancer has metastasized, that means it has spread, causing secondary tumors to grow in distant parts of the body away from where the first tumor formed.

Metastasis Classification Description
MX The presence of metastasis cannot be assessed.
M0 The tumor has not metastasized to other parts of the body.
M1 Metastasis to other parts of the body has occurred.
TNM Stage Grouping

TNM stage grouping combines the tumor, node and metastasis values to reveal the cancer's stage.

Stage Primary Tumor (T) Regional Lymph Nodes (N) Metastasis (M)
I T1 N0 M0
IA T1a N0 M0
IB T1b N0 M0
II T2 N0 M0
III T1,T2 N1 M0
T1,T2 N2 M0
T3 N0,N1,N2 M0
IV T4 Any N M0
Any T N3 M0
Any T Any N M1
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An Example Using the TNM System

A former shipyard worker visits his doctor and complains of relatively mild symptoms including difficulty breathing and a feeling of heaviness in the chest. Because the patient presents with a history of exposure to asbestos on the job, the doctor suspects mesothelioma.

After conducting a series of tests, the doctor finds a tumor that involves the supporting tissues of the lung and the diaphragm (T2), but finds no evidence that the tumor has spread to the lymph nodes (N0) or other areas of the body (M0). The doctor would likely diagnose the patient with stage II mesothelioma.

Butchart Staging System

The Butchart system is the oldest method of staging pleural mesothelioma. Eric Butchart proposed this system in 1976 in an article for Thorax medical journal.

The Butchart system classifies tumors as stage I through IV using the same basic parameters as the TNM and Brigham systems.

Butchart intended his system to help identify which patients are good candidates for radical treatment. Again, only patients with stage I or II cancer are candidates for curative treatment, and palliative treatment is offered to patients in the two late stages.

This system also may help doctors determine prognosis. In four multivariate studies, early stage is listed as a sign of good prognosis. Two of the studies cited stage I disease as a highly favorable factor for survival.

Butchart Staging System
Stage I

The cancer affects the pleura on only one side of the chest, and may have spread to the pericardium and diaphragm. Curative surgery is considered a first-line treatment.

Stage II

Cancer has spread to the chest wall and may affect both sides of the pleura. It may have spread to the esophagus, heart or lymph nodes of the chest. Butchart primarily recommends high-dose radiation therapy to most patients with stage II mesothelioma.

Stage III

Cancer has spread to the diaphragm or peritoneum. Mesothelioma cells have also traveled through the lymphatic system to lymph nodes outside the chest. These tumors are generally unresponsive to curative therapies, so patients are introduced to their palliative options. Butchart suggests tube drainage for pleural effusions and delivery of chemotherapy drugs directly to the chest.

Stage IV

The cancer has spread through the bloodstream to distant parts of the body. Tumors may now be present on the liver, brain or bones, among other organs. Patients with stage IV mesothelioma are considered terminal and Butchart recommends solely palliative treatments.

Tumor Grading

Imig staging system
Through a process known as tumor grading, doctors classify cancerous cells based on how they appear under a microscope. Researchers confirmed that cellular features of tumors can offer signs to help doctors better predict survival among mesothelioma patients.

One of several approaches to tumor grading is nuclear grading. The process classifies the size and shape of the nuclei in tumor cells while examining other factors, including nucleolus size, chromatin patterns and the rate of cell division. These variables play central roles in cancer cell genetics, and ongoing studies are exploring their clinical value as indicators of prognosis.

The nuclear grading system developed at Cleveland Clinic inspired other studies that investigated the connection between tumor grade and mesothelioma survival. In what turned out to be the strongest evidence supporting this relationship to date, researchers at Memorial Sloan-Kettering Cancer Center analyzed 232 cases of epithelioid diffuse malignant pleural mesothelioma for the following features:

Indicators of Prognosis
Nuclear atypia
Nuclear/cytoplasmic ratio
Chromatin pattern
Intranuclear inclusions
Prominence of nucleoli
Mitotic count
Atypical mitoses
The analysis proved that nuclear atypia (variations in cell nucleus appearance) and mitotic count (the number of cells actively dividing) were directly related to a patient's prognosis.

Severe nuclear atypia was found to drastically reduce overall survival, and a low mitotic count, which means that few cells are dividing and spreading, indicated the highest overall survival. Using this information, the researchers developed a three-tier nuclear grade score that divides patients into the following prognostic groups:

Grade Median Overall Survival
Grade 1 28 months
Grade 2 14 months
Grade 3 5 months
The results of this study also showed tumor cell's chromatin, which is a combination of nuclear DNA and protein, was also linked to survival.

Not only was nuclear grade found to be a simple, cost-effective prognostic tool for determining overall survival, but it also helped predict the time to mesothelioma recurrence among patients treated with surgery. Patients with a low mitotic count averaged 67 months before their cancer returned, and those with a high mitotic count averaged 14 months.

Mesothelioma Life Expectancy

Mesothelioma Life Expectancy

The average life expectancy for a mesothelioma patient ranges from 12 to 21 months, depending on a variety of factors, such as the stage in which the patient was first diagnosed with the cancer. About 40 percent of mesothelioma patients survive one year, and 20 percent live more than two years.

Staging and Mesothelioma Life Expectancy

Increasingly, people who have aggressive asbestos-related cancer find their lives being measured in years — not months. Improved therapies and emerging drug combinations offer newly diagnosed patients a reason to hope and spend more time with their loved ones.

Given the progressive nature of the disease, staging plays an important role in determining a mesothelioma patient's life expectancy.

Stage Median Life Expectancy
I 21 months
II 19 months
III 16 months
IV 12 monthsLife Expectancy Chart
Experts say generalized life expectancy predictions are almost impossible to make because each case is so different, but the news is slowly getting better.

Extending Life Expectancy

Today, patients live longer than ever before. Some survive three, five, even 10 years and beyond their original prognosis, providing inspirational comeback stories for other potential survivors. The disease can change you forever, but many survivors continue to lead active lives, traveling and doing activities with grandkids and other loved ones.

Cutting-Edge Treatment

Exceptions are becoming the rule, with the advent of genetic therapy, immunotherapy and today's multimodal treatments. Ongoing clinical trials are changing the perception of mesothelioma.

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Specialized Care

Specialty cancer centers give patients the best chance at survival. That's why finding a specialist with experience in treating the disease is the first step toward increasing your life expectancy.

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Factors That Affect Mesothelioma Life Expectancy

What influences how long you live after being diagnosed with mesothelioma? Factors that affect life expectancy include the stage of the cancer, tumor location and cell type as well as non-tumor factors such as age, sex, blood characteristics and general health.

Tumor-Related Factors

The stage of the cancer at the time of diagnosis, tumor cell type, and the location of the tumor are known as tumor-related factors. These factors influence the type of treatment options you have available to you.

Staging
Tumor Location
Cell Type
Staging

Staging refers to how far the cancer has progressed at the time of the diagnosis. The exact stage of the cancer has the highest impact on life expectancy. Unfortunately, most patients are not diagnosed until stage III or IV because symptoms can remain hidden, but the earlier the cancer is caught, the better the prognosis and expected survival rate.

Stage 1 Mesothelioma
Stage I mesothelioma is localized and life expectancy is significantly improved compared to stage III or IV cancer.

Tumor Location

Different types of mesothelioma are identified location and that placement can affect life expectancy. Tumors that initially form in the lung lining are called pleural mesotheliomas and average survival is around eight months if left untreated. Tumors that form in the abdominal lining are called peritoneal mesotheliomas and average survival is around six months if left untreated.

Treatment can extend survival for pleural and peritoneal mesothelioma, the two most common types of the cancer. People with pleural mesothelioma can live longer than a year with chemotherapy. Some early stage patients who undergo multimodal treatment with surgery can live beyond two or three years. People with peritoneal mesothelioma who undergo surgery and heated chemotherapy can live longer than three years.

The rarest types of mesothelioma affect the heart (pericardial mesothelioma) and testicles (testicular mesothelioma). Average survival for pericardial mesothelioma is around six to 10 months. People with testicular mesothelioma live at least two years on average.

Peritoneal Mesothelioma
Patients with peritoneal mesothelioma typically have a longer life expectancy.

Cell Type

Certain types of cells that make up a mesothelioma tumor respond better to treatment than others. Tumors made up primarily of epithelial cells respond best to treatment, and patients with this cell type have a better life expectancy. In contrast, tumors made up primarily of the sarcomatoid cell type or the biphasic (mixed) cell type are more difficult to treat and are associated with a shorter life expectancy.

Epithelial Cells
Tumors made up primarily of epithelial cells respond best to treatment.

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Non-Tumor Factors

In addition to tumor-related factors, other factors also can influence your life expectancy. Traits like overall health, age, gender and even characteristics of your blood indicate to a doctor how well your body will respond to treatment.

Performance Status
Gender
Age
Blood Characteristics
Performance Status

Performance status is a more technical term for overall health, and indicates the activity level and general fitness of a patient. Nearly all studies that examined performance status in pleural mesothelioma patients showed a significant effect on survival. The more active and fit you are, the more likely your body will be able to withstand and recover from aggressive cancer treatments.

Smokers & Mesothelioma
Smokers are 90% more likely to develop lung cancer after exposure to asbestos.

Gender

Historically, men experienced more occupational exposure to asbestos than women. Because of their increased exposure, men are four times more likely to develop mesothelioma than women. Studies show that women with epithelial mesothelioma tend to live longer than men do. Researchers are not sure why women have better life expectancies.

Gender Pie Chart
Men are four times more likely to develop mesothelioma than women.

Age

Younger, healthier patients with mesothelioma have more options for treatment than older, less healthy patients. That's because as we age, our bodies lose the ability to recover from aggressive therapies and procedures. And as we get older, we are more likely to have other health conditions that could leave certain types of treatment out of reach.

Age Pie Chart
75 percent of mesothelioma cases in the U.S. occur in men age 55 or older.

Blood Characteristics

Some cells and biomarkers found in the blood appear to have an impact on life expectancy. Several studies report that thrombocytosis (high blood platelet count) and leukocytosis (high white blood cell count) prior to surgery are associated with shorter life expectancy. Biomarkers such as COX-2, antigen p27, MIB-1, VEGF and glycoprotein 90K may have an effect on life expectancy. Your doctor can explain your blood test results and how they may affect your expected survival.

Blood Characteristics
Thrombocytosis (high blood platelet count) and leukocytosis (high white blood cell count) prior to surgery are associated with shorter life expectancy.

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Treatment and Life Expectancy

In developing a treatment strategy, your doctor will choose treatments that he or she believes will have the most positive impact on your life expectancy with the least physical side effects. He or she will take into account all the factors and develop a treatment strategy that will balance risk versus reward.

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Multimodal Therapy

Medical studies show that multimodal therapy has the most positive impact on mesothelioma life expectancy. However, this type of treatment strategy is usually considered aggressive and places a tremendous strain on the body. Based on your situation, you may not qualify for this type of treatment.

Generally, to qualify for multimodal therapy, the cancer must be in stage I or stage II. Some stage III patients qualify, too, if they are in otherwise good health, are relatively younger and have an epithelial or biphasic tumor type.

High-Dose Radiation

Doctors in Italy have conducted a study showing impressive results from a new high-dose radiation system following aggressive pleurectomy/decortication surgery. The two-year survival rate was 70 percent.

Alternative Therapy

Studies show that mesothelioma patients have benefitted from alternative or complementary therapies such as acupuncture, meditation, massage and yoga. These therapies may reduce stress, pain and improve quality of life.

Diet & Nutrition

In addition, a number of dietary changes can affect a mesothelioma patient's life expectancy. Considering nutrition in the treatment plan could have positive impacts on side effects, stress levels and response to treatment.

Experimental Treatments

There is a chance that your best opportunity at a longer life could come from experimental treatment in a clinical trial. Mesothelioma researchers constantly test new medications and treatment approaches, and clinical trials allow patients to take advantage of new treatments that may extend survival. Unfortunately, new treatment may also come with a higher element of risk.

There are several experimental therapies being investigated to slow the progress of mesothelioma. Some show promise in extending life expectancy, including immunotherapy and photodynamic therapy (PDT). Newer, targeted drugs that are effective in killing cancer cells — such as gene therapy — may soon extend life expectancy.

Medical advancements continue to refine methods of detecting and managing the disease. As a result, the life span of its sufferers is gradually improving. As more research is done and more alternative treatment options are explored, mesothelioma patients are being offered a wider range of choices that may ultimately modify their prognosis and significantly extend their life spans.

Survivor Stories

Karen Selby, Patient Advocate
Karen Selby talks about what she would say to someone who was just diagnosed with mesothelioma.

Many long-term survivors seem to have a unifying link: They integrate holistic and natural medicine into a traditional treatment plan. Nutritional regimens, supplementation and alternative therapies like acupuncture are among the holistic approaches mesothelioma survivors have used to their advantage. A number of mesothelioma patients have survived five years or longer because of their treatment, exercise and nutritional regimens.

Paul Kraus is an Australian factory worker who was diagnosed with peritoneal mesothelioma in 1997. Kraus applied several different therapies and lifestyle changes, including shifting to a vegetarian diet and taking nutritional supplements. He still has mesothelioma but is pain-free. At the extreme limit of mesothelioma survival is the case of acclaimed American scientist Stephen J. Gould, who lived for 20 years after being diagnosed. He died of an unrelated condition and authored a popular article about mesothelioma statistics that inspires patients to remain hopeful because each case is so unique.

Mesothelioma Prognosis

Mesothelioma Prognosis

Your prognosis with mesothelioma depends mostly on the stage and type of cancer you have. Improving that prognosis can depend on finding a specialist with experience treating your form of the disease.

Typical Prognosis

Improving your prognosis starts with having the right information

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Cancer specialists diagnose between 2,000 and 3,000 new cases of mesothelioma a year in the United States. When they confirm the existence of asbestos cancer, they quickly turn to prognosis — their best estimate of your battle ahead and also the probable outcome. Mesothelioma is a difficult disease to beat. And while there are many aspects to it that you can't control, there are things that you can do to help improve your quality of life and possibly improve your survival.

Although prognosis varies greatly depending on the factors described above, younger patients appear to have the most optimistic prognosis. A 2,959-patient study conducted by the American Cancer Society (ACS) noted that nearly 37 percent of mesothelioma patients younger than 45 years old survived for more than five years after diagnosis.

Approximately 20 percent of patients aged 45 to 54 survived for longer than five years. According to a study published by the Journal of Thoracic Oncology, the survival rate for patients is generally considered to be one year.

Patients Surviving 3 or More Years Following a Mesothelioma Diagnosis (%)

Mesothelioma Prognosis 5 Year survival rate pie charts
Although the typical survival rate for patients is low, there have been long-term survivors of the disease. Read their survival stories on our Wall of Hope.

Factors That Affect Your Prognosis

Dr. Fontaine Video Thumbnail
Dr. Fontaine explains what treatments give patients the best chance to live longer

Your mesothelioma prognosis depends on several factors, including the cancer's stage, plus your age, gender, overall health and history of asbestos exposure. Unique qualities of your cancer at the time of diagnosis such as the exact type of cancer you have, the cellular subtype, the stage of your cancer and whether your cancer has spread are all equally important in shaping prognosis.

These things also determine the treatments your doctor will recommend.

Types
Stages
Cell Type
Symptoms
Health
Other Factors
Type of Mesothelioma

There are several types of mesothelioma, each with its own prognosis. Statistically speaking, peritoneal patients have a better chance at long-term survival than those with any other type.

Research shows that approximately 40 percent of patients with the pleural form of the disease will survive for one year after diagnosis, while new treatments for peritoneal like heated chemotherapy have increased survival to more than seven years for some patients.

Pleural Mesothelioma 5-Year Survival Chart
10 percent of pleural mesothelioma patients survive > 5 years

The prognosis for pericardial mesothelioma is generally worse than for pleural and peritoneal. And while testicular mesothelioma is the rarest type, its prognosis is typically the best.

 Learn more about the different types of mesothelioma
Stage of Mesothelioma

The size of a tumor and how far it has spread (metastasized) from its original location affects prognosis. Doctors typically discuss tumor size and the extent of a cancer's spread in terms of stages, ranging from stage I to stage IV in order of severity. Patients with stage I or stage II (early-stage) will typically have a better prognosis than patients with stage III or stage IV (advanced).

In stage I and II, the cancer hasn’t metastasized much and remains contained within the lung lining and lung tissue, allowing for easier removal of tumors through surgery. By stage III, the cancer is still operable, but has metastasized beyond the lung and its lining and into the chest wall, nearby lymph nodes or the heart’s lining. Metastasis at stage IV is so extensive — tumors spread beyond the chest and into the spine, abdomen or other body parts — that surgery becomes ineffective.

 Learn more about the stages of mesothelioma
Cell Type Impacts Survival

The type of cells that make up your tumor, what doctors call histology, can impact your prognosis. Patients with epithelial mesothelioma generally have a better life expectancy than those with either the sarcomatoid or biphasic subtypes.

 Learn more about cell types
Progression of Symptoms

Patients suffering from serious symptoms, like severe chest pain or difficulty breathing, may have a worse outlook. This is because the presence of symptoms often means cancer has already progressed to a later stage of development.

 Learn more about the symptoms of mesothelioma
Overall Health

People in otherwise good health may qualify for treatments that are more intensive. On the other hand, if you have pre-existing health issues, you may not be able to tolerate aggressive surgery or chemotherapy. Additionally, non-smokers often have a better mesothelioma prognosis than patients who smoke.

Additional factors, such as age, gender and history of asbestos exposure can also affect your prognosis.

Favorable Prognostic Factors Poor Prognostic Factors
Stage I or Stage II cancer Stage III or Stage IV cancer
Tumor located in one area of the body Tumor has spread to other parts of the body
Good overall health Pre-existing health conditions or poor overall health
Epithelial cell type Sarcomatoid or biphasic cell type
Age 55 or below Over age 55
Non-smoker Smoker
Female Male
Next Factor 
Current Prognosis Studies: As results from ongoing asbestos-related cancer studies surface, doctors learn more about the diseases. New data leads to more accurate prognosis estimates. New research on cases reported to the National Cancer Institute from 2003 to 2009 show that 14.1 percent of women with pleural mesothelioma survive for five years, compared with only 6 percent of men. Additionally, a 2011 pleural mesothelioma study at Brigham and Women's Hospital in Massachusetts involving 636 patients found that patients who underwent an aggressive surgery called extrapleural pneumonectomy (EPP) experienced extended survival.

Another surgery called pleurectomy/decortication (P/D) has improved survival. A 2012 European study reported longer survival among epithelioid pleural mesothelioma patients who had a pleurectomy/decortication (P/D) surgery versus EPP surgery. Patients who had a P/D lived an average of 30 months while EPP patients lived for 14 months.

A 2015 Italian study found that age, epithelioid cell type and cancer-free lymph nodes were prognostic factors associated with long-term survival in pleural mesothelioma patients who had an EPP. Nearly 23 percent of the study’s 468 participants lived longer than three years.

Improving and Beating Your Prognosis

While you can't change important prognostic factors like your age, gender or cancer stage, you can choose to be proactive and take steps to improve your prognosis.

Find a Mesothelioma Specialist

A specialist is essential in providing you or a loved one with a treatment plan that can improve your life expectancy.

Find a Specialist
Beating the typical prognosis is happening more frequently with advances in treatment and care for mesothelioma patients. Survivors credit life span increases to multimodal treatment, improvements in nutrition and complementary medicines. There are other factors and ways that can play a part in improving a patient's prognosis.

Early Detection

Those diagnosed early in the cancer’s development have the best prognosis and longest survival. If doctors can diagnose the disease before it spreads into lymph nodes and to other parts of the body, treatment is more successful.

Other Ways

Enrolling in a clinical trial might improve your prognosis. These studies test up-and-coming therapies that may be more effective than current treatment options.

Once you've started treatment, you can take a few extra steps to improve your chances of recovery. If you're a smoker, find a cessation program. Smoking increases your risk of lung complications if you opt for surgery, so you should stop immediately. You can also talk to an oncology dietitian about how to strengthen your body through your diet, or ask your practitioner about complementary therapies that can help control your symptoms.

Survivors Who Have Surpassed Their Prognosis

Living with mesothelioma is far from easy, but not impossible. The latest treatment regimens, which often combine surgery with chemotherapy and radiation therapy, have helped many people survive past the disease's average life expectancy of one year. In some exceptional cases, mesothelioma survivors have lived with the cancer for more than a decade.

Judy G.
Wayne N.
Kasie Coleman
Judy G.

Judy Glezinkski & Mesothelioma
Judy, diagnosed with pleural mesothelioma in 1990, survived nearly 20 years. She extended her prognosis with extensive surgeries and radiation therapy. She also drank mangosteen juice and believed in the power of prayer. Judy shared her journey with the mesothelioma community in a book, Surviving Mesothelioma: Making your Own Miracle.

 Read Judy's full story in our free book

Mesothelioma Survivors

Mesothelioma Survivors

Survivors Collage
Although there is no cure for mesothelioma there have been long-term survivors of the disease. These individuals have lived from several years up to twenty years long and attribute it to specialized care and alternative treatments. Read more about them below and learn what makes a patient into a survivor.

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The majority of mesothelioma patients find their disease diagnosed in a late stage and often do not survive two years. But thanks to cutting-edge therapies and groundbreaking clinical trials, others live for three, four, five years and beyond. A few have reached the 10-year mark and continue to serve as living testimonials to beating this disease.

Surviving mesothelioma cancer won't be easy – likely the toughest battle you'll ever face – but it happens often enough now to provide realistic hope for a future. Allow these stories of real survivors to inspire you to continue on your own journey.

The mesothelioma community celebrates those who do survive so that others who find themselves walking the same path have role models to follow. Here at The Mesothelioma Center, we join in that celebration as well.

Notable Mesothelioma Survivor Stories

Ruth P.
Ruth P.

Diagnosis: peritoneal mesothelioma,

Year: 1999

Ruth opted against the conventional treatments that were recommended upon her diagnosis of peritoneal mesothelioma in 1999, taking an alternative-therapy approach, instead. She found the Immune Augmentative Therapy Centre in Freeport, Bahamas, which focused on rebuilding her immune system, allowing her body to fight off the cancer without the toxicity of chemotherapy or radiation. She returned to Freeport annually for many years and still relies on its herbal and homeopathic formulas that come from all over the world.

 Read Ruth's full Story
Alexis K.

Diagnosis: peritoneal mesothelioma

Year:2007

Alexis was diagnosed with peritoneal mesothelioma in 2007, had major surgery that removed part of her diaphragm and kept her wedding plans in place. She still rides to work on her scooter, refusing to let mesothelioma get in the way of a life she and her husband have. They don't know how many wedding anniversaries they will have, but they celebrate their time together. "It's kind of cool now to hear people say, 'You don't look or act sick,' " she says.

 Read Alexis's full Story
Alexis K.
Andy A.
Andy A.

Diagnosis: pleural mesothelioma

Year: 2010

Andy survived a horrific motorcycle crash that almost killed him in 2004, and he has every intention of surviving his 2010 diagnosis of pleural mesothelioma. He was not a surgical candidate because his cancer already had metastasized, but he found something better. With the help of mesothelioma specialist David Jablons, M.D., at the University of California-San Francisco, Andy enrolled in a clinical trial involving Amatuximab (MORab-009), an experimental immunotherapy drug that is working well for him. "I consider myself extremely lucky for a lot of reasons," he says. "I haven't won the lottery yet, but I'm working on that."

 Read Andy's full Story
Wayne N.

Diagnosis: pleural mesothelioma

Year: 1991

Wayne spent his career as a union electrician in Ohio. He was diagnosed with mesothelioma in 1991, pushing him into an early retirement. Now in his 80s, he is alive and thriving, attributing his success to antioxidants like melatonin that are found in red tart cherries, which he has eaten every night for more than two decades. "There's something magical in those cherries," he says. "I don't know exactly why they work, but they do."

 Read Wayne's full Story
Wayne N.
Sydney R.
Sydney R.

Diagnosis: pleural mesothelioma

Year: 2011

Sydney nearly died from rheumatic fever more than 60 years ago. She knows what it's like to fight for her life, which she has done successfully with pleural mesothelioma. She and her husband embarked on an aggressive treatment plan, and took charge of her care by questioning doctors and getting second and third opinions. "I'm an independent, outspoken person,” she says. “I certainly wasn't ready to say, `You win, mesothelioma.' We attacked this monster with every resource we could find."

 Read Sydney's full Story
Tim C.

Diagnosis: pleural mesothelioma, Year: 2002

Year: 2002

Tim originally decided against surgery and chemotherapy when he was diagnosed with pleural mesothelioma in 2002, but his daughter convinced him otherwise. He traveled to Boston and underwent an extrapleural pneumonectomy (EPP) at Brigham & Women's Hospital. The surgery and chemotherapy were taxing, but he has exceeded all expectations. "I've done a lot these last 10 years," he says. "I'm glad I listened to my daughter. My family now is what keeps me going."

 Read Tim's Full Story
Tim C.
Trina C.
Trina C.

Diagnosis: peritoneal mesothelioma

Year: 2001

Trina traveled the country - and loved every minute of it – after recovering from the cytoreductive surgery and hyperthermic intraperitoneal chemotherapy combination. She was diagnosed at a young age, which gave her a fighting chance at long-term survival. "I was told to get my affairs in order. The diagnosis was devastating, but I was determined to live long enough to see what my two children would become," she says. "I've done that. Now every day is a gift. So I'm out seeing the country." Her latest adventure? Traveling with a good friend in an 18-wheeler that serves as a home-away-from-home. "If it all ends today, I'll have no regrets," she says. "I lived longer than I ever thought I would."

 Read Trina's Full Story
Michelle M.

Diagnosis: peritoneal mesothelioma

Year: 2002

Michelle wanted something special to commemorate her 10-year milestone as a mesothelioma survivor. She had a tattoo artist write the word FAITH on her left wrist, where she could see it anytime she needed some help. "I do believe everything happens for a reason, and I have faith that God has a plan for me," she says. "After everything I've been through, it would be impossible to think otherwise." A single mom, Michelle was diagnosed at 44. Her daughter was 5 at the time. The hardest part emotionally was getting past the thought of leaving her daughter at such a young age. "She grew up quickly, taking care of me when I was so sick," Michelle says. "And now, I live for her."

 Read Michelle's Full Story
Michelle M.
Learn How to Improve Your Chances of Survival

These are only a handful of mesothelioma survivors. Their stories show that every person is unique and that surviving is possible, even though mesothelioma is considered a terminal cancer. You can learn more about improving your chances of survival through The Mesothelioma Center's free and comprehensive informational packet.

Free Mesothelioma Information Guide

Mesothelioma information packet
We needed the right information so that we could be prepared. Asbestos.com provided me with the best information I could use to help me out.

Patricia Hargrett, Mesothelioma Survivor


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Why Do Some Mesothelioma Patients Live Longer than Others?

Surviving mesothelioma is not an exact science. How long someone lives following a diagnosis depends on a number of factors, including the stage of the cancer, the location of it and a person's overall health, age and gender. Life expectancy varies from case to case.

Early detection plays a vital role in increasing someone's chance of becoming a long-term survivor. The earlier that mesothelioma is detected, the more treatment options a patient has. The development of new diagnostic techniques has led to more effective treatments.

Regardless of the type or sub-type of mesothelioma, living beyond two years is considered a success. Pleural mesothelioma is the most common form of the disease, but the most survivable type is peritoneal mesothelioma.

A knowledgeable specialist can attack the cancer aggressively, increasing your odds of surviving. Finding the right specialist can make a world of difference with a rare cancer like mesothelioma. Improved surgical techniques, better drug combinations and more targeted therapies are key to increased survival rates.

We feature inspirational stories on our Wall of Hope, including first-person accounts of how these mesothelioma survivors are fighting and winning their battles.

Each survivor has a different story, but all of them share something: hope. We hope their stories inspire you and help you in some way.

In Memoriam: Mesothelioma Survivors We Lost

Larry
Janelle
Christine
Mike
Judy
James
Larry D.

Larry D.
Larry lived six years after his diagnosis of mesothelioma, which also killed his father many years before. Larry, who lived in South Florida, was an avid runner who first organized the annual Miles for Meso road race in Boca Raton each February. He worked tirelessly to raise awareness of this dreaded disease, and raise money for research. Even after five surgeries, Larry still completed a Father's Day Triathlon in 2011 with his daughter in North Carolina. He shunned much of the traditional chemotherapy and radiation treatment and relied mostly on immunotherapy and alternative medicine. He died in June 2012.

 Read Larry's full story
Janelle B.

Janelle B.
Janelle was diagnosed with pleural mesothelioma at the age of 31, which is unusually young for mesothelioma. Her six-year fight against the disease turned her into a hometown hero in tiny Rushville, Ind., and a national spokesperson who advocated strongly for more research funding and more diligence in ending the asbestos era in America. The mayor of Rushville designated June 6 as “Wonder Woman Day,” to honor her fight. She played a key role in gaining congressional support for a resolution designating Sept. 26 as National Mesothelioma Awareness Day. She died in 2013.

 Read Janelle's full story
Christine S.

Christine S.
She lived in England and never worked around asbestos, but Christine believed she was exposed to it by her father, who mixed asbestos cement every day on his job site, then wore his work clothes home every night. Christine was diagnosed with mesothelioma in October 2007, years after her father had died, likely of the same disease, although it never was diagnosed. She discovered that repeated chemotherapy shrank the tumor and controlled the disease. It allowed her to be active in various cancer awareness events in the UK. Christine died August 2013.

 Read Christine's full story
Mike D.

Mike DeD.ws
Mike D. underwent his first surgery for mesothelioma in February 2001. After undergoing an additional surgery, as well as other treatments, he remained relatively physically active. He encouraged fellow mesothelioma patients to use the resources around them and rely on loved ones. Dews passed away in September 2011.

Judy G.

Judy G.
Judy was diagnosed with pleural mesothelioma in 1990 and lived with the disease until 2010. In addition to undergoing several extensive surgeries, she relied heavily upon alternative treatments such as meditation, massage therapy and nutritional remedies. Her story is chronicled in the book titled Surviving Mesothelioma: Making Your Own Miracle. She passed away in 2010.

 Get a Free Copy of Surviving Mesothelioma & Read Judy's Story
James O.

James O.
James was originally diagnosed with mesothelioma in October 2001. Despite being given less than a year to live, managed to survive another seven years. O'Connor did not undergo surgery, radiation therapy or chemotherapy, but rather chose to combat his disease through a strict nutritional regimen and mind-body therapy. He died in 2008.

Next Survivor 
Latest Stories of Survival from the Wall of Hope

When someone is able to beat mesothelioma, even for just a little while, we celebrate with them. The Wall of Hope is a place where survivors and caregivers can share their experiences and journey with this deadly cancer. And we're always looking for more stories to share!

Jimmy E., Survivor
Jimmy E., Survivor,

August 13, 2014 - Jimmy E. is a remarkable man. Inspired by the doctors who helped him overcome a rare form of childhood cancer, he forged a career as a skilled surgical nurse in southern California, driven by an urge to serve others. But more than 30 years after beating cancer, Jimmy developed a persistent fever, pneumonia and fluid around his lungs. This time, the diagnosis was a more insidious disease malignant pleural mesothelioma. Jimmy, who recently turned 38, is far too young for a [...]

 Read the Full Story
Billy K.
Billy K., Survivor

June 18, 2014 - Doctors told United States Army soldier Billy K. almost 50 years ago that he never would walk again, his left leg irreparably damaged by a spray of bullets when his patrol was ambushed in the jungle during the Vietnam War. Doctors told him last year he had six months to live, an unfortunate victim of malignant pleural mesothelioma, an aggressive and incurable cancer around his lungs. He didn't listen either time. Billy was back home last week cutting grass with a push mower, [...]

 Read the Full Story
Rich D.
Rich D., Survivor

May 23, 2014 - Rich D. opened the door and gazed with amazement at his posh suite on the 26th floor of the luxurious Bellagio Hotel in Las Vegas private sauna, flat-screen TVs throughout, super-king bed, a picturesque view of both the faraway mountains and the famed strip below and he just smiled. He dropped his bags and took the elevator down to the casino, where he kept turning up aces. "I may have mesothelioma, but mesothelioma doesn't have me," he said recently, recalling that day from [...]

 Read the Full Story
Kasie Coleman
Kasie Coleman, Survivor

May 9, 2014 - BATON ROUGE, La. Kasie Coleman is like a buzz saw without a stop switch now, whirling from one task to the next, leaving dust in her wake and anyone trying to follow, two steps behind. She doesn't slow anymore for negative thoughts, chemotherapy side effects or behind-schedule doctor appointments. Too busy for that. Coleman has children to raise, a husband to love, parents to help, a God to worship, a blog to write and a burgeoning bakery business to build. She's charging [...]

 Read the Full Story
Antonio L.
Antonio L., Survivor

April 23, 2014 - Will L. spends a lot of time now worrying about his father's health. He often wonders how different things might be if his father had never left Ecuador 45 years ago to create a better life for his family. He also wonders how something so good turned out so bad. How did the American dream become an American nightmare? Malignant pleural mesothelioma changed his perspective on a lot of things. "If my father had stayed in Ecuador, raised a family there, this never would [...]