The Prognosis for Mesothelioma
The prognosis for malignant mesothelioma depends greatly on how early in its development the mesothelioma is diagnosed and how aggressively it can be treated. Because of its long latency, and the absence or mildness of symptoms as it develops, most mesothelioma victims do not seek a diagnosis until the symptoms are more painful and disabling. By the time a diagnosis is established, the disease is far advanced.
Survival time from diagnosis can be less than a year. If the diagnosis is made while the disease is still relatively early, Stage I or Stage II, and aggressive treatment is undertaken, survival times of 12 to 18 months can be expected. Some patients will live another two to five years. In addition to the stage of the tumor, other factors affecting prognosis are the patient's age and general health, which affect the ability to tolerate surgery and the rigors of multiple-drug chemotherapies. The location of the primary tumor, how much can be removed, and how the mesothelioma responds to chemotherapy also affect the outcome.
One promising area of mesothelioma research is in genomics. When genetic damage in a population of mesothelioma patients was studied, it was possible to recognize specific genotypes that made more favorable responses to treatment. Although this research is just emerging in biomedical journals, the implication is that it may soon be possible to examine mesothelioma cells for DNA markers that will predict whether a given patient would benefit from aggressive surgical treatment or not.
The drugs used in chemotherapy, the combinations, and the way they are delivered all continue to evolve as oncologists learn more. Where the patient's staging and general health permit a two or three pronged approach of surgery followed by multi-agent chemotherapy and possibly radiation is the approach that shows the greatest promise. Newer agents, such as monoclonal antibodies drugs that target specific tumor cells and drugs that interfere with angiogenesis drugs are being investigated. Adjunctive drugs such as Interferon, Thalidomide and Cox2 inhibitors like Celebrex are being investigated for their potential to increase the effectiveness of chemotherapies.
