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Mesothelioma Prognosis

Mesothelioma has a poor prognosis with a 5-year survival rate of only 9%. Most mesothelioma patients have a life expectancy of about 1 year.

Key Points

  • 1

    Prognosis depends on many factors, including the stage of the mesothelioma.

  • 2

    The life expectancy for most mesothelioma patients is 1 – 2 years after diagnosis.

  • 3

    Early detection and treatment can improve mesothelioma survival rate for many patients.

  • 4

    Some with mesothelioma have beaten the odds and lived long past their prognosis.

Receiving a mesothelioma diagnosis is a life altering event for you and your loved ones. You will likely have many questions like “What do I do now?” and “How long do I have to live?”

While the prognosis for mesothelioma is poor, with a 5-year survival rate of only 9%, the good news is that you may be able to improve your prognosis through conventional treatment methods such as surgery and radiation therapy. Also, newer experimental methods have injected new hope for those seeking to get rid of their cancer. Even if these options are not available to you, you may be able to reduce pain and improve your quality of life through palliative care.

Survival and life expectancy statistics can be cold and frightening. However, it’s important to remember that malignant mesothelioma progresses differently in each individual. When discussing options, your doctor and your family are the best people to help you decide what is best for you. If you need help coping with your prognosis, you may find the information in our community section helpful.

Free 2020 Mesothelioma Prognosis Guide >

Mesothelioma Prognosis, Life Expectancy and Survival Rate

When discussing survival information, it is important to understand the different terms involved.

Understanding Terminology


A projection for how the disease is expected to progress and the overall likelihood of survival.

Survival Rate

A percentage that shows how many patients live for a given amount of time after diagnosis.

Life Expectancy

How long a patient is likely to live after diagnosis. This estimate depends on treatment success and other factors.

Survival statistics are based on large sample groups of people, they are not exact predictions of what will happen to you. Also, many statistics do not take into account the impact of emerging treatments, so the numbers may not be based on treatments being used today.

Coping with Your Mesothelioma Prognosis

After receiving a mesothelioma diagnosis, you will have a number of questions to answer and decisions to make:

Common Questions
  • Do I want to pursue treatment?
  • If so, what are the best treatment options for me?
  • What will the side effects of the treatment be?
  • How will I manage treatment side effects and care for myself?
  • How will I pay for treatment?

Finding a mesothelioma specialist who can help guide you through your treatment options is one of the most important decisions you can make. They will be able to answer your questions, evaluate your individual case, and discuss the best treatment options available for you. Conventional mesothelioma treatments like surgery, chemotherapy and radiation have been shown to positively affect prognosis, with mesothelioma survival rates improving even more when these treatments are combined.

For qualified individuals, enrolling in a clinical trial can be another way to improve your life expectancy. Clinical trials are research investigations in which people volunteer to test new treatments, interventions or tests as a means to prevent, detect, treat or manage various diseases or medical conditions. Many patients have benefited from the kinds of experimental treatments researched in these trials, such as gene therapy and immunotherapy. Talk to your doctor if you’re interested in learning more about clinical trials that may be available to you.

Survivor Stories – Hope

Fighting and beating mesothelioma requires strength, courage, and a strong support system. The Mesothelioma + Asbestos Awareness Center works with a number of long-term mesothelioma survivors who advocate for patients, as well as a ban on asbestos.

Read Long-Term Survival Stories

Factors Impacting Your Mesothelioma Prognosis

Your prognosis will be based on a number of factors, individual to you. No single statistic alone can accurately predict your life expectancy, though combined it may provide a scope into what you can expect.

The factors listed below affect your mesothelioma prognosis most directly. However, your doctor will be able to offer a better explanation of how each factor relates to your individual case.

Mesothelioma Cancer Stage

The stage of the cancer is the most important factor when determining your prognosis. Staging refers to the classification of the cancer based on how it has spread throughout a patient’s body. For instance, a stage 1 classification indicates that the cancer is localized and tumors present will likely be smaller. Stage 4, however, means the cancer may have spread widely throughout the body and patients may also have larger tumors. People diagnosed with mesothelioma at an early stage have a far better chance of long-term survival than those who discover their cancer at a later stage.

Mesothelioma Life Expectancy by Stage

mesothelioma life expectancy by stage

Mesothelioma Location

The type of mesothelioma a patient has is classified by where the cancer is located: the lungs, abdomen or heart. Along with the stage of your diagnosis, location is one of the most important indicators in determining your mesothelioma life expectancy.

Of all the types, malignant pleural mesothelioma is the most common, but with more recent treatment advancements, peritoneal mesothelioma patients have experienced improved overall survival rates. Because pericardial mesothelioma is so rare and much harder to diagnose, it has the worst prognosis, with only about half of patients surviving one year.

While many pleural and peritoneal mesothelioma patients survive for at least a year, pleural mesothelioma survival rates drop dramatically by 3 and 5 years of survival. For instance, while 73% of pleural mesothelioma patients survive one year, only 23% survive 3 years and 12% survive 5 years or longer. Peritoneal mesothelioma has better survival statistics, as 92% survive one year or more, which drops to 74% and 65% at 3 and 5 years of survival, respectively.

These improved peritoneal mesothelioma survival statistics are at least partially due to the success researchers have seen in better treatments, particularly surgery with heated chemotherapy (HIPEC). While there have also been treatment advancements in pleural mesothelioma and survival rates have improved slightly from the past, there is clearly more research needed to improve current treatments and find other effective alternatives.

Mesothelioma Cell Type

A mesothelioma diagnosis will also entail the cancer cell types that are involved (epithelioid, sarcomatoid and biphasic cells). This aspect of the diagnosis is referred to as the histology, and it’s important for oncologists to further differentiate mesothelioma by cell type to understand how these particular tumors will react to treatment. The cell types have different growth rates and likelihood of spreading, with the rare sarcomatoid cells being the most likely to metastasize and epithelioid mesothelioma typically seeing a longer life expectancy. Patients with biphasic mesothelioma can vary greatly, depending on whether sarcomatoid or epithelioid cells are more dominant.

Life Expectancy by Mesothelioma Type

mesothelioma life expectancy by type

Note:  Because pericardial mesothelioma is so rare, there is not enough data to calculate life expectancy.

Patient Characteristics

A patient’s age can also impact life expectancy. Older people who are diagnosed with mesothelioma generally have poorer survival rates than those diagnosed at a younger age. Seniors often have other health conditions that can complicate treatment or limit their options. Younger patients are likely to have better overall health, so their bodies may be better able to handle cancer treatment.

Fewer than 25% of mesothelioma patients are women. However, on average women have a better life expectancy, living nearly 6 months longer than men who are diagnosed at the same age. The reason why women tend to have a better mesothelioma life expectancy than men is not well understood – it may have to do with the fact that women tend to have better overall health and are more likely to get symptoms checked by a doctor earlier than men.

5-Year Survival Rate By Age

Mesothelioma survival rate by age

In addition to age at diagnosis and a patient’s sex, there are several other factors that can affect mesothelioma life expectancy.

Other Factors that Impact Prognosis

Several studies have shown certain genetic factors play a role in how long mesothelioma patients survive after diagnosis. One example is patients who carry a certain mutation of the BRCA1-associated protein-1 (BAP1) gene tend to have better mesothelioma survival rates.

Overall Health

The healthier you are, the more likely your body will be able to fight the cancer and handle aggressive treatments that can help you get better. Exercise, good nutrition, and a strong immune system all work together to improve your prognosis.

Smoking History

While smoking does not cause mesothelioma, smokers who are diagnosed with mesothelioma tend to die sooner than patients who have never smoked.

Blood Counts

High levels of white blood cells, hemoglobin, or platelets could indicate complications with your cancer, which can result in a poorer prognosis.

Improving Your Prognosis

Treatment is the best way to improve your mesothelioma prognosis. The type and stage of mesothelioma will have the biggest impact on the type of treatment available and the efficacy of the treatment in improving long-term mesothelioma survival.

Mesothelioma Survival Rate by Treatment

Mesothelioma survival rate by treatment type

As the stages of disease become more advanced, not only does the mesothelioma prognosis worsen, but patients face more limited treatment options. But mesothelioma life expectancy without treatment at all can leave patients with a prognosis of just 6 months or even worse. Because mesothelioma itself is so aggressive, patients who are able to undergo equally aggressive treatment have a better chance of longer survival. Most patients do, however, have a multimodal treatment, meaning they receive multiple types of therapy in combination whether to attempt to cure the disease or for palliative purposes.

Early stages of mesothelioma (stage 1 and stage 2) generally have no or very localized spreading of the disease, making it easier for oncologists to treat with a more intensive plan with curative intent. At these stages, surgery is usually still an option, as the cancer has not spread throughout the body and made surgery too risky. Depending on the location, patients will also often undergo chemotherapy or radiation in combination with surgery to achieve the best results. Peritoneal mesothelioma patients, for instance, have seen the best survival rates for early stage cancer treated by cytoreductive surgery with HIPEC, a heated chemotherapy wash, with a median survival of 53 months.

Stage 3 and stage 4 are the more advanced stages of disease, and patients may often be limited to palliative care to improve symptoms because of the distant spreading, including to the lymph nodes. Stage 3 is actually the most commonly diagnosed, so there have been some more clinical trials looking into potential curative treatments for these patients. At this late stage, surgery may no longer be an option, but there is still hope for treatment beyond palliative care depending on the individual case. Clinical trials are actively testing new treatments for these advanced stages of mesothelioma, like immunotherapy and photodynamic therapy.

Mesothelioma Life Expectancy Without Treatment

As mentioned, treatment is the best way to improve prognosis after diagnosis. However, patients sometimes choose to forgo treatment, whether for the high price of some cancer drugs, being diagnosed at a later stage or other personal reasons.

Several studies have determined that mesothelioma life expectancy without treatment is only a little over 6 months. Some older studies have seen some untreated patients live beyond a year after their cancer diagnosis, but these patients likely were diagnosed in early stages.

Mesothelioma Remission and Recurrence

Since there is no cure for mesothelioma, doctors prefer to use the term remission. Mesothelioma remission means the absence of active disease. It may be used when the mesothelioma has improved measurably, but may not be entirely gone from the body. In general, a patient is considered to be in remission when their disease is stable. Mesothelioma remission may be described as partial or complete.

Types of Mesothelioma Remission
Partial Remission
  • Tumors have shrunk by at least 50%
  • Most cancer symptoms are gone, but some may still be noticeable
  • Doctors may manage the disease as a chronic illness
Complete Remission
  • Scans don’t show any signs of cancer
  • All mesothelioma symptoms may be gone
  • Also referred to as “no evidence of disease” or “complete response”

Even patients with complete remission still need to undergo frequent scans to ensure the cancer doesn’t return. Unfortunately, due to the aggressive nature of malignant mesothelioma, recurrence is quite common. Recurrence refers to when the disease has been stable or in remission for some time and then begins to grow and spread again, sometimes to new areas of the body.

Studies have varied survival periods before disease progression, depending on the type and cell type of mesothelioma, the stage at diagnosis and the treatment plan. For some patients, it may just be weeks or months after treatment and remission, and sometimes even years before mesothelioma recurs.

Recurrence has been found to be highly likely even for those patients who undergo more aggressive treatments, like extrapleural pneumonectomy (EPP) or pleurectomy decortication (P/D). One study of pleural mesothelioma patients noted local recurrence rates could range from 41 – 72% with these surgeries, with high recurrence rates of 10 – 65% for distant recurrence, as well.

Ongoing monitoring and follow up care are crucial for all cancer patients, including those with mesothelioma. Even when patients achieve remission, the aggressive disease could still possibly recur at anytime. Having biannual or frequent scans and keeping close contact with your cancer care team can mean catching any disease progression early and starting treatment sooner, hopefully extending mesothelioma life expectancy and achieving remission again.