Mesothelioma Help

Statistics and prognosis for mesothelioma

Wednesday, January 9, 2008

Doctors collect statistical information about the different types of cancer and prognosis. Prognosis is the likely outcome of your disease and treatment. In other words, your chances of getting better and how long you are likely to live.

Following on this page, is quite detailed information about the survival rates of different stages of mesothelioma. We have included it because many people have asked us for this. But not everyone who is diagnosed with a cancer wishes to read this type of information. If you are not sure whether you want to know at the moment or not, then perhaps you might like to skip this page for now. You can always come back to it.

Please note: There are no national statistics available for different stages of cancer or treatments that people may have received. The statistics we present here are pulled together from a variety of different sources, including the opinions and experience of the experts that check each section of CancerHelp UK. We provide statistics because people ask us for them. But they are only intended as a general guide and cannot be regarded as any more than that.

There is a section explaining more about the different types of cancer statistics in the CancerHelp UK section on cancer statistics. Unless you are very familiar with medical statistics, you may find it helpful to read this before you read the information below.

Remember - statistics are averages based on large numbers of patients. They cannot predict exactly what will happen to you. No patients are exactly alike and response to treatment also varies from one person to another.

You should feel free to ask your doctor about your prognosis, but not even your doctor can tell you for sure what will happen. You may hear your doctor use the term '5 year survival'. This relates to the proportion of people in research studies who were still alive 5 years after diagnosis. This is because doctors follow what happens to people for 5 years after treatment in any research study.

The general outlook for mesothelioma

Generally speaking, with cancer the outcome depends on how advanced your cancer is when it is diagnosed. Usually with cancer, the statistics are given for each stage. Stage is just as important for mesothelioma as it is for other cancers. But finding the statistics is more difficult to do. This is because

Mesothelioma is not all that common, (although incidence is increasing)
It is usually diagnosed when it is advanced - people may not have symptoms early on and so don't go to the doctor
Statistics by stage aren't readily available because most people don't have surgery and accurate staging needs an operation

There are two types of mesothelioma. Pleural mesothelioma has three staging systems and peritoneal mesothelioma has no established staging system.

Overall, both types of mesothelioma have a poor outlook. By the time someone has symptoms and goes to their doctor, the disease is very often advanced. Because few people are diagnosed early, there are no reliable statistics for 5 year survival rates for the early stages of mesothelioma.

For both types of mesothelioma, patients are often told that they may have less than a year to live. But mesothelioma specialists, working in leading cancer centres throughout the world, often report better statistics than this based on clinical trials that they are carrying out. Some of these are reported below.

Generally, of all those people diagnosed with mesothelioma only about 1 in 10 (10%) will be alive 3 years later and 1 in 20 (5%) will be alive 5 years later. For those people who have been diagnosed and treated in the earlier stages of the disease, there is little information to draw on. But we have seen reports that quote survival rates of up to 1 in 2 (50%) after 2 years. So the range of survival times is very wide. Survival depends on other factors, as well as stage.

Survival rates from specific clinical trials

Although there are results from quite a few trials available, they are often quite small studies involving fewer than 20 patients or so. We have picked the trials below to report because they are large. The larger the trial, the more reliable the results are likely to be.

At the Dana-Farber Cancer Institute in Boston, doctors followed 120 patients, with different types of pleural mesothelioma, from 1980-1995. All these patients were treated with surgery to remove the lung and pleura (pleural pneumonectomy), followed by a combination of chemotherapy and radiotherapy, with or without immunotherapy. 54 out of the 120 (45%) patients in this trial were alive 2 years later and 26 out of the 120 (22%) patients were alive 5 years later.

Patients with sarcomatoid and mixed mesothelioma had a poorer prognosis. Of the patients with these types of mesothelioma only 20% were alive 2 years later and by 5 years later, all had died.

Patients with epithelioid type tumours and no cancer in the lymph nodes had a much better outlook. Nearly 3 people out of every 4 (74%) were alive 2 years later and more than 1 person in every 3 (39%) alive 5 years later. (The full results of this trial are published in the February 2002 edition of the medical magazine Seminars in Oncology, volume 29, issue 1, pages 41-50.)

Another study looked at survival with mesothelioma in an area of North West Italy. This is called a population study. The researchers look at the records of everyone diagnosed with the disease in a given area. This study looked at an area with a total population of 4.5 million. Throughout the world, this is the second largest, of 3 population based studies about mesothelioma survival. All three studies have had similar results. One year after diagnosis, on average, 1 in every 4 people (24%) with pleural mesothelioma and 1 in every 3 people (34%) with peritoneal mesothelioma were still alive. (The full results of this trial are published in the July-August, 2002 edition of the Tumori Journal, volume 88, issue 4, pages 266-9).

Other factors affecting prognosis

There are other factors that can affect your prognosis, apart from the stage of your cancer. One is how well you are overall. Doctors have a way of measuring this. They call it your 'performance status'. You may see this written PS. A score of 0 means you are completely able to look after yourself. A score of 1 means you can do most things for yourself, but need some help. The scores continue to go up, depending on how much help you need. This is relevant to survival because overall, the fitter people are, the better able they are to withstand their cancer and treatment.

Other factors include

The type of mesothelioma you have
Your blood counts

People with normal haemoglobin levels, and normal white blood cell and platelet counts, tend to do better. These tests are a measure of your overall health and the effect the disease is having on you.

How reliable are these statistics?

No statistics can tell you what will happen to you. Your cancer is unique. The same type of cancer can grow at different rates in different people for example.
The statistics are not detailed enough to tell you about the different treatments people may have had. And how that treatment may have affected their prognosis. Chemotherapy, surgery and radiotherapy may help people to live longer as well as relieving symptoms. There are many individual factors that will determine your treatment and prognosis. If you are fit enough to have treatment, you are likely to do better than average, particular if your cancer is more advanced.

Clinical trials

People treated at centres where clinical trials are taking place tend to do better. This is almost certainly because that is where the most expertise is concentrated - research is more likely to take place in specialist centres. For those in the trials, it may be partly to do with having a closer eye kept on them by their doctors than they might if not in a trial - more scans and blood tests for example. But it might also be something to do with morale. You may feel more positive if you are taking part in a trial because it is more obvious to you that something is being done to help you. There is more about understanding clinical trials in CancerHelp UK। To search our clinical trials database for trials that are recruiting for mesothelioma, click on the blue 'clinical trials button' to the left of your screen and pick 'lung' from the drop down menu of cancer types.

http://www.cancerhelp.org.uk

posted by Vick Template @ 2:47 PM

0 Comments: