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How do doctors determine the prognosis for mesothelioma?

On Behalf of | Oct 12, 2023 | Mesothelioma/Asbestos-Related Illness

Sometime after you receive a mesothelioma diagnosis, your doctor is likely to give you a prognosis. This is your doctor’s best educated guess about how the disease is likely to affect you.

It’s important to remember this is only an educated guess. There are things people can do to improve or worsen their situations. It is also worth understanding the factors your doctor may review on the way to that educated guess. Importantly, some of those factors are more telling and consistent than others.

A review of the prognostic factors for mesothelioma

A team of researchers recently addressed the prognostic factors for mesothelioma at the 2023 World Conference on Lung Cancer. They used the data from 3,101 patients as a baseline. Then, starting in 2014, they followed the progress of 1,733 new patients. The researchers tracked this new group’s cases against their original prognoses.

The researchers used their study to measure the reliability of six variables:

  • Age
  • Sex
  • Platelet and white blood cell levels
  • Tumor type
  • Surgery aimed at removing the cancer
  • Secondary treatment

The researchers used two different analytic models to look at the data. One tracked the symptoms the doctors could recognize early, along with the results of laboratory tests. The other model included additional factors available to doctors when they first diagnosed the patients.

The results from both models showed that three factors clearly indicated worse outcomes:

  • Non-epithelioid tumor types
  • Anemia
  • High platelet counts

The models placed differing degrees of importance on four other factors:

  • The lack of secondary treatment
  • Late-stage diagnosis
  • High levels of mesothelin, a tumor biomarker
  • Age 50+

One of the most important findings, however, was the overall accuracy of the prognoses. The researchers explained that their models would assign a score of 0.5 to factors which indicated nothing more than chance. A score of 0.7 would be a strong indicator. Neither model the researchers tested reached a score of 0.7. One reached a score of 0.652. The other reached a score of 0.668. In the words of the lead researcher, these scores are “moderately prognostic.”

What’s the point of a prognosis?

After you receive a mesothelioma diagnosis, you might wonder, “How much time do I have?” That, however, is not the main purpose of a prognosis.

Your doctor should offer you a prognosis for other reasons:

  • To inform you
  • To check whether you might qualify for various treatments or studies
  • To help you decide on a course of treatment
  • To personalize your follow-up care

Notably, researchers have long recognized that prognoses are more accurate with palliative care than with curative efforts. That means that when new studies show the factors used in determining your prognosis are only “moderately” reliable, your work to treat and fight the cancer makes those factors slightly less reliable.

In other words, your prognosis is most helpful when it focuses your treatment. You don’t need to use it for more than that.

No one can see the future

While it is important to accept the reality of your condition, in the present, you don’t want to make too much of any bad news you might receive.

Studies have found that long-term survivors tend to accept that they will have good days and bad. They focus on coping, and they focus on finding the best possible care. This is where your prognosis is useful. It doesn’t exist to predict your future; it exists to help you take control of your future.

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