Clapper, Patti, Schweizer and Mason

Prognosis of mesothelioma is difficult to assess as there is a great variability in time before diagnosis and progression of the disease. Mesothelioma begins with exposure to asbestos; however symptoms of the disease do not begin to appear until decades later.   Often, because of the challenges with making an accurate diagnosis, mesothelioma is not diagnosed until it has reached advanced stages and prognosis is poor.  

 

Prognosis is the medical term used to describe the likely outcome and course of an illness. Prognosis can help predict the course mesothelioma will take and be used as a tool to decide which treatments might be most useful. Earlier diagnosis of mesothelioma usually coincides with better prognosis, or outcome.

 

The primary prognostic factors used with mesothelioma patients are:

 

 

Performance status was first defined by David A Karnofsky in 1948 as a way of trying to quantify a patient’s overall well-being to assess if and what type of treatment might be best for their particular medical condition. The performance scale measures the patient’s ability to perform daily activities with or without assistance as a way of quantifying general health. Many oncologist use performance status scores to help determine survival duration and response to treatment, as well as to measure quality of life and comorbidity. The performance status helps to determine if a patient is physically able to undergo certain treatments and/or qualify to participate in clinical trials. 

 

Histology refers to the anatomical study of the microscopic structures, such as tissues and cells, of the body.   By looking at the histology of a patient, oncologists can better identify diseased cells as well as track effects of different medications, especially chemotherapy drugs. Scientific data presented at the 44^th Annual Meeting of the American Society of Clinical Oncology (ASCO) confirmed that taking histology into consideration when treating non-small cell lung cancer can improve treatment, especially the use of pemetrexed in non small cell lung cancers such as mesothelioma.

 

Lymph nodal status is an important factor in making a diagnosis of mesothelioma to calculate prognosis after treatment and also in calculating the stage of the cancer.   A lymph node is one of three hundred small, bean shaped organs found mostly in the neck, armpit and groin. They are filled with lymphocytes (type of white blood cell) and act to trap viruses, bacteria and substances recognized as foreign, such as mesothelioma cancer cells. Mesothelioma can spread into the lymphatic system, causing the nodes to swell as the system goes into high activity in attempts to produce immune cells to fight the cancer. 

 

For most mesothelioma patients, it’s helpful to be informed. Doctors and mesothelioma specialists will use many new terms when discussing your diagnosis and treatment. Hopefully this information helps you to better understand and can guide you in making the best treatment choices.