Mesothelioma Remission

Mesothelioma remission occurs when doctors can no longer find traces of the cancer in a patient’s body. Remission is rare for mesothelioma, which is aggressive and fast-spreading. Even without remission, the right treatments help patients live longer and with fewer symptoms.

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What Does Remission Mean?

According to the National Cancer Institute (NCI), remission is defined as the absence of signs and symptoms of cancer in people diagnosed with mesothelioma or any other type of cancer.

There are two remission types for cancer:

• Complete remission means that all signs of cancer have disappeared.
• Partial remission is when some of the cancer signs and symptoms (at least 50%) have disappeared.

Per the American Cancer Society (ACS), cancerous tumors that shrink must stay that way for at least one month for the patient to be considered in partial remission.

Can Mesothelioma Go Into Remission?

Remission is possible with mesothelioma but rare. Most patients have a poor prognosis and are unlikely to achieve complete or even partial remission. Mesothelioma remission is rare for a few reasons:

• Mesothelioma is an aggressive cancer that spreads readily.
• Most people diagnosed with mesothelioma are already in the later stages when the cancer has spread.
• Mesothelioma doesn’t always respond well to treatment.
• Many patients with mesothelioma are not good candidates for surgery to remove all or most tumors.

Has Anyone Ever Gone Into Remission for Mesothelioma?

Yes, there are recorded cases of mesothelioma remission, although they are uncommon:

• A case study published in 2007 described a 61-year-old woman with pleural mesothelioma who was found to be in remission from mesothelioma six months after her diagnosis. Doctors followed up with her five years later, and she was still cancer-free. This was an extremely rare case of spontaneous remission without treatment. Researchers do not know why it happened.

• A 71-year-old peritoneal mesothelioma patient went into remission 223 days after surgery to remove the tumors. Cancer recurred in the pleural tissue eight months later.

• A 2019 report described a case study of a 53-year-old man who achieved remission from stage 4 pleural mesothelioma. It is especially rare to go into remission from late-stage mesothelioma. The man received chemotherapy, immunotherapy, and an experimental treatment.

• Paul Kraus was diagnosed with metastatic mesothelioma in 1997 and was given six months to live. He chose lifestyle changes and complementary medicine and achieved remission. Although he has had recurrences of other types of cancer, Kraus has been in remission from mesothelioma for decades.

What Factors Influence Whether a Mesothelioma Patient Is Considered Cured?

Determining if a mesothelioma patient is truly “cured” as opposed to being in remission involves assessing multiple factors. Here’s a breakdown of the key elements:

1. Type and Stage of Cancer
   The specific characteristics of the mesothelioma, including its type (such as pleural or peritoneal) and stage at diagnosis, play a crucial role. Early-stage cancers generally have a better prognosis, making the path to being considered cured more attainable.
2. Effectiveness of Treatment
   The success of treatments—ranging from surgery and chemotherapy to radiation therapy—significantly influences outcomes. A treatment plan that effectively eradicates cancer cells increases the likelihood of considering a patient cured.
3. Patient’s Overall Health
   The individual’s baseline health and ability to tolerate aggressive treatments impact their recovery and potential for a cure. A robust immune system may better eliminate residual cancer cells.
4. Timeframe of Non-Recurrence
   Doctors often use time as a measure, typically waiting five years or more of no cancer recurrence before considering a patient cured. This period can vary based on the cancer’s nature and recurring tendencies.
5. Medical Definitions and Caution
   Physicians tend to be cautious with the term “cured.” They may prefer terms like “complete remission” or “no evidence of disease” for an extended period to ensure long-term cancer absence.

The decision to classify a mesothelioma patient as cured is a complex and cautious one, influenced by each of these interlinked factors.

What Is the Average Life Expectancy After Being Diagnosed With Mesothelioma?

Life expectancy varies significantly by individual. It depends on the type of mesothelioma, the stage of the disease, the patient’s age and health, and other factors. On average, and for all types and stages of mesothelioma, the life expectancy is 12 to 21 months.

Treatments That Can Lead to Remission

There are currently a variety of treatment options that can help lead mesothelioma patients to remission. Clinical trials that offer unique medication, chemotherapy, radiation therapy, and surgery are among the many treatments offered for mesothelioma.

Surgery

Surgery holds the most promise for mesothelioma remission. During surgery, for those who qualify, surgeons remove as much of the cancer as possible.

Age, stage of the disease, and overall general health are assessed before physicians can determine which patient qualifies for surgery.

Two aggressive types of surgery give pleural mesothelioma the best chance of achieving remission:

• Pleurectomy/Decortication (P/D). During a P/D procedure, the surgeon removes the entire pleura from the chest cavity, including the tissue around the lungs and heart. They reconstruct the pleural tissue using mesh.
• Extrapleural Pneumonectomy (EPP). EPP is more aggressive and risky. It involves removing the pleural tissue and one entire lung on the side of the chest cavity where the mesothelioma originated.

All surgery comes with risks, but EPP is particularly risky. Even when completed successfully, patients face many health issues living with just one lung. It is important to weigh the risks and benefits when choosing this procedure.

Remission is more likely with peritoneal mesothelioma than pleural mesothelioma. One reason is an effective treatment called cytoreductive surgery with HIPEC.

The treatment begins with surgery to remove as much of the cancer as possible. The second step is circulating heated chemotherapy drugs throughout the abdominal cavity.

A similar treatment for pleural mesothelioma, called hyperthermic intrathoracic chemotherapy, is becoming more common.

Radiation Therapy

Radiation therapy alone isn’t too powerful when helping mesothelioma patients go into remission. However, combined with chemotherapy or surgery (known as multimodal therapy), patients have a better chance of remission.

The Role of Radiation Therapy

Radiation therapy is a well-established treatment for various types of cancer, including mesothelioma. On its own, it may not be sufficient to achieve remission. However, its effectiveness increases significantly when used as part of a multimodal approach.

• Pre-Surgery Use: Radiation can be used to shrink tumors before surgery, making them easier to remove and potentially improving surgical outcomes.
• Post-Surgery Application: After surgery, radiation helps to “clean up” any remaining cancer cells, which can further increase the chance of remission.

Effectiveness in Multimodal Therapy

While radiation therapy alone is unlikely to cause remission, its integration with other treatments has shown promising results. This combined approach, especially when paired with surgery or chemotherapy, has led to significant strides toward achieving remission in mesothelioma patients. By targeting cancer cells from multiple angles, the likelihood of remission improves, offering hope to those undergoing treatment.

Through these strategies, radiation therapy plays a crucial role in a comprehensive treatment plan, enhancing the overall effectiveness in the battle against mesothelioma.

Chemotherapy

Chemotherapy is powerful when fighting against mesothelioma, but similar to radiation therapy, a combination of treatment methods is usually the best way to achieve remission.

Chemotherapy can help boost the chances of remission by killing any cancer cells or small tumors that a surgeon could not remove.

With advancements in medical care, several strong chemotherapy medications are available today that were not available in the past.

Assessing the Effectiveness of Immunotherapy in Mesothelioma Remission

Immunotherapy has emerged as a promising treatment option for mesothelioma, particularly when surgery is not viable. This approach is gaining traction as it offers a new avenue for those battling this aggressive cancer.

FDA Approvals and Treatment Combinations

Several immunotherapy drugs, such as Opdivo, Keytruda, and Yervoy, have received FDA approval for cases where surgery isn’t an option. Notably, Opdivo and Yervoy are often used together, enhancing their impact on mesothelioma. On their own, these drugs offer a median survival extending between 18 to 20 months.

Keytruda, in particular, is often administered alongside chemotherapy. This combination aims to boost treatment efficacy and improve overall patient outcomes.

Role of Immunotherapy in Multimodal Therapy

The incorporation of immunotherapy into multimodal treatment plans is critical, as it provides a more comprehensive strategy against mesothelioma. Specialists indicate that the best chances for achieving remission could be through such combined approaches. Immunotherapy can be deployed either before or after surgical interventions in clinical settings, serving to enhance the effectiveness of the surgery.

Potential for Remission and Limitations

Much like chemotherapy, immunotherapy has the potential to lead patients into partial or complete remission. However, it’s important to note that these remissions may be temporary, often lasting only a few months. While not a definitive cure, immunotherapy offers an essential hope for extending survival times and improving the quality of life for patients.

In conclusion, while immunotherapy presents a valuable tool in the fight against mesothelioma, its effectiveness is still subject to individual patient circumstances and should be viewed as part of a broader treatment strategy.

Clinical Trials

Clinical trials are a way for scientists to test out new treatment methods for mesothelioma, as well as a way for mesothelioma patients to discover treatments that can help them get their disease under control and possibly into remission.

There are several promising novel therapies currently being explored in clinical trials. These include oncolytic virus therapy, gene therapy, and various types of immunotherapy. Among these, CAR T-cell therapy stands out as a leading option. Traditionally successful in blood cancer cases, this therapy is now showing potential for solid tumors like mesothelioma, although more research is needed to replicate those successes.

There are no guarantees that clinical trials will work. A clinical trial provides a chance for a mesothelioma patient to achieve remission with a novel therapy.

One inspiring example is mesothelioma survivor Kendra Ferreira, who found remission through participation in clinical trials. Her story exemplifies the potential benefits of exploring these cutting-edge treatments.

Some people may be hesitant to participate in clinical trials since the medications and treatment options aren’t available to the public. It’s important to remember that every treatment for every type of disease was once in its novel stages before being released to the public. This highlights the importance of considering all available options, especially for patients with advanced cancer seeking alternative solutions.

Recurrence After Mesothelioma Remission

Recurrence occurs when doctors find signs of cancer after total remission. Types of cancer recurrence include:

• Local Recurrence. This occurs when the cancer comes back to the area where it originally developed. In pleural mesothelioma, this would be a recurrence in the pleura.
• Regional Recurrence. Recurrence is regional when it develops in lymph nodes near the original cancer site.
• Distant Recurrence. This occurs when the cancer develops in another part of the body, for instance, in the bone of someone in remission from pleural mesothelioma.

In some cases, what looks like a recurrence is really a progression of the cancer. Progression is when cancer spreads or gets worse. For many patients, the cancer was probably not completely in remission, so regrowth is really a progression of the disease.

How to Reduce the Risks of Recurrence

Remission is a great achievement in mesothelioma treatment, but recurrence is likely. If you achieve remission, you can take certain steps to reduce the risk of recurrence. Just keep in mind that you will likely eventually experience a recurrence.

For the best possible chances of avoiding remission, keep all medical appointments and treat mesothelioma as an ongoing illness. Although mesothelioma can go into remission, it’s never completely cured.

To manage this disease effectively, consider the following steps:

• Regular Surveillance: Schedule and attend regular doctor appointments. Consistent monitoring through surveillance testing is crucial for catching any signs of recurrence early.
• Recognize Symptoms: Be proactive in recognizing and reporting symptoms associated with mesothelioma, no matter how minor they may appear. Immediate consultation with your doctor can make a significant difference.
• Treatment Options: If a relapse occurs, remember that treatment options like chemotherapy or immunotherapy can be restarted. Discuss with your healthcare team to determine the best course of action for your situation.

Maintain good overall health with lifestyle choices: a healthy diet, regular exercise, getting enough sleep, and managing other illnesses.

While remission may be rare with mesothelioma, it is possible. Talk to your doctors about the best treatments for you and your goals. Remember, achieving remission once means it can happen again with the support of your medical team.

Additional Help and Resources for Mesothelioma Patients

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