Patients with metastatic mesothelioma are in the late and final stages of the disease. Metastasis means that the cancer has spread from its original location to other areas of the body. Treatment options are much more limited once mesothelioma tumors have metastasized. Sadly, that impacts many patients because they are not usually diagnosed with mesothelioma until the disease is in its advanced stages.
Patients face a grave prognosis, with a median survival time of less than 12 months from the time of diagnosis. There is no known cure for the disease. However, treatment may help prolong life and increase comfort for patients.
If you or a loved one has been diagnosed with metastatic mesothelioma, you should know that there is financial compensation available to help with the cost of treatment and related expenses.
How Does Mesothelioma Metastasize?
Mesothelioma originates in the tissues lining the lungs, abdomen, heart and/or testicles. However, once the cancer metastasizes, it’s possible for secondary tumors to develop anywhere in the body.
Metastasis usually begins locally, near the area of the original tumor. The cells then spread into distant tissues, organs and lymph nodes via the lymphatic system or bloodstream. Once the cells invade those healthy body structures, a process called angiogenesis begins.
Angiogenesis is the formation of new blood vessels. This is a key part of metastasis because tumors need a consistent blood supply in order to grow. Researchers are currently testing whether an antibody called bevacizumab can prevent angiogenesis from occurring in cancer patients. Other drugs, called angiogenesis inhibitors, are also being used to cut off the blood supply to tumors.
Stages of Metastatic Mesothelioma
Doctors diagnose mesothelioma and other cancers by stages. Staging is important because knowing the patient’s stage of cancer will guide doctors in developing a treatment plan.
There are 4 stages of malignant mesothelioma:
- Stage 1: The tumor is localized on one side of the body with no signs of metastasis.
- Stage 2: The primary tumor has grown and spread to other nearby tissues and organs.
- Stage 3: Mesothelioma is present throughout one side of the body and possibly the lymph nodes.
- Stage 4: The asbestos cancer has metastasized into the lymph nodes and well as nearby and distant organs. Both sides of the body may be involved.
Currently, the only formal staging system is used for pleural mesothelioma. The Tumor, Nodes and Metastasis System (TNM) system determines the stage by looking at:
- T: The primary tumor’s extent throughout the body.
- N: How many lymph nodes show signs of mesothelioma.
- M: How far the tumor has metastasized to other regions.
The TNM system is the most widely used for diagnosing peritoneal mesothelioma as well. Some doctors use the Peritoneal Cancer Index (PCI) to score the disease and assign a stage, although this method is not recognized as a universal standard by the American Joint Committee on Cancer. There is no staging system to describe pericardial or testicular mesothelioma because cases are so rare.
Because the stage of the cancer a is key in dictating treatment decisions, patients should consider a getting second opinion. Another doctor might find that a patient is in an earlier stage than previously thought, making more aggressive treatments possible.
Factors Influencing the Rate of Metastasis
This cancer develops in or near some of the body’s most vital organs. As a result, even local metastasis can cause patients to decline rapidly. Doctors may be able to provide a general idea of life expectancy for patients upon diagnosis. Some of the factors influencing the rate of metastasis for people with mesothelioma are:
- Stage: Patients with Stage 3 or Stage 4 mesothelioma have fewer treatment options than people who are diagnosed early.
- Cell type: Mesothelioma tumors are made up of epithelioid, sarcomatoid or biphasic cells. Epithelial cells respond best to treatment. Sarcomatoid cells spread rapidly and are more difficult to treat. Biphasic tumors are made up of both epithelial and sarcomatoid cells. The prognosis is better if epithelioid cells are dominant in biphasic tumors.
- Treatment: Doctors often use a combination of surgery, chemotherapy and radiation therapy to attack the cancer. But patients in the late stages of the disease may not be able to withstand aggressive methods. In those cases, oncologists might use those same methods palliatively, with the goal of reducing pain by preventing tumor growth.
- Age and overall health: Patients who are younger and generally in good health are better candidates for aggressive treatments. Because of mesothelioma’s long latency period (15-60 years), most patients are not diagnosed until their 60s or later. However, mesothelioma has been found in younger adults and even children.
- Sex: Women respond better to mesothelioma treatment than men. Almost half of women with mesothelioma live for 1 year after diagnosis and more than 10 percent live for a decade.
It’s not always clear when metastasis begins. Patients may report new or worsening symptoms that gives doctors a clue that the mesothelioma has metastasized. Another sign is the development of symptoms not commonly associated with asbestos cancer. Doctors will use imaging and other medical tests to monitor the progression of the disease.
Once mesothelioma metastasizes, the cancer could spread to anywhere in the body. The location of the initial tumor gives oncologists an idea of what organs are likely to be involved.
Patients with metastatic pleural mesothelioma may find the cancer has invaded organs and areas of the body such as the:
- Adrenal glands
- Chest wall
- Lymph nodes
Mesothelioma of the peritoneum may spread to the:
- Tissues covering the small intestine and colon
- Adrenal glands
Less is known about the spread of pericardial mesothelioma because it is so rare. Some studies suggest that the disease spreads through the heart and pulmonary artery to area such as the lungs, abdominal cavity and chest wall.
Metastatic mesothelioma rarely impacts the brain. But recent studies have shown that the disease also metastasizes to uncommon locations such as the bone marrow, meninges (the membranes lining the skull and spinal cord), skin and even the tongue. Researchers in a 2017 study published in the Journal of Oncological Sciences cautioned that physicians should always be on the lookout for unexpected metastases of malignant mesothelioma.
In addition, scientists are learning that mesothelioma metastases may occur at some sites more frequently than previously thought. For example, cases of bone metastases have rarely been documented among patients with mesothelioma. But a recent study that reviewed clinical data from 165 asbestos cancer patients from 1992 to 2016 found significantly more cases of lytic bone metastases than expected. Results like these may help doctors develop new protocols to monitor their patients with mesothelioma.
Signs that mesothelioma is beginning to spread may be difficult to detect. Because mesothelioma metastasizes locally at first, patients may only notice that their existing symptoms are getting worse. As the cancer spreads to distant areas of the body, new or unusual symptoms may indicate that other organs are involved.
Signs of mesothelioma cancer include:
- Shortness of breath
- Fluid buildup
- Difficulty swallowing
- Chest pain
- Night sweats
- Coughing up blood
- Unexplained weight loss
- Abdominal pain
The emergence of new symptoms that are not typically associated with mesothelioma can give doctors an idea of the location of metastasis. For example, a patient who suddenly develops jaundice may be showing signs that the mesothelioma has spread to the liver. Blood in the urine could be a sign that there is a secondary tumor on the kidneys.
Patients with mesothelioma who are experiencing new or worsening symptoms should contact their doctors immediately to evaluate whether the disease could be advancing into a later stage.
Unfortunately, treatment options for mesothelioma patients in the late stages of cancer are limited. By Stage 3 or Stage 4, the disease has likely progressed too far for curative surgery to be a realistic option. Chemotherapy or radiation may still be used palliatively to relieve discomfort, but more aggressive approaches are not often possible in the patient’s deteriorating condition.
It’s important to understand that palliative care is not the same as hospice care. Palliative care is a form of treatment that doctors perform in an effort to prolong life. Hospice care begins when all medical treatment stops.
For patients, palliative care could involve a combination of therapies and procedures, including:
- Pleurodesis: Sealing the pleural area to prevent fluid build-up
- Pleurocentesis or thoracentesis: Removing excess fluid from the chest cavity
- Paracentesis: Removing fluid from the abdominal cavity
- Pericardiocentesis: Removing fluid build-up from the pericardial sac around the heart
- Hydrocelectomy: Removing fluid that causes swelling around the scrotum
- Chemotherapy: To kill cancerous cells and improve quality of life
- Radiation therapy: To shrink the tumors and increase comfort in the affected areas
Palliative care can still result in harsh side effects for patients with metastatic mesothelioma. However, the intent is to keep the side effects manageable so that patients can enjoy the remaining time with their friends and families.
Patients sometimes opt for alternative therapies alone or in conjunction with conventional medical care. Alternative treatments are intended the treat the whole patient — mind, body and spirit. A holistic approach aims to strengthen a patient’s body and immune system to fight mesothelioma.
Some examples of alternative treatments include:
- Acupuncture: Acupuncturists apply thin needles at strategic locations in the body to stimulate the nerves and muscles to fight disease. According to the National Cancer Institute, some evidence suggests that acupuncture may be successful in alleviating the nausea and vomiting associated with chemotherapy.
- Meditation: Researchers are investigating how a patient’s mindset can play a role in cancer progression. One study used a mindfulness-based cancer recovery (MCBR) program developed by the Massachusetts Medical Center to evaluate the impact of stress relief interventions (including guided meditation) on the cellular activity of breast cancer patients. It found that the length of participants’ telomeres ― a protein at the end of chromosomes that plays a role in cellular aging — were longer than in patients who did not participate in MCBR and other stress reduction programs. Shorter telomeres have been linked to cellular malfunction and a heightened risk of diseases like cancer.
- Homeopathy: In homeopathy, patients take diluted amounts of natural substances that produce symptoms similar to the disease it is trying to cure. The National Institutes of Health reports that there is insufficient evidence to support homeopathic treatments as an effective medical treatment. It also warns that some of treatments could cause harmful side effects or drug interactions. It is important to talk to a doctor before trying homeopathic remedies as a complementary treatment.
- Vitamins and herbal supplements: Vitamins can be a healthy choice for anyone. But according to the American Cancer Society, some vitamins ― especially in large doses — have been shown to increase the risk of developing cancer. It also cautions that many herbal supplements that are marketed as “natural” are not approved by the U.S. Food and Drug Administration and may not contain the substances marked on the labels.
Maintaining a healthy diet and exercise program can also help strengthen the body to fight cancer. However, it’s essential for patients to talk to their doctors about what types of nutrition and activity are appropriate given their conditions.
Life Expectancy for Patients with Mesothelioma
Unfortunately, there is no cure for mesothelioma. However, early detection makes a considerable difference when it comes to survival times for patients with the disease. The American Cancer Society reports that the median survival time for patients in the early stages of pleural mesothelioma (the most common form of the disease) is 21 months after diagnosis.
Survival times get shorter as the cancer becomes more advanced. Patients with Stage 3 mesothelioma may live longer than the average of 1 year if they are candidates for surgery and respond well to post-operative therapies.
The median survival time for Stage 4 patients with mesothelioma is 12 months, depending on how well the treatment is working. Sadly, the cancer is expected to spread rapidly at this stage, even with ongoing palliative care.
Legal & Financial Help
Mesothelioma is an aggressive cancer that requires immediate treatment. But it is an expensive disease to treat, often requiring a multi-modal approach in order to achieve the best possible prognosis.
The only known cause of this cancer is asbestos exposure. Most patients were exposed to asbestos fibers while working in certain industries and the military. Disturbingly, some of the companies that manufactured asbestos were aware of the health risks but did not inform the public of the dangers. All patients who have been diagnosed with asbestos cancer should contact an attorney to learn about their eligibility for compensation.
Financial relief for this diagnosis could come from several sources. Some asbestos companies went bankrupt and were required to create asbestos trust funds to pay victims for their losses. Patients may be able to file a trust fund claim to obtain the compensation they deserve.
It is also possible for the patients to file personal injury lawsuit against the company responsible for their asbestos exposure. Families can pursue a wrongful death claim if a loved one has died from this disease. Because the life expectancy for patients is so short, many settlements can be reached within 30 days.
In addition, victims suffering may be eligible for Social Security disability benefits, veterans’ benefits or workers’ compensation benefits.
Compensation can cover losses such as:
- Current, past and future medical costs
- Any travel expenses for treatment
- Lost wages and lost earning capacity
- Pain and suffering
- Funeral and burial expenses in wrongful death claims
Talking with a knowledgeable attorney gives patients a chance to learn about their legal rights and options. A top rated mesothelioma lawyer will identify the company or companies responsible for a patient’s mesothelioma diagnosis by reviewing his or her employment history, military service records and any other relevant documentation.
Working with a top-rated mesothelioma attorney is the best way to hold asbestos companies accountable for their negligence. A lawyer with a track record of success in handling mesothelioma cases can build a strong and solid claim for compensation. A seasoned lawyer also knows how devastating a cancer diagnosis can be for patients and their families and will be a compassionate advocate for full and fair compensation.
If you are ready to speak with a dedicated mesothelioma attorney about your right to compensation, contact us today for a free consultation with no obligation. It costs nothing to get a thorough case review, but the benefits for you and your family could be life-changing.
Download Your Free Patient’s Guide to Mesothelioma
When you and your family are coming to terms with a mesothelioma diagnosis, it can be difficult to know where to get the best guidance. Let the team at Mesothelioma Help assist you. Our free guide to mesothelioma can provide important information such as:
- Legal support from one of the nation’s top mesothelioma attorneys
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- A guide to mesothelioma medical centers, doctors and treatment facilities near you
- Suggestions on reputable sources of information about mesothelioma and other asbestos-related diseases
Journal of Clinical Oncology