Mesothelioma Remission: Am I Cured?

Types of Mesothelioma Remission

In the context of a cancer diagnosis, the term “remission” refers to a reduction or disappearance of signs and symptoms of the disease. For mesothelioma cancer, remission indicates that the mesothelioma is under control but not necessarily cured. Remission can be partial or complete:

• Partial remission – This occurs when there is a significant reduction in the size of the tumor or cancerous cells and a decrease in the severity of symptoms. However, some cancer cells may still be present in the body.
• Complete remission – This is when all signs and symptoms of cancer have disappeared, and no evidence of the disease can be detected using standard tests. While this is a positive outcome, it does not guarantee that the cancer will not return in the future, as some cancer cells may remain undetected in the body. 

It is essential for patients in remission to continue attending regular follow-up appointments and monitoring their health, as the cancer may recur, or new cancers may develop. The duration of remission can vary greatly depending on the type and stage of cancer, as well as the effectiveness of the treatment received.

Can Mesothelioma Be Cured?

The short answer is yes. There have been many mesothelioma patients who are considered by their doctors to be cured. However, the term cured is only used when the likelihood of mesothelioma recurrence is extremely low or virtually non-existent and the patient is considered to have the same life expectancy as someone who has never had mesothelioma.

Mesothelioma spreads in a unique way from other cancers. Mesothelioma tumors are often tiny and sometimes so small they don’t show up on scans. Stray mesothelioma cells can also hide in crevices of body cavities or on organs, which doctors cannot see. These cells can lay dormant for years and begin spreading again, which is why mesothelioma remission doesn’t necessarily mean the patient is cured.

The point at which doctors declare a patient “cured” rather than in “complete remission” depends on various factors, including the type and stage of cancer, the effectiveness of the treatment, and the patient’s overall health.

Generally, doctors are cautious about using the term “cured” and may prefer to use “complete remission” or “no evidence of disease (NED)” for an extended period. 

In many cases, doctors will consider a patient cured after a specific period of non-recurrence, often five years or more. This period varies depending on the type of cancer and its likelihood of recurrence; therefore, your doctor may not be willing to state that you are cured of your mesothelioma for six or more years without recurrence of the disease. 

“Since going through P/D surgery in 2015, I’ve had eight years of clean CAT scans, but my doctor still won’t say I’m ‘cured’ when discussing the status of my mesothelioma,” said Gary M., a mesothelioma survivor. “He just keeps saying that the scans look good, there are no signs of recurrence and I’m still in remission. Personally, I don’t want to tempt fate by thinking I’m cured, but it would be comforting to hear my doctor say it, although I understand his reluctance.”

It is important to note that even after being considered cured, patients should still attend regular follow-up appointments and maintain a healthy lifestyle, as there may still be a risk, albeit a very small one of recurrence.

Stories of Mesothelioma Remission 

The goal for all mesothelioma patients is to achieve remission of their disease. Although mesothelioma typically has a short prognosis compared to other types of cancer, many patients have beat the odds and achieved remission. Read stories of how mesothelioma survivors have reached remission in our mesothelioma survivors section.

Which Treatments Offer the Best Hope of Mesothelioma Remission?

Mesothelioma survivors attribute many different treatments to the remission of their cancer. These treatment options range from surgery to successful clinical trials testing new therapies or combinations.

The treatment for mesothelioma offering the greatest chances of complete, long-term remission is surgery, especially when used in combination with immunotherapy, chemotherapy or radiation. 

Chemotherapy and immunotherapy are the next best options. They can be given before or after surgery or as a stand alone treatment when surgery isn’t possible. Some clinical trials are testing the combination of chemotherapy and immunotherapy to offer the best of both treatments. Both can create partial remission for patients and extend their lives by precious and meaningful months.

Radiation therapy alone rarely promotes remission. It has little effect on life expectancy and is typically reserved for the most advanced diagnoses. Radiation is often part of a palliative treatment to slow the growth of cancer and relieve patients of symptom pain and breathing difficulty.

Mesothelioma Remission Chances by Treatment

• Surgery: Most successful. All visible tumors are physically removed from the body.
• Chemotherapy: Moderate success. Chemotherapy kills cancerous cells but can damage healthy cells.
• Immunotherapy: Moderate success. Immunotherapy enhances the immune system to work more effectively in fighting cancer while not injuring healthy cells and tissues.
• Least successful. On its own, radiation therapy helps to slow the growth of cancerous cells, but can also harm healthy tissue.
• Circumstantial. The type of clinical trial and success leading to remission is based on each case, such as cell type, stage, age and treatment history.

Surgery for Mesothelioma Remission

Surgery has the best odds of leading to remission of mesothelioma. During mesothelioma surgery, most or all of the tumors are removed improving the chance of complete remission, in most cases, with the help of other treatments like chemotherapy and immunotherapy.

There are three surgeries for mesothelioma. Each initiated a move towards remission in many patients and has produced survivors. They are:

• Extrapleural pneumonectomy (EPP) for pleural mesothelioma
• Pleurectomy/decortication (P/D) for pleural mesothelioma
• Cytoreductive surgery with HIPEC for peritoneal mesothelioma

The average life expectancy of mesothelioma patients is 12-16 months, though survival times are improving. Surgery survival times are considerably better since most tumors are removed, reducing the risk of metastases.

Some patients who had an EPP survive upwards of 19 months, P/D patients live for 2-3 years, and those having cytoreductive surgery with HIPEC often live 3-5 years after the procedure.

Chemotherapy for Mesothelioma Remission

Chemotherapy for mesothelioma has come a long way since its initial development. There are several new chemotherapy drugs and drug combinations that have a strong effect on mesothelioma tumors. The two main chemotherapy drugs are cisplatin and pemetrexed (Alimta). Carboplatin, vinorelbine and gemcitabine are alternatives.

Patients often have partial remission from chemotherapy, but the tumors eventually grow resistant to the drugs. Remission only lasts several months for most patients.

Furthermore, the inception of intraoperative chemotherapy with surgery has produced promising results for mesothelioma remission, especially for people with peritoneal mesothelioma.

Immunotherapy for Mesothelioma Remission

Immunotherapy is the newest FDA-approved treatment for mesothelioma. Opdivo and Yervoy are approved for unresectable mesothelioma. These are cases that cannot be treated with surgery.

Opdivo and Yervoy for mesothelioma have a median survival of 18-20 months when used on their own. Opdivo is the brand name for nivolumab, and Yervoy is the brand name for ipilimumab. Other immunotherapy drugs are Keytruda (pembrolizumab) and Imfinzi (durvalumab).

Immunotherapy is also an option in clinical trials before or after surgery. Mesothelioma specialists believe the best chance of achieving cancer remission is with multimodal therapy. Immunotherapy is a useful part of multimodal treatment plans. When surgery removes the tumors, immunotherapy can prevent the cancer from returning.

Similar to chemotherapy, immunotherapy can lead to partial or even complete mesothelioma remission. However, the remission often only lasts a few months.

Radiation Therapy for Mesothelioma Remission

Radiation therapy is another traditional treatment method for all types of cancer. Unfortunately, on its own, radiation therapy is unlikely to cause mesothelioma remission. However, multimodal therapy that combines radiation therapy with surgery or chemotherapy has shown significant strides toward causing remission in mesothelioma patients.

Novel Therapies and Clinical Trials for Mesothelioma Remission

While novel treatments generally require more research and testing to fully realize their potential, there are several current clinical trials offering novel treatments to patients. These novel therapies include oncolytic virus therapy, gene therapy and types of immunotherapy.

CAR T-cell therapy is one of the leading cell and gene therapies in clinical trials for mesothelioma. CAR T-cell therapy has led to complete remission and long-term survival for blood cancer patients. This therapy has yet to duplicate the success for solid tumors like mesothelioma. However, the breakthroughs in blood cancers mean there is a possibility of achieving complete mesothelioma remission for some patients.

At some point, even the most trusted treatment methods were being researched and tested in trials, so patients shouldn’t limit themselves to traditional treatments if their cancer is advanced and a novel treatment in a study holds the possibility of remission.

Mesothelioma survivor Kendra Ferreira participated in clinical trials responsible for the remission of her disease. If you have been diagnosed with mesothelioma and are exploring treatment options, a clinical trial may be a treatment option that may provide remission.

Recurrence After Mesothelioma Remission

Reappearance of mesothelioma after remission is an unfortunate but real possibility. Therefore, chronic diseases like mesothelioma should be treated as an ongoing disease requiring constant management. This ongoing treatment and constant management means regular surveillance testing, doctor appointments, and possibly restarting chemotherapy or immunotherapy treatments.

You or a family member with mesothelioma should be diligent about checkups and recognizing symptoms associated with this cancer. If a relapse occurs, this doesn’t mean all hope is gone. Any patient who achieved remission once can do it again with the help of mesothelioma doctors, nurses and cancer center staff.

Contact our team for help finding a mesothelioma cancer center or specialist to learn more about mesothelioma remission. We can also help if you’ve had a recurrence. Reach out to patient advocate Karen Ritter, who is a registered nurse, by email at karen@mesotheliomaguide.com. You can also contact her with this link to send a message directly to her or another patient advocate.