A diagnosis of malignant mesothelioma is heart-wrenching. The rare asbestos-related disease is always considered fatal and is extremely fast-moving and aggressive. This leaves patients and their families with a difficult decision: should they ask physicians to prolong survival at all costs, or opt for hospice and palliative therapies that focus on quality of life?
Study Shows Immunotherapy May Play a Role in Mesothelioma Patients’ Decisions
In the last several years, medical organizations have encouraged physicians to discontinue the use of systemic anti-cancer therapies at the end-of-life, and to encourage patients with aggressive cancers like mesothelioma to explore palliative care and hospice enrollment. But a study published in Jama Oncology reveals that is not what’s been happening.
The study, written by researchers from Yale Cancer Center, found that instead of suggesting patients consider comfort and quality of life, clinicians are replacing the use of chemotherapy with immunotherapy, and that patients are pursuing aggressive protocols up until their last days.
Aggressive Treatment vs Earlier Palliative Care for Mesothelioma
Though the study did not specifically mention mesothelioma, it relied on a national electronic health record database to identify the treatments used on adult patients with cancer who died within four years of diagnosis. The researchers found that over the study period, rates of treatment within 30 days of death among all cancer types combined did not change, with similar trends seen within 14 days of death. What did change was the treatment itself: chemotherapy was replaced by increased use of immunotherapy.
Speaking of the group’s findings, Kerin Adelson, MD, Associate Professor of Medicine (Medical Oncology), Chief Quality Officer and Deputy Chief Medical Officer for Smilow Cancer Hospital, and senior author of the study said, “Over the last decade, the landscape of systemic anti-cancer therapy has changed dramatically following the approvals of multiple new targeted therapies. The quality measure that was developed ten years ago by professional oncology organizations focuses on reducing end-of-life chemotherapy with the goal of providing patients with earlier palliative care. It is unclear whether this has benefited the end-of-life care patients receive.”
If you or someone you love is facing a mesothelioma diagnosis, there are many tough decisions in your immediate future. For assistance and resources, contact the Patient Advocates at Mesothelioma.net today at 1-800-692-8608.
