Malignant mesothelioma is so rare that it presents a challenge for many physicians. It is not uncommon for doctors never to have seen a patient with the disease and, if one is diagnosed, to be unfamiliar with the appropriate course of treatment. In response to this and to refresh available information for others, two researchers from the Icahn School of Medicine at Mount Sinai in New York have published updated guidance for the treatment of patients with the rare and fatal asbestos-related cancer.
Report Highlights Challenge of Staging Mesothelioma
Writing in the August journal Surgical Oncology Clinics of North America, Drs. Andrea S. Wolf and Raja M. Flores point to staging systems previously used to craft mesothelioma treatment, as well as the limitations imposed by those systems only having been used for surgical patients or by using the same system used in lung cancer. Dr. Wolf told MedPage Today, “The best staging system would generate discrete categories of patients whose survival differs, and that is not what we’ve seen with historic systems.”
The result of the disease’s aggressiveness and limited effective treatment has been a mortality rate that leaves only 47% of mesothelioma patients alive one year after their diagnosis, and a five-year survival rate of only 10%. Roughly 2,600 mesothelioma patients die every year, with the disease impacting 1.6 per 100,000 men and .04 per 100,000 females. This difference is likely due to the greater degree of asbestos exposure that men have faced on the job.
Report Presents Data on Surgical Approaches for Mesothelioma
The researchers included an updated analysis of data on different surgical approaches in their report, including extrapleural pneumonectomy and radical pleurectomy/decortication, as well as an assertion about the importance of pre-operative staging. This staging should include PET CT scans in order to assess whether the disease has metastasized, as well as endobronchial ultrasound or mediastinoscopy to determine whether the disease has spread to the mediastinal lymph nodes and chest MRI where there are indications of disease spread to other areas.
The updated guidance presents prognostic characteristics that favor surgery and indicates that the more radical pleurectomy decortication “is the preferred operation for these patients,” as well as nonsurgical therapies including chemotherapy, photodynamic therapy, radiotherapy and immunotherapy.
If you or someone you love has been diagnosed with malignant mesothelioma, you need the most current information available. For access to more resources, contact the Patient Advocates at Mesothelioma.net at 1-800-692-8608.