Italian cancer researchers have released new data on how patient location impacts mesothelioma therapy in the country.
Pleural mesothelioma is a rare cancer. Most doctors see very few cases in the course of their careers. This lack of expertise may explain why the preferred treatments vary from one region to the next.
Italy’s Scientific Institute for Research, Hospitalization and Healthcare led the new research. They analyzed pleural mesothelioma outcomes across the country. The conclusion is that location impacts mesothelioma therapy in Italy because there is not enough sharing of information.
Choosing a Mesothelioma Treatment Approach
Pleural mesothelioma is challenging to diagnose and even more difficult to treat. Even experienced mesothelioma doctors often struggle to know the best way to approach it.
Mesothelioma is caused by exposure to asbestos and can take many years to develop. By the time most patients receive a diagnosis, the disease may already be advanced. Advanced mesothelioma is less responsive to treatment.
How location impacts mesothelioma therapy depends on the experience of doctors in the region. Providers are likely to come back to the treatments they know, especially when dealing with an unfamiliar disease.
Another problem is that even experts disagree about the best therapy for mesothelioma. Some doctors advocate surgery first. Others prefer chemotherapy. Some physicians recommend radiotherapy, too. Most mesothelioma patients receive some combination of these.
How Location Impacts Mesothelioma Therapy
To determine how location impacts mesothelioma therapy, researchers analyzed 2,026 cases diagnosed between 2003 and 2008. They pulled the cases from 26 cancer registries covering 70 percent of Italy.
They discovered big differences in mesothelioma treatment in different areas of the country.
“Patients from Piedmont, Liguria and Campania were more likely to receive no cancer-directed therapy; those living in Tuscany and Sicily were more likely to get surgery; patients from Marche and Lazio were more likely to receive chemotherapy,” writes first author Annalisa Trama. “These differences were not explained by age, sex, stage, histology and availability of a thoracic surgery department.”
The researchers conclude that “limited expertise” is the main reason that location impacts mesothelioma therapy in Italy. They say doctors from different regions do not share best practices with each other. The result is unequal access to treatment
Location impacts mesothelioma therapy in the US, too. Several studies suggest that mesothelioma patients who get care at a major cancer center have better outcomes. These centers tend to have experience with mesothelioma and be familiar with current therapies.
Trama, A, et al, “Treatment patterns among patients with malignant pleural mesothelioma: An Italian, population‐based nationwide study”, May 4, 2020, Thoracic Cancer, Epub ahead of print, https://onlinelibrary.wiley.com/doi/full/10.1111/1759-7714.13456