Long-Term Mesothelioma Survival: Follow-up is Critical
A newly published French case report is a reminder that long-term mesothelioma survival requires long-term follow-up.
The case comes from Aix-Marseille University in Marseille. In the Annals of Medicine and Surgery, doctors wrote about a man who survived mesothelioma for 14 years. In all that time, his cancer did not progress.
The situation is unusual for mesothelioma. The life expectancy of most mesothelioma patients is about 18 months. Prolonged survival is two years or more. But the authors of the new report say their case shows that long-term mesothelioma survival is not impossible with the right approach.
Treatment for Malignant Mesothelioma
Malignant mesothelioma usually occurs in people who have lived or worked around asbestos. Many do not know they have it until it is very advanced. Advanced cases are harder to treat. The first key to long-term mesothelioma survival is to get a diagnosis as early as possible.
Chemotherapy with Alimta is usually the first treatment for mesothelioma. But it is not a cure for most people. Most long-term survivors have a combination of treatments or “multimodal” treatment.
The most common multimodal approach to mesothelioma includes chemotherapy, surgery, and radiology. Chemotherapy poisons mesothelioma cells. Surgery removes visible signs of disease. And radiotherapy scrambles the DNA inside cancer cells so they cannot replicate.
Researchers around the world are still trying to figure out the best combination of these for long-term mesothelioma survival.
French Patient with Long-Term Mesothelioma Survival
The man in the French case report had epithelial mesothelioma. This mesothelioma subtype tends to be most responsive to treatment. The man underwent multimodal mesothelioma treatment. His doctors removed his mesothelioma tumor and one of his lungs in a procedure called extrapleural pneumonectomy (EPP).
EPP is the most radical and controversial mesothelioma surgery. It carries a high risk of complications. Many surgeons believe the risk is too high. But some studies suggest that EPP is the best way to achieve long-term mesothelioma survival.
After surgery, the French patient had chemotherapy and radiotherapy. The goal was to kill any remaining cells and prevent mesothelioma recurrence. Doctors followed the patient’s progress for 14 years. There were no additional tumors during that time. They say the case shows that follow-up is critical.
“This case illustrates that despite being an aggressive disease, multimodal management including radical surgery may allow a prolonged response in MPM but requires a whole-life surveillance,” writes lead author Julien Guinde.
Characteristics of Mesothelioma Survivors
Previous studies show the longest-living mesothelioma survivors have several things in common. The following characteristics are associated with long-term mesothelioma survival.
- Under age 60
- Surgery (Survival is similar between EPP and PD)
- Epithelioid mesothelioma
- Some amount of chemotherapy
- No cancer in the lymph nodes
Women tend to experience long-term mesothelioma survival more than men.
Some of the longest-living mesothelioma survivors also use alternative therapies. The world’s longest-living survivor, Paul Kraus of Australia, has used herbs, supplements, meditation, and a healthy diet to survive for more than two decades.
Sources:
Guinde, J, et al, “Prolonged survival after multimodal therapy for pleural mesothelioma: Don’t give up the follow-up. A case report”, Annals of Medicine and Surgery, November 11, 2020, pp. 442-444, https://www.sciencedirect.com/science/article/pii/S2049080120304623?via%3Dihub
Nakas, A & Waller, D, “Predictors of long-term survival following radical surgery for malignant pleural mesothelioma”, January 30, 2014, European Journal of Cardiothoracic Surgery, Epub ahead of print.
