Managing Mesothelioma During the COVID-19 Pandemic: New Guidelines

New guidance suggests that patients should continue to receive treatment for malignant mesothelioma during the COVID-19 pandemic. Two new reports include recommendations for hospitals to keep vulnerable patients safe.

COVID-19 is especially dangerous for people with lung-related cancers like pleural mesothelioma. Their immune systems are not as strong as healthy people and their lungs are already damaged. 

But two new reports suggests that it may be even riskier to put off treatment for lung cancers like mesothelioma during the COVID-19 pandemic. 

How the Virus Could Impact Lung Cancer Patients

Both of the new reports come from researchers in Pennsylvania. They focus on people with lung cancer rather than mesothelioma. But pleural mesothelioma is also a lung-related cancer. It carries many of the same risks and symptoms as lung cancer, making the guidelines relevant for mesothelioma during the COVID-19 pandemic, too. 

Even otherwise healthy people struggle to fight COVID-19. The reports say people with compromised immunity or poor lung function – such as mesothelioma patients – are even more vulnerable. Cancer treatment can make it even harder to fight off illness.

Patients undergoing treatment for mesothelioma during the COVID-19 pandemic may be tempted to delay therapy. They may see this as a way to avoid contracting the virus. But that could be a mistake. 

Managing Mesothelioma During the COVID-19 Pandemic Could be Different

The first article appears in JCO Oncology Practice. Researchers from the University of Pennsylvania write, “Although we have extensive treatment guidelines for the standard management of lung cancer…at this critical time, we may need to deviate from this standard of care as we try to balance the risk of COVID-19 and mortality from lung cancer.”

Among the suggestions could that could also apply to people with mesothelioma during the COVID-19 pandemic are:

• Continue to follow standard treatment guidelines, where possible
• Maximize physical distancing 
• Streamline workflows to account for decreased staff
• Use imaging techniques like PET or CT for staging
• Use needle biopsy instead of putting instruments into the lungs
• Minimize the number of radiotherapy visits by giving larger doses

The second report comes from doctors at Penn State Cancer Institute. They also advise minimizing face-to-face visits. They say patients should be screened for COVID-19 before having a surgery or chemotherapy. If they test positive, these treatments should be delayed. 

Just as importantly for patients managing mesothelioma during the COVID-19 pandemic, they say clinical trial enrollments should continue.

Malignant mesothelioma is a rare cancer with a poor prognosis. Clinical trials may offer the best chance of long-term mesothelioma survival.

Sources:

Singh, A, et al, “Management of Lung Cancer During the COVID-19 Pandemic”, July 2020, JCO Oncology Practice, https://ascopubs.org/doi/full/10.1200/OP.20.00286

Dingamans, AM, et al, “Treatment Guidance for Patients With Lung Cancer During the Coronavirus 2019 Pandemic”, July 1, 2020, Volume 15, Issue 7, Journal of Thoracic Oncology, https://www.jto.org/article/S1556-0864(20)30382-8/fulltext