| | |

Mesothelioma Quality of Life Improves After Surgery

ByAlex Strauss
mesothelioma quality of life improves after surgery

New research confirms that surgery followed by HIPEC improves mesothelioma quality of life for people with peritoneal disease.

Every mesothelioma surgery carries risks and can cause serious side effects. These problems often have a negative impact on mesothelioma quality of life in the short term.

But researchers at Wake Forest University say cytoreductive surgery followed by intraperitoneal chemotherapy (HIPEC) boosts life quality for most mesothelioma patients over time.

Evolving Management of Peritoneal Mesothelioma

Malignant mesothelioma is a fast-growing cancer with a very low cure rate. Peritoneal mesothelioma accounts for about a fifth of all mesothelioma cases.

With peritoneal mesothelioma, tumors start on the membrane that surrounds the abdominal organs and can spread to other parts of the body. Fatigue, pain, and gastrointestinal problems may reduce mesothelioma quality of life.

But new surgical techniques have changed the outlook for many peritoneal mesothelioma patients. During cytoreductive surgery (CRS), doctors remove as much of the cancer as possible. CRS followed by a rinse of heated chemotherapy drugs (HIPEC) directly in the abdomen is now the gold standard treatment for peritoneal mesothelioma.

Measuring Mesothelioma Quality of Life

The Wake Forest researchers followed the cases of 46 peritoneal mesothelioma patients between 2002 and 2015. More than half of the patients were men and their mean age was just over 52. About 70 percent of the patients were functioning well before their surgery.

Patients completed a series of surveys related to mesothelioma quality of life before and after surgery. They answered questions about their mental and physical health, social functioning, and pain levels.

Patients filled out the surveys before their CRS/HIPEC procedures and again at 3, 6, 12 and 24 months afterward.

Mesothelioma Quality of Life Goes Down Before it Goes Up

The biggest take-away from the study is that mesothelioma quality of life after CRS/HIPEC surgery usually goes down before it goes up.

Patients reported worse depression three months after their surgery. But the same patients felt happier two years later than they did going in.

The same was true with physical functioning. At three months, it was worse than it had been before surgery but it was back to normal by 12 months. General health was better at 6 months than it had been prior to surgery. Emotional well-being was also better after surgery.

Surgery also had a positive impact on the length of patients’ lives. Participants had a median survival of 3.4 years and 36% of them were still alive at five years.

In a summary of their study in the Annals of Surgical Oncology, the researchers conclude that the chances of improved mesothelioma quality of life make surgery worth the risk for most patients.

“Despite the risks associated with this operation, patients may tolerate HIPEC well and have good overall QOL postoperatively,” they write.

Source:

Ali, YM, et al, “Effect of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy on Quality of Life in Patients with Peritoneal Mesothelioma”, May 8, 2019, Annals of Surgical Oncology, Epub ahead of print, https://www.ncbi.nlm.nih.gov/pubmed/31069554

Similar Posts

Doctors Describe "Concrete Therapeutic Approach" for Mesothelioma
| |

Doctors Describe "Concrete Therapeutic Approach" for Mesothelioma

ByAlex Strauss

A team of medical researchers in Italy have achieved what they are calling “excellent” tumor control and survival results in malignant pleural mesothelioma patients using a combination of surgery, chemotherapy, and radiotherapy. Caused by exposure to asbestos, mesothelioma typically spreads quickly across the lung-encasing membrane called the pleura. There is no known cure but treatments are improving. In the current prospective study, 20 malignant pleural mesothelioma patients underwent radical pleurectomy/decortication followed by high doses of radiation. After surgeons removed as much of the visible mesothelioma tumor and surrounding tissue as possible, patients received 50Gy of radiation to the effected side of their chest, delivered in 25 fractions. Regions of particular concern for mesothelioma regrowth got an extra radiation “boost” to…

Does Radiotherapy Reduce Mesothelioma Pain?
| |

Does Radiotherapy Reduce Mesothelioma Pain?

ByAlex Strauss

A new study says there is not enough evidence to support the use of radiotherapy for the treatment of pain associated with malignant pleural mesothelioma. Researchers at the University of Edinburgh in Scotland reviewed a range of past studies on mesothelioma pain and radiotherapy by searching databases that date back as far as 1974. To be eligible to be included in their review, the study had to focus on malignant pleural mesothelioma and radiotherapy given “with the intent of improving pain”. The study also had to report doses and fractionation of the radiotherapy and how the pain responded. In all, the researchers found eight studies on mesothelioma pain and radiotherapy that met the criteria. Two of the studies were prospective…

Ape Virus Shrinks Mesothelioma Tumors in Lab
|

Ape Virus Shrinks Mesothelioma Tumors in Lab

ByAlex Strauss

A virus that causes leukemia in gibbon apes may have the power to help fight malignant mesothelioma in people. Gibbon ape leukemia virus (GALV) has been tested for years as a viral vector, a carrier of therapeutic genetic information, in the treatment of various human illnesses, including cancer. A new study in Japan compared GALV with a leukemia virus derived from mice to see which carrier communicated most efficiently with mesothelioma cells. While both types of viruses replicated in most of the mesothelioma cell lines tested, the mouse-derived virus was not effective in a mesothelioma cell line called ACC-MESO-1. In this cell line, only the GALV spread efficiently both in culture and in mice that had been given human mesothelioma…

Radiotherapy for Mesothelioma: Better But Still Limited
| |

Radiotherapy for Mesothelioma: Better But Still Limited

ByAlex Strauss

A form of highly-targeted radiation therapy for mesothelioma is better than it used to be, but is still risky. That is the message of a recent article on intensity-modulated radiation therapy (IMRT) in Seminars in Thoracic and Cardiovascular Surgery. Author Kenneth E. Rosenzweig, MD, a Radiation Oncologist with Mount Sinai Hospital in New York, reviewed recent studies on IMRT and mesothelioma. He concludes that, while the “troubling toxicity” associated with IMRT when it was first introduced has not been entirely eliminated, the fact that clinicians now have more experience with it is making a positive difference for mesothelioma patients. Before targeted therapies like IMRT were available, high-dose radiation was not usually a feasible option for mesothelioma since the irregular shape…

A Second-Line Option for Mesothelioma?
| |

A Second-Line Option for Mesothelioma?

ByAlex Strauss

Although survival was not significantly extended, the chemotherapy drug vinorelbine might be a treatment option for mesothelioma patients whose cancer has returned after first-line chemotherapy with pemetrexed. A new study on vinorelbine as a second-line treatment finds that the drug is “moderately active” in mesothelioma patients who were initially treated with pemetrexed-based chemotherapy. Pemetrexed (Alimta), along with a platinum-based drug like cisplatin, is the primary first-line drug therapy for mesothelioma. But vinorelbine is gaining attention as a possible option for mesothelioma, in part because it is available in a less expensive generic form. In “Vinorelbine in pemetrexed-pretreated patients with malignant pleural mesothelioma”, the Italian authors detail the results of their study on 59 patients with unresectable pleural mesothelioma.  These patients…

Repeat HIPEC Improves Mesothelioma Survival
| |

Repeat HIPEC Improves Mesothelioma Survival

ByAlex Strauss

If one cytoreductive surgery and HIPEC procedure for mesothelioma is good, subsequent treatments may be even better. That is the central message of research conducted at the Moffitt Cancer Center in Florida. The study’s aim was to assess overall survival among peritoneal mesothelioma patients who had not just one, but two or more rounds of heated intraperitoneal chemotherapy (HIPEC) after cytoreductive surgery. The cytoreduction/HIPEC approach has become popular for peritoneal mesothelioma, a treatment-resistant cancer of abdominal membranes caused by asbestos. Cytoreductive surgery involves removing as much of the mesothelioma tumor as possible from the abdomen. Because the shape and spreading pattern of mesothelioma tumors make complete cytoreduction difficult, the surgery is often followed by a rinse with a heated solution…