A new study of mesothelioma treatment and survival in the US contains some disturbing facts about treatment trends.
Among them is the fact that people over 70 are much less likely to get any treatment for malignant mesothelioma, a rare but but fast-growing malignancy that can be quickly fatal. In fact, nearly a third of mesothelioma patients receive no therapy at all.
The study was based on 2011 data from the National Cancer Institute’s Surveillance, Epidemiology and End REsults (SEER) database. It included 389 patients with pleural mesothelioma and 53 patients with non-pleural mesothelioma.
The researchers used statistical models to identify the factors associated with receiving mesothelioma treatment and to calculate mortality rates.
Mesothelioma Treatment and Survival
One of the most striking findings was that 29.3% of the pleural mesothelioma patients and 21.5% of the non-pleural patients received no therapy at all. Among the patients with pleural mesothelioma – the most common variety which starts on the pleural membrane around the lungs – older patients were less likely to receive therapy.
Mesothelioma is a highly aggressive cancer. Without treatment, it is typically fatal in just a few months. Including the data on both treated and untreated pleural mesothelioma patients, the researchers found that median survival was just 9 months.
The news was somewhat better for patients with non-pleural mesothelioma. The median survival for this group was 18 months.
Multi-Modal Treatment Yields Best Outcomes
As with previous studies, the new report suggests that there is no single treatment that works best for mesothelioma but, rather, that the most powerful way to attack the asbestos cancer is from multiple angles.
“Receipt of either surgery or systemic therapy and particularly the combination of these two modalities was associated with better all-cause survival,” reports researcher Lindsey Enewold in the new October issue of the journal Lung Cancer.
Among the pleural mesothelioma patients, being younger and in a lower socioeconomic bracket was associated with better overall survival. Having other health problems (comorbidities) did not appear to be linked to whether or not a patient received treatment or even their survival.
The researchers conclude that there are clear inequities in the way mesothelioma treatment is delivered in the US and that more should be done to ensure that all patients who need mesothelioma care can receive it.
Enewold, Lindsey, et al, “Patterns of care and survival among patients with malignant mesothelioma in the United States”, October 2017, Lung Cancer, pp. 102-108