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Palliative Care for Mesothelioma: Earlier is Not Necessarily Better

palliative care for mesotheliomaNew research suggests that palliative care for mesothelioma may be most helpful in later stages of the disease.

Scientists in the UK and Australia say there is no reason for most mesothelioma patients to be referred to a palliative care specialist when they are diagnosed.

As long as patients have access to palliative care when they need it, early referral does not seem to make much difference in quality of life.

What is Palliative Care for Mesothelioma?

Palliative care for mesothelioma aims to manage the symptoms of the disease and the treatment.

Chest pain and shortness of breath are common symptoms of mesothelioma. Mesothelioma treatment can cause fatigue, nausea, and weight loss.

Physical symptoms can cause depression or anxiety, which can make treatment harder.

A palliative care specialist offers ways to make these kinds of symptoms more tolerable for patients. Some studies show early palliative care can improve life quality for cancer patients.

Palliative Care Referral and Quality of Life

The new study focuses on the cases of 174 mesothelioma patients diagnosed between 2014 and 2016.

Patients received treatment at one of 19 UK hospitals or a large Australian hospital.

The goal was to see what role palliative care could play in how mesothelioma patients felt in the early months of their illness.

Some study subjects saw a palliative care specialist within three weeks of diagnosis. These patients had a consultation about palliative care for mesothelioma once a month.

Another group of patients had standard treatment for malignant mesothelioma. They did not get a referral for palliative care.

Both groups of patients filled out questionnaires about their health-related quality of life every four weeks.

What Difference Did Palliative Care for Mesothelioma Make?

After three months, the researchers saw no difference in health-related quality of life between the two groups of patients.

The patients who received palliative care for mesothelioma and the patients who did not had similar levels of depression and anxiety.

The palliative care did not make any difference in how the patients’ caregivers were feeling either.

The researchers concluded that there was no reason for patients to receive palliative care for mesothelioma until they need it.

“There is no role for routine referral to specialist palliative care (SPC) soon after diagnosis of malignant pleural mesothelioma for patients who are cared for in centres with good access to SPC when required,” they write.

The UK and Australia have the highest per capita rates of malignant mesothelioma in the world.


Brims, F, et al, “Early specialist palliative care on quality of life for malignant pleural mesothelioma: a randomised controlled trial”, January 19, 2019, Thorax, Epub ahead of print, https://thorax.bmj.com/content/early/2019/01/18/thoraxjnl-2018-212380

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