Ability to tolerate post-surgery mesothelioma treatment is one of the most important survival factors for elderly mesothelioma patients.
That is according to a new article in the Annals of Surgical Oncology. The article says surgery alone will not help older mesothelioma patients live longer. It says they need post-surgery mesothelioma treatments like chemotherapy to get the survival benefits of surgery.
But, as a recent mesothelioma study demonstrated, surgery can weaken some older patients. These patients may then be too fragile to have other treatments that could extend their lives.
Few Older Patients Have Post-Surgery Mesothelioma Treatment
As Surviving Mesothelioma recently reported, many mesothelioma patients over 80 get no treatment at all. In more than 60 percent of cases, mesothelioma doctors prefer to watch and wait.
About one in five elderly mesothelioma patients only have chemotherapy. Thirteen percent just have surgery. Only two percent of elderly mesothelioma patients have both surgery and chemotherapy. This is the combination that is most likely to help them live longer.
Thoracic surgeon Justin Karush, DO, of Rush University Medical Center in Chicago is the author of the new article. It explores how more elderly patients could benefit from post-surgery mesothelioma treatment.
Adjuvant Treatments Extend Lives
The rate of elderly mesothelioma patients who die after surgery is high. But this is not just because of their age. Other factors like nutritional status and overall health also play a role. Dr. Karush says the numbers do not tell the full story.
The other problem is that surgery by itself is not a recognized mesothelioma treatment. Still, in the study mentioned above, 85% of surgery patients did not have post-surgery mesothelioma treatment.
Dr. Karush says this also makes the post-operative mortality rate for older patients look high. The high death rate may make doctors leary about offering surgery to elderly mesothelioma patients.
What to Consider When Thinking About Surgery
Dr. Karush says doctors and patients should consider other factors when deciding about mesothelioma surgery.
One key factor is whether the patient is healthy enough to have both surgery and post-surgery mesothelioma treatment.
“When selecting patients with mesothelioma for surgery, it is paramount to consider the ability to offer adjuvant [post-operative] treatment,” he says.
Dr. Karush predicts that both pre- and post-surgery mesothelioma treatments will keep getting better. He expects to see advances like new drugs and new radiation strategies.
Karush, JM, et al, “How Old is Too Old to Operate for Mesothelioma?”, May 10, 2019, Annals of Surgical Oncology, Epub ahead of print, https://link.springer.com/article/10.1245%2Fs10434-019-07357-0
Verma, V, et al, “Management of Malignant Pleural Mesothelioma in the Elderly Population”, April 22, 2019, Annals of Surgical Oncology, Epub ahead of print, https://link.springer.com/article/10.1245%2Fs10434-019-07351-6