Malignant pleural mesothelioma is a type of cancer that develops from the thin layer of tissue that covers many of the body’s internal organs.
Mesothelioma is a difficult disease to study on a global scale for many reasons. Yet, there has been tremendous progress in mesothelioma research over the last decade.
However, current cancer guidelines are fragmented. An editorial in the Annals of Oncology recommends that new guidelines need to focus on both global and gender perspectives.
Shifting Timeframes Make it Difficult to Study Mesothelioma
Cases of mesothelioma are rising in some countries and falling in others. This makes it difficult to study the disease on a global level. There are a few different reasons for this global variation.
First, different countries implemented asbestos bans at different times. Although asbestos use has mostly been banned, mining to export asbestos continues in developing economies. This means that mesothelioma is still an active developing disease in some countries. While others are working hard to eliminate the disease permanently.
Second, it takes a very long time from asbestos exposure to the diagnosis of mesothelioma. The long period between exposure to mesothelioma presentation can be up to four decades. This timeframe also makes it hard to study the disease.
These two different factors make it tricky for doctors to study the disease. It also helps to explain why the number of mesothelioma cases is different across the globe.
The Value and Creation of Standard Cancer Care Guidelines
Cancer care guidelines provide doctors with evidence-based decision-making. These guidelines provide recommendations for diagnosis, treatment, and follow-up care.
Guidelines give recommendations based on good practice and the most recent scientific evidence. They provide the best diagnostic methods. And they help doctors choose the best combination of therapies.
New data related to mesothelioma care are always being published. The number of mesothelioma clinical trials has risen lately. This means more and more doctors are studying the disease.
These cancer guidelines also help to understand maintenance therapy and personalized treatment options.
When guidelines are created, they use specific and universal standards. These standards are both the level of evidence and the ESMO-Magnitude of Clinical Benefit Scale (MCBS). This helps doctors judge the value of the recommendations in a standardized way.
Are the Current Cancer Guidelines Outdated?
The last standardized cancer guidelines were published in 2015. Since that time, new treatments have been found and new data has been published. Doctors have learned more about the disease. Despite the difficult timeframes and number of cases, we are making progress.
There have been meaningful improvements in mesothelioma treatment strategies. And yet, the cancer guidelines have not yet been updated.
One of the goals of guidelines is to give care recommendations according to scientific evidence. But sometimes evidence and recommendations are not aligned with daily clinical practice. This is especially true when guidelines are trying to address different countries.
Europe’s Beating Cancer Plan for 2022: Global and Gender Perspectives
One movement coming out of Europe shows hope. There is a new 2022 Beating Cancer Plan in Europe. This will include a legislative proposal to further reduce workers’ exposure to asbestos.
This policy would lead to the reduction of mesothelioma in males. But it is unlikely that women would get the same benefit because of the focus on workers. An editorial in the Annals of Oncology recommends that legislation needs to focus not only on workers. New laws should focus also on environmental and familial asbestos exposure.
There is now a call to action in the medical community for new cancer guidelines. These new guidelines need to focus on both global and gender perspectives.
Remon, J., Hendriks, L. E. L., & Bironzo, P. (2022). Malignant pleural mesothelioma: new guidelines make us stronger for defeating this disease. Annals of Oncology, 33(2), 123-125. https://doi.org/10.1016/j.annonc.2021.11.019