Best Option for Mesothelioma Underutilized

According to a recent study, aggressive surgery, intended to treat malignant pleural mesothelioma, is being underutilized and costing patients a significant amount of survival time.

The study was the largest of its kind, comparing the survival rates of those with aggressive surgery to that of those without. It looked at patients with all three histological subtypes of the disease (epithelioid, biphasic, and sacromatoid mesothelioma). It also looked at the median survival rate by histology with or without surgery.

The study involved 4,207 patients who met certain criteria. Out of that number, there were 2,867 with epitheloioid, 773 with sacromatoid, and 567 with biphasic disease.

Surgery Can Make a Difference

Although surgeons appear to be reluctant to perform it, surgery can make a big difference for those battling any of the three histological subtypes of the disease. The National Comprehensive Cancer Network (NCCN) has only encouraged the surgery for those battling epithelioid mesothelioma, leaving about 40 percent of patients without the option.

A radiation oncologist for the University of Maryland School of Medicine, explained that because of this, those with biphasic or sacromatoid mesothelioma are often overlooked.

Solely based on histology, those suffering from epthelioid had a median survival rate of 16.5 months, those with biphasic had 11 months, and those with sacromatoid had 7.6 months.

Less Surgeries Performed

For some years now, doctors have been increasingly moving away from performing this aggressive surgery, as they believe that the effects of it will cause more harm than good. Most patients diagnosed with the disease receive only systemic chemotherapy.

Unfortunately, mesothelioma cannot be cured. Even with surgery and removal of all visible tumor cells, it will still almost always return with a vengeance. Because of this, and the risks involved in surgery, it has been removed as a recommended treatment.

When considering whether surgery is an option, physicians look at age, overall health, stage and lymph node involvement, stage and progression of the cancer.

Cancer centers with mesothelioma experience are more likely to recommend surgery than those without. A specialty center is more likely to recommend surgery than a thoracic oncologist who rarely sees any mesothelioma patients and may not be as familiar with the complexity of the disease.

The Three Surgical Options

• Extrapleural Pneumonectomy (EPP) – Usually used in those with stage 1 or 2 pleural mesothelioma. It is the complete removal of the affected lung, pleura, and a part of the diaphragm.
• Pleurectomy/Decortication (P/D) – This is a removal of the lung’s lining and any visible tumors. This is commonly used for those with stage 1 pleural mesothelioma.
• Cytoreduction with HIPEC – This is the removal of the lining of the abdomen, called the peritoneum. This is often done in combination with heated intraoperative chemotherapy (HIPEC).

Another study looked at the results of those who received surgery from high-trafficked centers, usually academic institutions. It found that these patients experienced fewer complications, less time in the hospital, lower 30-day readmission rates, and better overall survival rates.

There are many different doctors who specialize in various types of surgery. It is always a good idea to seek out a second opinion concerning your options.

Pennsylvania Mesothelioma Lawyers at Brookman, Rosenberg, Brown & Sandler Help People Suffering from Mesothelioma

If you or a loved one have been diagnosed with mesothelioma, you deserve a lawyer who will fight for what it is that you deserve. The Pennsylvania mesothelioma lawyers at Brookman, Rosenberg, Brown & Sandler have experience helping victims of mesothelioma. For a free consultation call 215-569-4000 or contact us online.