A mesothelioma diagnosis can be grim and have life-long
impact on the patients and family. The aggressive nature and the late diagnosis
of the disease make it difficult to treat. The average life expectancy after
initial diagnosis is on average one year, but with treatment – especially
multimodality treatments – patients can live much longer. However, a study
published in the Annals of Thoracic
Surgery noted a disparity in overall survival of mesothelioma that can be
attributed to patients choosing not to receive any treatment at all.
Conventional treatments for mesothelioma are as follows:
- Surgery (taking out the cancer)
- Radiation therapy (using high-dose x-rays or
other high-energy rays to kill cancer cells) - Chemotherapy (using drugs to fight the cancer)
The American Society of Clinical Oncology and the National
Comprehensive Cancer Network recommends the multimodal approach, which is a
combination of surgery, chemotherapy, and radiation treatments for those
suffering from mesothelioma. In this latest
study, 3,419 mesothelioma patients were investigated and results showed that
those who endure combination treatments have a higher chance of survival.
- Chemotherapy – 15.4 months
- Surgery and chemotherapy – 21.1 months
- Surgery, chemotherapy, radiation – 21.7 months
Unfortunately, 29.3% of those suffering did not receive any
treatment; insurance status being one of the main factors. In cases like mesothelioma,
treatment is more about extending life since there currently is no cure. Some may
not have insurance so are unable to afford treatment. Others may even be
dropped by their insurance or unable to obtain insurance because of their pre-existing
condition. Furthermore, some may refuse treatment because of the inevitable outcome
and do not wish to prolong the suffering of themselves and their loved ones. Age is also a factor when deciding on
treatment as studies have shown 41% of those who receive a mesothelioma
diagnosis and are in their 80s, refuse treatment. Facility location is an additional factor that
is taken into consideration when deciding the best treatment plan. The average
survival rate for those who refuse treatment is 10.2 months.
Scientists and researchers are continually researching new
and potentially effective treatments for those suffering from mesothelioma.
While there is still no cure, much progress has been made over the years (most
recently the first
FDA approved mesothelioma treatment in 15 years). However, if patients are
refusing treatment based upon various circumstances, treatment guidelines and overall
survival statistics will be impacted.
Source:
Fernando Espinoza, Mercado, M.D. et. al. “Disparities in
Compliance with National Guidelines for the Treatment of Malignant Pleural
Mesothelioma,” The Annals of Surgery (April 2019). [Link]