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.
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]