From the blog

Timely Treatment for Mesothelioma Could Improve Survival

Published: December 16, 2022

It is best to treat peritoneal mesothelioma as soon as possible. Waiting to receive treatment could prevent a patient from living longer than possible. Information from a study looking at treatment start times was published in the Journal of Gastrointestinal Surgery in November. Researchers observed patients who either received treatment quickly, had a delay in receiving treatment, or had no treatment. Results of the study were presented at the annual Society for Surgery of the Alimentary Tract meeting in San Diego. The study was co-authored by surgeons and oncologists at the University of Pennsylvania, Sidney Kimmel Medical College in Philadelphia, and the University of Colorado Hospital in Aurora.

The cytoreductive surgery and hyperthermic intraperitoneal chemotherapy combination is a good treatment option for mesothelioma. A life expectancy simulator looked at 1,000 cases of peritoneal mesothelioma that either received timely treatment (fewer than four weeks from diagnosis), delayed treatment (4 to 24 weeks from diagnosis), and no treatment. The timely treatment group had a life expectancy of 5.24 years, the delayed from 4 to 12 weeks group had a life expectancy of 4.8 years, the delayed from 13 to 24 weeks group had a life expectancy of 4.37 years, and the no treatment group had a life expectancy of 2.11 years. This shows that timely treatment is extremely helpful in improving life expectancy. Three out of five patients who qualify don’t receive treatment though. This could be due to oncologists not knowing much about the benefits of treatments, which is why mesothelioma specialty treatment centers are so important.

Peritoneal mesothelioma is a rare cancer of the mesothelium that surrounds the abdominal cavity that can be caused by either inhaling or ingesting asbestos fibers. Due to the rarity of the disease, many oncologists will never see a case of mesothelioma. Peritoneal mesothelioma is typically more treatable than pleural mesothelioma, the cancer of the lining of the lungs, but both cancers do not have a cure. Doctors cannot always give a definitive diagnosis early enough, which delays treatments. Peritoneal mesothelioma symptoms are very similar to abdominal issues and can include abdominal pain, nausea, fatigue, fever, and loss of appetite. Once people are diagnosed, they usually are only treated with chemotherapy and palliative care (care that reduces symptoms.)

CRS-HIPEC is a long and complex procedure. The surgery and chemotherapy combination can last up to 12 hours. The surgery removes visible cancer cells while HIPEC is circulated around the abdominal cavity to kill any cancer cells that are not visible. The chemotherapy is circulated throughout the abdominal cavity for up to 90 minutes and then drained from the body. A study looking at this procedure could not only help peritoneal mesothelioma sufferers, it could also help doctors who want to examine the effectiveness of surgery for pleural mesothelioma.

Armaun D. Rouhi et al., “Delayed CRS-HIPEC Is Associated with Decreased Survival in Patients with Malignant Peritoneal Mesothelioma: A Markov Decision Analysis” Journal of Gastrointestinal Surgery (November 28, 2022). [Link]
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