Surgery is used to try and remove the tumour itself, or just to reduce pain and symptoms.
Undergoing surgery can make mesothelioma patients and their families anxious, due to potential issues that could crop up during or after the operation.
While the chance of any of these complications occurring is very low, it’s important to know about them if you or a family member is going to be undergoing surgery.
Respiratory failure occurs when the lungs are not functioning properly and cannot provide enough oxygen to the rest of the body.
This could occur for a number of reasons and may mean that the patient struggles for breath and experiences chest discomfort.
This is usually treated with oxygen therapy and medication to help support the patient’s breathing.
Blood clots can occur during any kind of surgery, although those undergoing mesothelioma treatment are more at risk because they are bed-bound for long periods of time.
Blood clots in the legs (known as deep vein thrombosis) can lead to the calves becoming swollen and painful.
This can usually be treated fairly easily with medication if it is caught early on, but if not it could lead to a pulmonary embolism.
This is where the clot breaks off from the vessel in the leg and travels up to the lungs, which is obviously much more serious.
This could cause symptoms such as difficulty breathing and coughing up blood.
To prevent blood clots from happening, patients are usually given blood thinners and compression stockings.
There are also various exercises you can perform to prevent clots from forming.
Pneumonia can sometimes occur after surgery and causes the patient to suffer from a high temperature, shortness of breath and a cough.
It is usually treated with a course of antibiotics, extra oxygen and chest physiotherapy.
After surgery, excess fluid may start to build up around the lungs. This can then lead to chest pain, shortness of breath and general fatigue.
This can, of course, be very dangerous, so doctors may use a small tube known as a chest drain to help drain the excess fluid.
What are the risks?
While it’s important to be aware of these risks, it’s also important to know that doctors and nurses do everything in their power to prevent them from happening.
For example, in the period following an operation, they will ask the patient to undergo deep breathing exercises and get out of bed to help improve their circulation as well as prescribe medication to help ward off any complications.
If you are at all worried about surgery, make sure to sit down with your doctor to discuss any worries and bring along a friend or family member so that everybody is aware of the risks, and what the doctors are doing to minimise them.Read More
New research has identified another tool which can help doctors diagnose pleural mesothelioma, a form of lung cancer caused by long term exposure to asbestos.
A team of mesothelioma specialist at the University of Hawaii Cancer Centre, lead by DR Michele Carbone, discovered that a tumour-suppressing protein called BAP1 can help oncologists clearly and accurately differentiate between mesothelioma from lung cancer.
The study found that people lacking in the BAP1 protein are more likely to develop malignant mesothelioma.
During the research team’s study, all of the 45 non-small cell lung cancer samples tested positive for normal BAP1, whereas more than half of the 35 pleural mesothelioma samples which were tested showed a distinct lack of BAP1.
Following the test, Dr Carbone said, “Now we have an additional tool that we can use to increase the accuracy of a diagnosis. The fact is today there is a high rate of misdiagnosis and there are many reasons for that. We need to use this tool to help get it right.”
The research team brought together many of the top specialists in the field, as the team included a number of doctors and researchers from both New York’s Langone Medical Centre and the Queens Medical Centre, Honolulu.
Their study was published in Oncotarget on 18th July. Oncotarget is a multidisciplinary medical journal. You can read the study here.
All over the world, misdiagnosis of mesothelioma has been a growing concern for cancer patients and specialists. Mesothelioma is often misdiagnosed because it carries a number of similarities to lung cancer.
Ultimately, this often means too much time is wasted performing the wrong treatments and by the time the actual problem is diagnosed it has developed.
“We still don’t know for sure how many cases are being misdiagnosed in the United States, but 10 percent is a safe bet,” Dr Carbone said.
“That means there are lots of people not receiving the proper treatment. It’s important to increase the accuracy of the diagnostic process because the last thing you want as a patient is to be treated for the wrong disease.”
In comparison, there are over 45,000 cases of lung cancer diagnosed each year in the UK (according to Cancer Research UK). Despite diseases being focused on the lungs, the correct treatment for mesothelioma is very different from the treatment for lung cancer.
Pleural mesothelioma is a particularly rare and aggressive form of cancer which starts in the thin membrane that surrounds the thoracic cavity. There are just over 2,600 cases of mesothelioma diagnosed each year in the UK, so clearly many oncologists fail to see the disease.
Why Patients Are Misdiagnosed
The inability to diagnose mesothelioma in its early stages is one of the reasons why prognosis is often poor in comparison to other cancers. The three main reasons for misdiagnosis are:
- Doctor inexperienced in mesothelioma
- Misguided needle biopsy
- Inadequate specimen
If the process of searching for BAP1 is implemented across the board in cancer centres, it will almost certainly improve diagnosis for mesothelioma, halting so many cases which waste precious time treating a lung cancer, which isn’t even present.Read More
According to recent analysis, older patients suffering from pleural mesothelioma could almost double their chances of survival by undergoing aggressive surgery.
It aims to debunk the myth that age is a barrier to surgery and show that nobody is too old to benefit from mesothelioma surgery.
Thoracic surgeon Dr Mark Berry from the Stanford University Medical Center said: “More and more, we’ve come to realise that age is just a number.
“Some patients at 75 are great candidates for surgery, and some younger than 55 are not so great. Age alone should not deter these patients from surgery.”
Berry was part of the team of surgeons and oncologists who looked into the Surveillance, Epidemiology and End Results (SEER) database in the US and analysed 879 pleural mesothelioma patients, with the hope of determining exactly how age impacts the potential benefits of surgery.
Their findings were published in the latest issue of Clinical Lung Cancer and Berry went on to say: “The thing that surprised me a little was the magnitude of the benefit of surgery was kind of similar with the older group and the younger group.
“The midterm survival for the older group that had surgery almost doubled. I don’t know if I would have expected that much improvement.”
The issue of age is all the more important when it comes to mesothelioma, as it is usually diagnosed in those who have recently retired after years of asbestos exposure.
In fact, the period between initial exposure and appearance of symptoms is usually as much as 48 years for men or 53 for women, meaning most are at least 65 by the time they are diagnosed.
These new findings support earlier findings from the University of Chicago Medical Center.
Back in 2015, Dr Wickii Vigneswaran said: “There has always been this tendency to say ‘He’s a little too old for surgery.’, but the fact is, if you’re fit enough, regardless of age, you can benefit.”
This was backed up by the SEER analysis, which found that surgery was generally associated with better survival compared with nonsurgical treatment methods.
One-year survival was 63% for those who opted for surgery, and 44% for those who did not, while the three and five-year survival rates were 21 and 11% and 8 and 3% respectively.
And for those who opted not to receive surgery, 30-day mortality was 11.7%, compared to 4.3% for those who did.
While it’s great to see that older patients can still benefit from surgery, it’s always important to stress a multidisciplinary approach, to decide if surgery is the right option for each individual.
As Dr Berry said: “I think progress is being made [with mesothelioma], although we haven’t come up with anything that dramatically alters the outcomes.”
“We’ve done a better job of picking the right treatment plan for each individual and selecting which patient will benefit from which treatment. We are doing better.”
Make sure to keep checking our news feed here at Asbestos Advice Helpline for all the latest on new treatments and trials regarding asbestos-related diseases.Read More
Understandably, it is a tough time for anyone if they have lost a partner or close family member to mesothelioma or another asbestos released disease.
Because of the controversy surrounding asbestos use as recent as the late 1990’s, Many of those who have been affected (be it physically or personally), could well be entitled to some form of compensation.
The bottom line is that this corporate negligence is far more serious than basic misconduct, it isn’t a sprained ankle on a wet floor. The mistakes made by employers in the use of asbestos has lead to many millions of people having to suffer personal tragedy.
Despite not being one of the most common forms of cancer, mesothelioma is considered one of the worst forms of cancers to be diagnosed with.
Mesothelioma develops as a result of prolonged exposure to asbestos, a group of minerals made of micro fibres which §were widely used in construction and mechanics.
When inhaled, these tiny fibres get stuck in the lungs. Over time, these fibres damage the lining of the lungs. While the use of asbestos was banned in the UK in 1999, people who were exposed are still being diagnosed due to the length of time in which the cancer takes to develop.
Understandably, because of the industries asbestos was regularly used in, the majority of those diagnosed are men.
The statistics of survival rates are worst for men too, as Cancer Research UK figures show. They say that on average, 46 out of every 100 men diagnosed will survive at least one year, but just 6 in every 100 will survive 5 or more years.
Of Course, it isn’t just the individual that’s affected by a disease as awful as this, it’s the families who suffer financial, emotional and potentially even physical pain themselves as a result of watching their loved on deteriorating.
While it doesn’t even come close to helping this awful, life changing situation, it seems totally unjust for the companies potentially responsible, to get away for free while the utterly innocent suffer for their negligence.
It’s because of this that even if the worst happens, that the family of the mesothelioma sufferer act by searching for what you might be owed.
Making A Claim
The standard procedure for either a family or individual to claim for compensation against an employer is within three years of the initial diagnosis of mesothelioma.
If unfortunately the person suffering from mesothelioma passes away during a claim, before a claim or before they have been diagnosed (diagnosis is often found in a post-mortem) then the claim must be made within three years of their death.
Obviously, if your loved one is still alive when it becomes clear what disease they have, it is imperative that you act as fast as possible in making a claim, to get the most out of the money you receive.
Understandably, it can be hard to bring yourself to begin such proceedings while you are going through such a difficult experience, it is important to consider the short timescale on compensation and how it might help you.
More often than not, a compensation claim for asbestos exposure comes against the employer of the person who has been diagnosed. The initial problem with mesothelioma is that it takes so long to develop. caner.org report that it can take between 20 and 50 years following exposure.
If it takes as long for 50 years after exposure for your loved one to develop mesothelioma, there’s a decent chance that their former employer might not still be in business.
So a very reasonable question which families tend to ask at this stage is whether it is still possible to make a claim if the previous employer’s business is not in existence? Simply put, the Answer is YES.
The process of claiming involves searching for the employer’s insurer, so, if they are no longer in business, it is just a case of searching for their former insurer or insurer records. Nothing can halt a claim as long as the information is available, even if a business has long since stopped trading.
Getting an experienced specialist solicitor for this kind of intricate research is pretty important, and is what we would always recommend when pursuing a claim to ensure you leave no stone unturned for this type of information.
That said, things have become slightly easier thanks to a recent initiative. Back in 2011, the insurance industry set up the Employers’ Liability Tracking Office. Essentially, they created a massive database which holds millions of insurance policies from many industries and dating back many years previous.
If the worst happens, and you cannot track down any record of former employer’s, you can apply for government compensation. As of 2014, the UK government raised their mesothelioma compensation scheme from £115,000 to £123,000. See more here.
How Much Is A Claim Worth?
Whether a loved one is still battling with mesothelioma or has sadly passed away, as a family member, it is reasonable to wonder what sort of money you might be able to claim.
Obviously, there is no set figure and things tend to change in a case by case basis. However, a government study from 2014 suggests that on average, claims range between £137,000-153,000.
While this is the average it is not unusual for a compensation deal to be far higher. For example, a recent case which we settled at Asbestos Advice Helpline saw a widow receive in excess of £260,000 following her husband’s death from mesothelioma.
How Long Does It Take To Settle A Claim?
This largely refers back to the previous government report discussed in an earlier point. Essentially, this all comes down to individual circumstances and the complex nature of legal proceedings. However, it was reported that the average time for a family to receive compensation for following another family member’s diagnosis with mesothelioma as 14.5 months.
Does Death Affect The Claim?
As mentioned in an earlier point, it is entirely possible to make a claim as a family member, even if your suffering family member sadly passes away. However, the government report above does suggest that on average, the payout is slightly reduced.
The report states that the amount of compensation received by families of those diagnosed with mesothelioma that was still alive was roughly £14,000 higher than those whose family member had passed away. While this is a reduction, it’s only really 10%, therefore not a massive difference.
If your family member or loved one has recently been diagnosed with mesothelioma and you are still unsure how to go about approaching for compensation, please feel free to take a look at our compensation guide.
For more information on other cases which may well be similar to yours, take a look at our recent successful claims page where you will find in-depth case studies of a number of claims.Read More
While the majority of asbestos-related compensation cases deal with the cancer known as mesothelioma, it’s important to remember that a claim can be made for any asbestos-related condition, including asbestosis, if it can be proven that the exposure was not the fault of the patient.
Unfortunately, as asbestos-related diseases can be terminal, there are sometimes cases where those suffering from the disease will not live long enough to see through their compensation claim.
We’re going to take a look at what the options are for those who are claiming on behalf of a relative or spouse who has unfortunately passed.
What Is Asbestosis?
Firstly, we’ll define what exactly asbestosis is. Asbestosis is very similar to mesothelioma, in that it is a disease caused when inhaled asbestos fibres irritate the lungs, which causes scarring and thickening, making hard for the lungs to function properly.
However, it’s important to know that the two are distinctly different conditions, are both treated differently, and will be awarded different levels of compensation.
As with other asbestos-related diseases, asbestosis is most likely to occur in those who have had long-term exposure to the material such as those who have worked in construction, shipbuilding, plumbing or other industries.
It usually manifests as shortness of breath, chest pain and an unexplained cough and general chest tightness, but is not a form of cancer like mesothelioma.
For more info on asbestosis and the treatment methods available, head to NHS Choices.
It’s important to know that you can claim on behalf of your loved one if they suffered from asbestosis if they were exposed to it in the workplace, even if they’re no longer with us.
Of course, if someone suffering from asbestosis contacts us to pursue a claim, we will do everything in our power to ensure that the claim is settled within their lifetime.
However, due to the speed at which the disease can progress, should they then pass away, then a spouse or other relation can continue the claim on their behalf.
If a claim process had not been started before the person’s death, or if the link with asbestos wasn’t proven until a post-mortem, then it may still be possible to begin a claim.
While it can, of course, be a little more difficult to prove occupational asbestos exposure after death, it’s certainly still possible.
Is There A Time Limit?
Generally speaking, asbestosis patients usually have three years to claim from the point at which they were diagnosed (not the point at which they were exposed to asbestos).
In the event that they are to pass away, then this time limit resets.
While the period following the death of a loved one is obviously a very difficult time for anyone, we do encourage you to initiate this process as soon as possible, and the sooner you do so, the sooner you could be receiving the compensation that your family are entitled to.
What If A Former Employer Is No Longer Trading?
Seeing as your loved one was likely exposed to asbestos as long as 40 or 50 years ago, there’s always a chance that their employer is no longer trading.
As such, you may think that it could be difficult to trace them for compensation, but this isn’t always the case.
Usually, the insurers of the former employee can be traced, in which case there is no reason why a claim cannot still go ahead.
The ELTO (Employers’ Liability Tracing Office) have a database holding millions of records of insurance policies dating back a number of years, making it a lot easier to track down the insurers of previous employers and making the claims process run a lot smoother.
How Much Is An Asbestosis Claim Worth?
Another worry that those who are claiming on behalf of a relative often have is whether it is worth it or not, and it’s perfectly understandable that you wouldn’t want to put your family through any more stress than you’ve already gone through.
However, the first thing to say is that the claims process is not as stressful as one might think.
Most cases are usually fairly straightforward once the responsible party has been identified, and the while they can over as quickly as a couple of months, the average length of a case is around a year.
As for how much the claim is worth, again it can obviously vary, but the average claim is worth between £137,000 and £153,000 according to this report from 2014.
However, it is important to note that the death of a claimant will slightly affect the amount of compensation received.
The same report found that the amount received was generally around 10% lower in cases where the patient had passed away, although it’s still absolutely an avenue that you consider pursuing.
If you are considering making a claim on behalf of a loved one, then we recommend getting in touch with us here at the Asbestos Advice Helpline so that we can help you discuss your options and move forward with a claim if you wish.Read More
A triplet combination of treatments has been recommended by the National Comprehensive Cancer Network (NCCN) in the US.
Although the standard of care for mesothelioma hasn’t changed for over a decade, experts are now suggesting that it should.
Unfortunately, not all patients respond to the standard treatment of cisplatin/pemetrexed chemotherapy treatment, the NCCN are always looking for new combinations and have now suggested that bevacizumab (sold under the brand name, Avastin) should be added to the treatment.
The Mesothelioma Avastin Plus Pemetrexed-cisplatin Study (MAPS) took place back in September 2015, and found that: “The treatment of pemetrexed, cisplatin, and bevacizumab is a new treatment paradigm for patients with malignant pleural mesothelioma.”
And now the combination has been named by the NCCN in their guidelines for treatment of malignant pleural mesothelioma, the most common form of mesothelioma.
The findings were that the combination resulted in significantly longer survival rates, stating: “The NCCN panel recommends cisplatin/pemetrexed (category 1) for patients with MPM. The NCCN panel also now recommends bevacizumab/cisplatin/pemetrexed as a first-line therapy option for patients with unresectable MPM who are candidates for bevacizumab.”
The one downside is that the triplet treatment showed similar side effects of other treatments.
The NCCN itself is a non-profit alliance of some of the world’s leading cancer centres who work together to help improve the quality, effectiveness and efficiency of cancer care.
Their guidelines are intended to help those suffering from mesothelioma and their families, as well as the medical teams that support them to make decisions on how best to manage their cancer and are regularly updated to reflect the latest developments.
It’s being suggested that these recommendations could be ‘paradigm shifting’ for mesothelioma treatment, as it was as long ago as 2003 when the standard treatment was last changed (adding pemetrexed to cisplatin).
Make sure to keep checking the latest news on our feed here at the Asbestos Advice Helpline for all the latest on new treatments and trials regarding asbestos-related diseases.Read More
A team of expert mesothelioma researchers say there may now be a better way of distinguishing between malignant mesothelioma and carcinoma (lung cancer).
It has long been the issue for those suffering from these two diseases that diagnosis simply comes too late to actively tackle cancer.
This is because they are a lot alike. Lung carcinoma and pleural mesothelioma are both malignancies which develop on the lungs.
However, mesothelioma can develop and spread differently to lung cancer and also can respond better to different treatments to lung cancer. Because they are so hard to differentiate between, it means patients might end up receiving a lesser treatment or are wrongfully diagnosed.
Now researchers at the University of Hawaii and the NYU’s Langone Medical Centre believe they have discovered a way to improve the diagnostic accuracy of immunohistochemical (IHC) staining for mesothelioma. They key to all of this is a protein called BAP1.
Essentially, BAP1 is a tumour suppressing protein encoded by the BAP1 gene. Experts have discovered that people with a mutation in the BAP1 tumour suppressor gene are unfortunately more likely to develop certain kinds of cancer, one of which being malignant mesothelioma.
Despite this, statistics show that you have a better chance of surviving mesothelioma if you have the mutation, than those who do not.
The reasons for this were found in a study published last year. It found that mesothelioma patients with BAP1 mutations tend to be younger (and therefore healthier) than those diagnosed without the mutation.
Improving Diagnosis with BAP1
While IHC can often help tell lung cancer and mesothelioma apart by picking out distinct biomarkers, the new report suggests that in about 10-20% of cases, the IHC results “can be confusing and inconclusive”.
During the study, Dr Michele Carbone added a BAP1 test to the equation to see if it could make diagnosis any more accurate. To do so, the research team stained 45 non-small cell cancer samples and 35 malignant mesothelioma biopsies for BAP1.
“All 45 non-small cell cancer biopsies stained positive for nuclear BAP1, whereas 22/35 of the malignant mesothelioma biopsies lacked nuclear BAP1 staining, consistent with previous data,” said Dr Carbone in the journal Oncotarget.
Dr Carbone also said, “Our study indicated that absence of nuclear BAP1 stain helps differentiate malignant mesothelioma from lung carcinomas.”
Following the study, the research team has recommended that BAP1 staining should be added to the IHC panel which is currently used to distinguish between the two types of cancer.
To find out more about this fascinating study, you can read the entire piece here.Read More
Getting a diagnosis of mesothelioma can be difficult, and it often only made when absolutely all other options have been ruled out.
One of the signs which generally shows that the condition IS mesothelioma is the presence of pleural effusion.
Pleural effusion is excess fluid in the chest cavity, often referred to as ‘water on the lungs’ and it’s present in as many as 90% of mesothelioma patients.
What is it?
Pleura refers to a thin layer of membrane which surrounds the lungs and the chest cavity.
The outer layer is known as the parietal pleura and the inner one as the visceral pleura.
These layers are lubricated by a small amount of pleural fluid which allows them to slide over each other when the lungs expand and retract as we breathe.
Healthy people usually only have around a teaspoon’s worth of pleural fluid, but in cases of pleural effusion, much more builds up and makes the lung separate from the chest wall which causes breathing difficulty.
Depending on the cause of the effusion, the fluid could either be transudative (watery) or exudative (protein-rich).
As well as mesothelioma, pleural effusion can be caused by pneumonia, heart failure, cirrhosis of the liver, rheumatoid arthritis or low levels of protein in the blood.
Those who suffer from pleural effusion usually don’t realise until they seek help for shortness of breath, or it is sometimes picked up on a chest x-ray which is being performed for some other reason.
They usually then undergo a treatment known as a thoracentesis, which is a procedure to drain the fluid which has built up in the lungs.
If patients are later found to have mesothelioma, they may have this procedure done more than once, and the symptoms will ease as mesothelioma treatment takes over.
If patients do still suffer from pleural effusion as their mesothelioma develops, there are steps that can be taken to manage their discomfort.
For example, a catheter can be placed in the chest which allows the patient to drain fluid themselves at home rather than having to come into hospital for a thoracentesis and it’s up to the patient whether they wish to pursue this option if it would work for them.
However, this is often a popular option as it allows patients to spend more time at home with their family rather than in hospital.
For more information on pleural effusion, its causes and symptoms, check out this post on WebMD and for all the latest news regarding mesothelioma and all asbestos-related diseases, keep checking our blog here at Asbestos Advice Helpline.Read More
Targovax, a Scandinavian-based biotechnology company, has launched the latest clinical trial exploring immunotherapy for pleural mesothelioma. The researchers hope that the trial will deliver a better way to treat patients with asbestos-related diseases.
Essentially, the researchers are administering the immunotherapy as a first-line therapy in combination with chemotherapy, combining cisplatin and pemextrexed.
The initial randomised part of the trial analyses the performance of ONCOS-102 which is an engineered human adenovirus. This adenovirus is designed to induce systematic anti-tumour responses.
Dr Magnus Jaderberg is the chief medical officer at Targovax and said ahead of the trial, “Based on what we’ve seen in our first study of patients with various solid tumour types, which is good tolerance and response in a couple of mesothelioma patients, we’re hopeful for something positive from this trial”
During the trial, doctors will inject 30 patients with ONCOS-102, directly into their tumour lesions of the pleura, which is the thin lining around the lungs. Each patient will receive six treatments over a five-month period.
How ONCOS-102 Works
This engineered virus has been developed to only replicate in tumour cells while leaving normal cells unharmed.
This process breaks down cancer cells, and as they break down, they release specific tumour signals which are picked up by immune cells. These immune cells can then find and attack the tumour.
However, there are potential side effects. Because ONCOS-102 is made from an adenovirus, it creates flu-like symptoms within the patient which may last a few days after the initial injection.
The trial is Europe-wide, with patients in Italy, Spain, France and the UK. The first patient of the trial received treatment in Barcelona, Spain.
There has been early optimism for the trial after an earlier stage of the trial was deemed a success in Finland. ONCOS-102 elicited a 40% disease stabilisation rate across all tumour types in the trial. Among those being treated were two patients suffering from mesothelioma.
One particular patient in the early trial saw a 47% reduction in the size of a tumour.
Mesothelioma and ONCOS-102
Dr Jaderberg also explained why this is such an important trial for mesothelioma patients in particular.
“Mesothelioma is known as a highly malignant disease which is usually diagnosed too late for surgery, and as a result, there is very little that patients can be treated with. New therapies are needed. We hope our immunotherapy can provide additional benefit to the standard of care chemotherapy.”
Immunotherapy and Future Treatment
Most doctors and experts in this field believe the future of cancer treatment lies in the development of immunotherapy. This is why there are now dozens of immunotherapy drugs currently in development.
Targovax is continuing its good work by launching further trials later this year with ONCOS-102. These new trials will focus on melanoma, prostate and ovarian cancer.
Dr Jaderberg commented on these further trials, saying “based on the data we have generated so far, I would say there is a good chance that we will find solid tumours where we will show enhanced efficacy. I hope one of those will be mesothelioma.”Read More
Doctors have confirmed that a new rotation procedure can now be combined safely with an aggressive lung surgery to boost survival times and the quality of life in those with mesothelioma.
After over a decade of researching and refining, a select number of mesothelioma specialist facilities are now using intensity-modulated pleural radiation therapy (IMPRINT) as part of the recent advancements in multidisciplinary treatments.
We spoke to radiation oncologist Dr Kenneth Rosenzweig of the Mount Sinai Health System who said on the advancement “We’re hoping that all centres with experience in treating mesothelioma will now look at this as another technique to put in their arsenal.”
It’s exciting that technology has caught up with what we needed to help these patients.”
Dr Rosenzweig has spent over 20 years treating patients with mesothelioma and was an early contributor to the recent phase 2 study of IMPRINT that found an acceptably low incidence of radiation pneumonitis (RP), a potential adverse side effect.
The Journal of Clinical Oncology published that particular study back in June. You can read it here.
Helping Lung-Sparing Surgery
It is thought that these findings should boost the belief among mesothelioma specialists that the lung-sparing pleurectomy (P/D) is actually a better option for the majority of patients who require surgery than extrapleural pneumonectomy (EPP), a surgery which entirely removes the lung.
Previously, the conventional radiation techniques have successfully lowered the risk of regional recurrence after an EPP. However, it was difficult to safely offer the same dosage levels to the lung after P/D surgery without excessive toxicity o the lung.
Dr Rosenzweig also explained this in more detail. He said, “one concern for surgeons was that if they don’t remove the lung, and the patient does need radiation afterward, there isn’t going to be a way to do it effectively.”
“That was the challenge we were trying to overcome, but now we think if a surgeon has concerns about doing a more limited resection (P/D, we can allay that at this point.”
This trial began with 45 patients who initially received pemetrexed and either cisplatin or carboplatin chemotherapy. Eighteen were actually ineligible because of either disease developments or complications, which ruled out surgery or radiation therapy. The remaining 27 then continued to the IMPRINT stage.
Manageable Side Effects
Eight of the patients developed either grade two or three radiation pneumonitis, something which creates pneumonia-like symptoms. Importantly, all eight recovered quickly after corticosteroid treatment.
All in all, 21 patients underwent P/D surgery. The other six were seen to be unresectable and did not have surgery between chemotherapy and radiation.
The results showed that the median progression-free survival of all patients was 12.4 months and 23.7 months respectively. Those who underwent surgery had survival rates of 80% for one year and 59% for two years.
The one-year survival rate was recorded at 74% among those with unresectable disease, however, the two-year rate dropped to just 25%.
The effects of chemotherapy were much more promising, with a 100% one-year survival rate and a 53% two-year survival rate.
On the chemotherapy, Dr Rosenzweig said, “W know that giving radiation after surgery makes it less likely for the tumour to come back, but it’s very challenging to deliver it safely when the lung is still there.”
“Over the last 10 to 12 years, we’ve been working on this technique to deliver it safely. This is very encouraging.”
He believes this study will encourage other facilities to begin using IMPORT and that the next step is for a much larger trail.
“Even if radiation isn’t the ultimate cure, it’s still a good thing if we can get patients a significant amount of quality time with minimal side effects. It’s a sign that things are getting better.”Read More
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