Among the most interesting discussions at the recent International Symposium on Malignant Mesothelioma, held in Washington, D.C., June 25-27, was a panel discussion about the challenges of finding treatment once a patient is diagnosed with mesothelioma. The panel featured physicians from three of the leading programs in treating peritoneal mesothelioma, Dr. Paul Sugarbaker, Dr. H. Richard Alexander, and Dr. John Chabot.
Peritoneal mesothelioma affects the lining of the abdomen, and makes up about 10-15 percent of all mesothelioma diagnoses. The more common form of mesothelioma is pleural, which affects the lining of the chest and lungs. All mesothelioma is linked to asbestos exposure.
The current “best practice” for the treatment of mesothelioma is a multi-modality approach, which is a combination of surgery and chemotherapy, along with immunotherapy.
“It’s a sequence of treatments that make sense,” Dr. Chabot explained.
However, Dr. Sugarbaker pointed out, only a small fraction of mesothelioma patients receive multimodality treatment.
“So many more things could be done to manage the treatment of this rare disorder,” Dr. Sugarbaker said. “We should have accumulated many thousands of data points on people with peritoneal mesothelioma. Unfortunately, a majority of patients in the U.S. do not get to a treatment center.”
There are still only a handful of treatment centers that specialize in mesothelioma, and even then there are distinctions in the treatment of peritoneal or pleural mesothelioma that narrows the field even further. Also, there are not a large number of physicians currently treating mesothelioma, and no established surgical training programs specifically for this field to develop more doctors experienced in mesothelioma treatment.
Awareness also is still an issue. Many patients are diagnosed too late for effective treatment.
Even if awareness is high and a patient is diagnosed early enough to be a viable candidate for successful mesothelioma treatment, the logistics of receiving treatment can be difficult. Most of the centers for mesothelioma treatment are located on the East Coast. There is one on the West Coast, but almost no options in the Midwest or other areas of the country. Treatment is usually extended over many months, making it necessary for patients to relocate to be near a treatment center if they are not lucky enough to live nearby.
“People often move and rent temporary housing. People live in trailers,” Dr. Chabot said. “More advocacy is needed to provide patient and family support for treatment. The travel issues for people who need treatment are huge.”
The Mesothelioma Applied Research Foundation, which sponsors the annual Meso Symposium, is laying the groundwork to facilitate discussions and establish a collaborative strategy, simply by bringing together the experts in this field. There is an emphasis now on forming a consortium to establish a new standard of care, and to try to combine the knowledge of the existing research and treatment centers, and to expand access to that research and treatment.
But, the experts acknowledge, there is still much to do.
Tags: asbestos, Dr. H. Richard Alexander, Dr. John Chabot, Dr. Paul Sugarbaker, mesothelioma, Mesothelioma Applied Research Foundation, multimodality treatment, research, treatment, WashingtonThis entry was posted on Monday, July 13th, 2009 at 2:48 pm and is filed under Events, News, Research/Treatment. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
