Straight Talk about Mesothelioma, a blog series created by Michael T. Milano, M.D., Ph.D., a radiation oncology specialist, as a resource for mesothelioma patients and their loved ones.
A recent study, published by Joseph Friedberg and colleagues in Annals of Thoracic Surgery, examined the survival rate of 73 people with advanced malignant pleural mesothelioma, all of who underwent lung sparing surgery from 2005-2013 (i.e. avoiding complete removal of the lungs); all underwent photodynamic therapy, a process in which light is used to kill cancer cells, and 92% also received chemotherapy.
While patients who receive only chemotherapy generally live for 12 to 18 months following treatment, the median survival for the 73 patients in this study (all of whom had lung-sparing surgery and photodynamic therapy) was 3 years.
The Doctor and the Study
Dr. Friedberg directs the Mesothelioma and Thoracic Oncology Treatment and Research Center at the University of Maryland. Dr. Friedberg notes that while it is very difficult to cure mesothelioma, through surgery they hoped to improve the quality of patients’ lives.
While the patients lived an average of 3 years after the surgery, it is notable that for 19 patients whose cancer had not migrated to the lymph nodes, that time was extended to 7.3 years.
In general, about 15 to 20 percent of persons who have mesothelioma undergo surgery, but usually the whole lung and the diaphragm are removed. This less drastic alternative takes out only the parts of the lung that have cancer. Friedberg noted that taking out part of the lung also lowered the risk of complications. He suggested this procedure could be effective for 20 to 40 percent of mesothelioma patients, and that surgeons need to develop more treatments that could extend the life and quality of life for those who have mesothelioma.
Mesothelioma and Asbestos Exposure
According to the American Cancer Society (ACS), most malignant mesothelioma is caused by asbestos exposure. Inhaled asbestos fibers can become lodged in the pleural linings of the lungs and chest. A majority of asbestos exposure happens in the workplace, particularly among those who are employed in construction and shipbuilding, or who work with insulation. The Occupational Health and Safety Administration (OSHA) has suggested that over 1 million workers are being exposed to “significant” amounts of asbestos.
Their family members can also be exposed to asbestos through inhaling fibers that are brought home on clothing. Individuals are also at risk for exposure in older buildings if the asbestos starts to decompose, or if it is exposed during renovations. It can take a very long time to develop mesothelioma, 20 to 50 years, so any harm caused to the lungs may not be evident for decades.
The Positive Takeaway
In his critique of this treatment study, Dr. Gregory Masters, who works at the Helen F. Graham Cancer Center and Research Institute in the U.S. National Cancer Institute Community Oncology Research Program, noted that the doctors chose their patients carefully. Those involved were healthy enough to withstand surgery, and they had an epithelial subtype of mesothelioma that would generally do the best with this kind of treatment.
While those factors sway the results, Dr. Masters also stated that the fact this surgery extended life significantly for a group of patients was a very positive development.