In an attempt to provide mesothelioma patients with a higher standard of care and improved survival rates, new comprehensive guidelines for diagnosing, treating and managing mesothelioma are being developed by researchers across the world.

Understanding Mesothelioma

Mesothelioma is an aggressive, and relatively new, form of cancer that can originate in the linings of the lungs, abdomen and heart. It almost always develops in patients with a history of exposure to asbestos—a class of microscopic fibers found in building supplies that cause irritation and inflammation when inhaled.

The World Health Organization has estimated that the global fatalities of asbestos-related diseases is over 100,000. For this reason, asbestos is recognized as one of the most important occupational chemicals.

Around 90% of diagnosed cases are pleural mesothelioma (found in the lungs), 4-7% in the abdomen, with less than 1% occurring in the pericardium (a lining within the heart).

The overall median survival rate of mesothelioma is poor, at 9.5 months, with survival rates of 1 year being 41% and 3 years being only 12%. Paired with the poor survival rates are large variations in diagnosis and treatment guidelines, which may be leading to reduced quality of care.

Why Develop a Comprehensive Guideline for Mesothelioma?

A study in 2008 found that the lack of consistency or adherence to diagnosis, treatment and follow-up protocols is one of the main barriers to providing cancer patients with quality care.

Traditionally, practitioners define “quality care” as being patient-focused, free of avoidable errors and delivered in a timely manner. But due to increased rates of mesothelioma over the past several years, scientists believe that the current clinical guidelines for quality care need redefining.

Experts feel current care guidelines aren’t specific enough to mesothelioma, as they were developed for the diagnosis, treatment and management of lung cancer—which is considered an entirely different disease from mesothelioma.

In 2017, responding to the gap in mesothelioma quality care, United Kingdom researchers released a new evidence-based guideline for pleural mesothelioma, ensuring the highest care standards for diagnosed patients.

What’s in the New Comprehensive Guideline for Mesothelioma?

The comprehensive mesothelioma guideline defines the best diagnosis steps and treatment plans for pleural mesothelioma cases.

Mesothelioma Diagnostic Guidelines

It also looks at protocols for imaging and tumor sample testing as well as special diagnosing considerations where patients may not be fit for invasive tests. Researchers have found that there are currently large variations in the use of biomarkers (cellular traits) when diagnosing pleural mesothelioma, which may be adding to long list of misdiagnosed cases. To mitigate misdiagnosis, the new guideline includes a list of preferred biomarkers for accurate diagnosis.

Mesothelioma Treatment Guidelines

There are large variations in mesothelioma treatment—from surgery to radiation and chemotherapy, but there were no official best practice guidelines. The new guidelines investigate various treatment methods and provide further insight into their specific roles in treating mesothelioma patients.

The guideline closes by providing primary care physicians, oncologists, respiratory specialists and others a summary of therapeutic treatments and agents that may be available in the next 5 years.

Benefits of the New Comprehensive Guideline for Mesothelioma

A new guideline for the diagnosis, treatment and management of pleural mesothelioma brings promise to the mesothelioma community. Improved and evidence-based guidelines will give medical professionals more confidence and insight when making diagnosis and treatment decisions. Ultimately, comprehensive guidelines could deliver more favorable survival rates and overall quality of life for those affected by the disease.

The new guideline will also ensure primary physicians, oncologists and specialists are aware of the most effective treatment methods and new therapies emerging in the future. With increased standardization, medical professionals like oncologists, respiratory specialists, radiologists and pathologists are more likely to recognize new cross-sector approaches to mesothelioma treatment and management.

It is important to acknowledge that these new guidelines may not be suited for all patients in all situations, as every diagnosis varies by location, stage and cell type. However, evidence-based guidelines will ensure a patient’s doctor is aware of the most relevant and effective diagnosis and treatment methods to deliver the highest quality of care.

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Sources
  1. Journal of Clinical Pathology, "BTS guideline for the investigation and management of malignant pleural mesothelioma." Retrieved from: http://bmjopenrespres.bmj.com/content/5/1/e000266. Accessed on March 16, 2018.
  2. Journal of Thoracic Disease, "Guidelines for the diagnosis and treatment of malignant pleural mesothelioma." Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3886874/. Accessed on March 16, 2018.
  3. Cancer, "Understanding high-quality cancer care: a summary of expert perspectives." Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed?term=%22Cancer%22[jour]. Accessed on March 16, 2108.

Last modified: September 1, 2018