For decades now, incremental advances have been made in the treatment of mesothelioma — but there is still a lot more to be learned about this complex and devastating disease caused by asbestos. While many new studies and trials focus on cutting-edge technologies in the hopes of finding a “cure,” a recent study published in the European Journal of Cardio-Thoracic Surgery has questioned something that medical professionals have perhaps taken for granted — which is the efficacy of how mesothelioma tumors are staged in the first place.
Why Accurate Staging Matters
Those affected by cancer know that the calculated stage of the disease’s progression is integral to determining the proper course of treatment. In other words, if mesothelioma is often incorrectly staged at diagnosis — as this study suggests — then it stands to reason that the disease can, as a result, be somewhat improperly treated.
As the M.D. Anderson Cancer Center’s Guideline for Patients points out: “It is essential that cancers be properly staged prior to embarking on treatment so that the most effective form of therapy can be delivered to the patient.”
How Malignant Pleural Mesothelioma Differs from Other Cancers
In reporting on this new study, Oncology Nurse Advisor explains the difficulties unique to staging mesothelioma: “Unlike other types of tumors, mesothelioma tumors have similar density to surrounding tissues, vary in thickness, and are dispersed.” As a result of these unique properties, the conventional strategy of staging is often ineffective.
“The conventional classification strategy of tumor/node/metastasis (TNM) accounts for size and range of the tumor, whether the tumor has spread to lymph nodes, and whether the cancer has metastasized. CT scans and MRIs precisely determine TNM classification when tumors are discrete, but such approaches are imprecise for mesothelioma assessment.”
The Study’s Findings
The study — led by Wickii Vigneswaran, MD, MBA, of Loyola University Medical Center and Loyola University Chicago Stritch School of Medicine in Chicago, IL — is the first to examine the effect of a tumor’s weight and volume on mesothelioma outcomes. In other words, the study is the first to explore an alternative, and perhaps more effective, way of staging tumor growth. It’s incredible that something so elemental, so integral to diagnosis, has not been questioned before.
The study enrolled 116 people diagnosed with malignant pleural mesothelioma who underwent extended pleurectomy and decortication – one of the most aggressive types of surgery for mesothelioma. Once removed, the tumors were weighed and their volumes were measured. The study found that tumors with a lower weight and volume were indicative of a longer survival time and improved outcome.
It’s possible that these same tumors, when understood only by using the conventional TNM method, would not suggest such a positive outcome. Perhaps this new understanding of mesothelioma tumors will result in more patients undergoing curative surgery, since their prognosis may be more hopeful than originally thought. Either way, the more that is known about an individual, the more effective patient care can be — both emotionally and physically.
The Importance of Research that Is Patient-Centered and Patient-Specific
Oftentimes, researchers can treat cancer as a faceless and uniform enemy — when in reality cancer is very individual and very personal. Each patient requires a different course of action. Each patient has their own specific challenges and victories.
Thankfully, in recent years, cancer research and medical care has gradually become more about the individual. New research focuses on the person, on the genome, and on the immune system. With this study, it’s promising that the treatment of mesothelioma can follow suit.
The ability of a medical researcher to “re-see” the problem, and approach it in a new way, is integral to the fight against cancer. This study, which questions one of the most basic assumptions about mesothelioma tumors, will inform subsequent research which, hopefully, will continue the trend and do the same.