Study: 3 Important Benefits of Specialty Mesothelioma Care

A multidisciplinary tumor board sits at a rectangular table reviewing a mesothelioma case. The board includes a thoracic surgeon, a radiologist, a pathologist and a medical oncologist.

New research shows malignant mesothelioma outcomes may depend on the care team’s experience. General oncologists may not offer mesothelioma patients any cancer-fighting treatment at all. But mesothelioma specialists commonly offer life-extending treatment options.

Patient misconceptions about cancer care can complicate this issue further. Newly diagnosed patients may believe swift treatment is more important than seeing a specialist. Some may also think their treatment options will be the same whether they see a specialist or not. This new study shows that belief is far from the truth.

Researchers at Kaiser Permanente Northern California (KPNC) published the new study. They analyzed the effects of improving access to specialty care for pleural mesothelioma patients. Results show specialty care provided 3 important benefits, including improved survival. You can learn about all 3 benefits below.

How Kaiser Permanente Studied the Effects of Mesothelioma Specialty Care

Kaiser Permanente is a large healthcare and hospital system, and KPNC is one of its branches. KPNC researchers studied the effects of mesothelioma specialty care by looking at 2 groups of pleural mesothelioma patients.

  • Standard care group: This group underwent treatment between 2009 and 2014. Their surgeries were performed by 2 surgeons at 2 different centers. The surgeons and treatment centers had little mesothelioma treatment experience. It is unclear who made treatment recommendations in this group. It is possible each center’s general oncologist made the decisions.
  • Specialty care group: This group underwent treatment between 2015 and 2020. Their surgeries were performed at 1 center by 1 thoracic surgeon. A tumor board consisting of an oncologist and a thoracic surgeon reviewed each case in this group. The board worked together to make treatment recommendations in line with established guidelines.

The specialty care group was more likely to get any form of treatment. They also underwent surgery at more than 3 times the rate of the standard care group. KPNC researchers attributed these improvements to the implementation of specialty care. The tumor board and surgeon saw more mesothelioma patients and had a better understanding of their treatment. This helped the specialists offer the right treatments to the right patients.

1: Specialty Mesothelioma Care Improved Access to Surgery

Specialty mesothelioma care dramatically improved the rate of surgery-based treatment. In the standard care group, only 6% of patients had mesothelioma surgery. That is far less than the specialty care group where 22% of patients had surgery.

According to the study, this increase came from simply offering surgery to qualified patients. In other words, the standard care group may have had the same number of patients eligible for surgery. But these patients were not given the option, which kept the surgery rate low.

What Does It Mean for Mesothelioma Patients?

Specialty care access made it more likely for qualified patients to:

  • Know they were eligible for surgery
  • Go through with surgery

This represents a major benefit of specialty care since treatments that include surgery are so effective. For example, the life expectancy for pleural patients treated with chemotherapy alone is about 14 months. But in a study, patients who received surgery followed by heated chemotherapy lived more than 3 years.

Mesothelioma patients may want to keep this in mind when deciding whether or not to pursue specialty treatment.

2: Specialty Mesothelioma Care Boosted Survival for Patients Undergoing Aggressive Treatment

The study also found a link between mesothelioma experience and survival. When the care team treated mesothelioma more frequently (as in the specialty care group), aggressive therapies were better at extending life.

In the study, median survival with surgery-based combination treatment was:

  • Standard care group: 17 months
  • Specialty care group: 23 months

In the specialty care group, the same surgeon treated every mesothelioma patient. So treatment from a more experienced surgeon extended survival by about 6 months versus the same treatment from a less experienced surgeon.

What Does It Mean for Mesothelioma Patients?

Mesothelioma patients who qualify for surgery have a shot at long-term survival if they choose a mesothelioma specialty surgeon. A surgeon who has a lot of current experience treating this rare cancer will know more about it than a general surgeon. This knowledge may mean the surgery and follow-up treatment will be more effective at improving survival.

3: Specialty Mesothelioma Care Led More Patients to Get Treatment

Specialty mesothelioma care increased the percentage of patients undergoing any form of treatment. In the standard care group, only 44% of patients received treatment. In the specialty care group, 63% of patients received treatment. So specialty care increased the treatment rate by more than 40%.

This trend also appeared in a subset of patients with early-stage mesothelioma. For context, patients in Stage 1 or Stage 2 generally have several treatment options. They also tend to have the best survival outcomes.

In the standard care group, a significant number of these patients were not offered any form of treatment. In the specialty care group, these early-stage patients were 39% more likely to be offered treatment. This jump may mean that all early-stage patients in the specialty care group were offered treatment. But the study is unclear on that point.

The study authors noted this gap in offered treatments may stem from a lack of knowledge. The standard group oncologist may have underestimated the benefit of some therapies. This may have kept the oncologist from offering treatments that could have truly helped.

“We suspect that [standard care group] oncologist did not commonly recommend chemotherapy over supportive care due to a perception of low benefit of chemotherapy in [mesothelioma patients].”

Ossowski et al., Journal of Thoracic Disease

What Does It Mean for Mesothelioma Patients?

Patients may have a better chance of receiving effective treatment options with specialty care. Mesothelioma specialists will likely have better knowledge of current treatments and their benefits. This can help them design a more effective treatment plan than a general oncologist.

Mesothelioma Patients Should See a Specialist

The KPNC study demonstrated 3 important benefits of mesothelioma specialty care:

  1. Improved access to surgery
  2. Better survival for patients undergoing surgery-based treatment
  3. Improved overall treatment utilization

These benefits may play an important role in maximizing mesothelioma treatment efficacy. Patients aiming for the best outcomes should speak with a mesothelioma expert. Specialists and cancer centers with lots of mesothelioma experience may offer patients the widest selection of treatments. This may help improve patients’ chances of long-term survival.