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Study: Aggressive Mesothelioma Treatments on the Rise Among Medicare Patients


Healthcare providers in sterile garb and gloves exchange a surgical instrument in the operating room. This exchange is emblematic of the potential rise in surgery-based mesothelioma treatments among Medicare patients.

New data shows an encouraging trend among mesothelioma patients. The rate of patients undergoing surgery-based therapies has jumped significantly. This may mean doctors are offering these treatments to more patients. It could also mean patients are agreeing to surgery-based approaches more often.

Surgery-based treatments generally boost prognosis better than others like chemotherapy. If more patients receive these aggressive therapies, it could boost survival rates in the United States. For example, studies show patients who undergo surgery may live six times as long as those not receiving treatment.

Fact: Treatment decisions can have a powerful impact on mesothelioma life expectancy. Pleural mesothelioma patients who decide to forgo treatment generally live about 6 months. Those treated with standard chemotherapy live about 1 year. Checkpoint inhibitor treatment can boost survival to about 1.5 years. And surgery-based treatments can extend survival beyond 3 years.

Study Looked at Recent Medicare Beneficiaries

Researchers at the National Institute for Occupational Safety and Health (NIOSH) led the study. They analyzed Medicare claims made from 2016 to 2019. Close to 60% of those claims included information about surgery and other treatments.

Of those claims, about 6% included a treatment combination of chemo, radiation and surgery. Historically, this multimodal approach has achieved some of the best outcomes for mesothelioma. In fact, long-term survivor Heather Von St. James went through this treatment. She celebrated 17 years of survivorship in February 2023.

Mesothelioma Treatments in the NIOSH Study

Researchers found varying rates of use for different treatment approaches:

  • Chemo alone: 9%
  • Radiation alone: 2%
  • Surgery alone: 19%
  • Chemo + radiation: 3%
  • Chemo + surgery: 16%
  • Surgery + radiation: 1%
  • Chemo + radiation + surgery: 6%

Study Data Compares Favorably to Treatment Rates of the Past

An earlier study from Mayo Clinic researchers found less frequent use of surgery-based therapies. The Mayo researchers analyzed entries in the National Cancer Data Base from 2004 to 2013. They found only about 3% of patients had the combo of chemo, radiation and surgery.

The rate found in the NIOSH study is about twice that number. Researchers did not investigate why this rate jumped between the early 2000s and 2019. But it may have something to do with doctors and patients having a better understanding of treatment options.

A study released in 2022 found higher rates of treatment among patients receiving specialty mesothelioma care. Patients were more than 3 times as likely to undergo surgery when treated by specialists. The study said specialists may have offered some therapies more often due to accurate knowledge of their benefits. So the rate of surgery-based therapies in the NIOSH study could be tied to education and awareness.

This may include patient education and awareness, too. Because surgery-based treatments are classified as aggressive, patients may be reluctant to receive them. But research shows the value of this treatment method. Recent studies show it can even help patients with stage 3 and stage 4 mesothelioma. This information may help patients see more potential benefits than risks from surgery-based treatments.

What Does This Mean for Mesothelioma Patients?

This study provides evidence that mesothelioma treatment patterns can evolve in positive ways. In the past, surgery was considered a valuable treatment option for few, select patients. But treatment and research advances have led to broader qualifying criteria. This has given more patients access to surgery and its many potential benefits.

Some patients may believe certain factors would prevent them from qualifying for surgery. But they should feel empowered to ask their doctors to explain all therapy options. If a general oncologist does not offer an aggressive treatment, mesothelioma patients should seek a second opinion from a mesothelioma expert.