Elderly Patients Are Being Denied Mesothelioma Treatments
The median survival rate for mesothelioma patients over the age of 80 is a mere 4.1 months. In the past, this tragic statistic has been attributed to several correlating factors, including age, constitution, and the likelihood of additional medical conditions and complications.
However, a recent study published by The Annals of Surgical Oncology has discovered a far more alarming and insidious factor: approximately two-thirds of all elderly patients are dying without ever receiving cancer-related treatments. In other words, healthcare professionals may be judging patients by their ages and quietly making end-of-life choices without their permission or consent.
Of course, the authors of the study admit that “elderly patients pose unique management challenges because of the increased risk of therapy-related toxicities and mortality. Because there are so high-volume retrospective studies, prospective trials, or dedicated treatment recommendations for this population, this investigation addresses a major knowledge gap by examining national practice patterns and postoperative/survival outcomes in elderly MPM patients.”
Details of the study are as follows:
- The authors included mesothelioma specialists from five highly rated facilities.
- They evaluated 4,526 patients over the age of 80 who were diagnosed with nonmetastatic pleural mesothelioma.
- Only 63% of these patients were “observed” by their physicians.
- 22% of the patients received chemotherapy and survived an average of 9.5 months.
- 8% of these patients underwent definitive surgical resection.
- Most of the patients had Medicare insurance.
- By comparison, 17% of younger patients receive multimodal treatments that combine surgery and chemotherapy, with 47% only choosing chemotherapy.
To learn more about the results of this study, Tim Povtak, a senior content writer at asbestos.com, interviewed one of the study’s authors, Dr. Charles B. Simone II, the chief medical officer at the New York Proton Center.
Dr. Simone hopes the results of this study will encourage patients to seek out mesothelioma specialty centers instead of relying on general practitioners and referrals. As he explained to Povtak, “Too many elderly patients are being denied valuable survival time. Given the dramatic survival difference in this study, and given that several prior randomized trials have shown that chemotherapy actually improves symptoms and/or quality of life, I strongly encourage patients – regardless of age – to at least explore cancer-directed therapies. While age alone should not be a reason to refuse surgery, providers and patients should be aware of the risks. They should be considered for systemic therapy if they have a good performance status, regardless of age.”
Back in 2015, the University of Chicago Medical Center released a similar study that compared the surgical outcomes of patients both under and over the age of 70. Although elderly patients struggle with aggressive multimodal treatments, the author of that study, Dr. Wickii Vigneswaran, is resolute that age should not preclude patients from curative surgeries. As Povtak describes, “In over 100 consecutive surgeries for mesothelioma, [Dr. Vigneswaran] found advanced age did not translate into higher mortality rates or shorter long-term survival.” In fact, Dr. Vigneswaran asserts that age shouldn’t be a “cutoff” because elderly patients do just as well as younger ones.
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