Improving the Outlook for Peritoneal Mesothelioma?
25 Apr 2017
It is estimated that up to 500 of the 2500 mesotheliomas that occur in the UK are peritoneal mesotheliomas.
Sadly this cancer has lagged behind most other cancers in terms of diagnosis, treatment and research.
What are some of the steps that need to be taken to help improve the situation?
1. The Setting Up of The Peritoneal Mesothelioma National Multi Disciplinary Team (NMDT)
The setting up of the NMDT was a critical step and ideally going forward all cases of peritoneal mesothelioma would have to be referred to the NMDT who will be able to make informed and expert treatment recommendations, and be able to collate the outcomes of treatment to assist in future assessment.
This will hopefully allow consistency in treatment and remove the variations in treatment across the country.
The treatment options for peritoneal mesothelioma are currently very limited. The main treatments considered currently are chemotherapy and surgery. The NMDT will have a very important role in matching patients to appropriate treatment.
The value of surgery for peritoneal mesothelioma is particularly controversial. There is innovative surgery known as a complete cytoreduction which involves the removal of the tumour by removing the lining of the abdomen and the affected organs and then washing the abdomen through with heated chemotherapy. Expert assessment is necessary before this surgery is contemplated. In particular it is necessary to determine that the mesothelioma has not spread beyond the abdomen. The NMDT will have a key role in making this assessment.
2. Increase information available to GPs to allow early referral
Like other cancers early diagnosis for peritoneal mesothelioma is very important.
Unlike pleural mesothelioma there is no protocol for when the GP should refer the case onto a specialist.
The earlier the cancer is diagnosed, the less likely it is to have spread beyond the abdomen and the more likely that surgery will be of benefit.
Unfortunately peritoneal mesothelioma can be difficult to diagnose speedily with symptoms including abdominal pain and swelling, constipation and/or diarrhoea , tiredness, loss of appetite and weight loss not always being symptoms readily associated with an asbestos related condition.
With these symptoms the GP needs to be thinking about asbestos exposure and referring the patient on for assessment as early as possible.
3. Put Pressure on Drug Companies to conduct trials for peritoneal mesothelioma patients
The number of mesothelioma trials has increased considerably over the last few years. However, the majority of these have been limited to pleural mesothelioma given the greater numbers of potential patients and the drug companies requirements for 'clean' data ( all data for a specific type of mesothelioma). It is important that either specific trials for peritoneal mesothelioma are set up, or at least patients with peritoneal mesothelioma are not excluded from current and forthcoming mesothelioma trials.