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New mesothelioma study offers surprising take on surgery

On Behalf of | Oct 20, 2023 | Mesothelioma/Asbestos-Related Illness

After you receive a mesothelioma diagnosis, you’ll want to get the best treatment possible. With luck, if your doctors diagnose the disease early enough, they may be able to remove any tumors and put the disease into remission. More often, doctors do not diagnose mesothelioma until the later stages.

In any case, it’s important for you to work with your doctors to find the best course of treatment. Even if you cannot completely cure the cancer, you can buy yourself more time and a higher quality of life. But what is the best course of treatment? A new study contradicts some of the lessons scientists thought they knew.

Results from the MARS 2 study

Recently, much of the research on mesothelioma focused on the benefits of aggressive treatment. This often meant pursuing a combination of surgery and chemotherapy. Some studies had supported the idea that treatments using both surgery and chemotherapy were more effective than chemotherapy alone. These studies found that the combined treatments were among the top factors in improved survival rates.

However, a phase 3 clinical trial, called MARS 2, argues that chemotherapy is often more effective without surgery. Indeed, the trial yielded several important findings you’ll want your doctors to review:

  • Patients who had only chemotherapy suffered fewer adverse health outcomes than those who also had pleurectomy decortication.
  • Patients who chose not to undergo pleurectomy decortication reported a higher quality of life.
  • Patients who pursued surgery had a lower survival rate for 42 months. The survival rates then appeared to even out.

The findings were surprising enough that one surgeon said, “You have no idea how much it pains me to conclude that extended pleurectomy decortication – an operation that we have been offering for over 70 years – has been associated with a higher risk of death, more serious complications, poorer quality of life and a higher cost.”

The MARS 2 study may not be the final word

While we would all love for the science to offer perfect certainty, that is not how science works. Science demands that we find ways to test hypotheses and then see if we can replicate the results. When the results of different tests or studies appear to contradict each other, we need to get more information.

Specifically, some health care professionals have already raised concerns about the MARS 2 study:

  • It failed to show any meaningful differences in survival rates and quality of life beyond 42 months. This means it was limited in its scope.
  • There were meaningful medical differences between the groups that had and didn’t have surgery. The study may not have fully accounted for the differences.
  • 45% of the patients who had surgery went to centers that did not specialize in the surgeries. Other studies have found that patients who pursue treatment at specialized centers tend to enjoy better outcomes.

In other words, the MARS 2 study certainly offers a new take on the combination of surgery and chemotherapy. It may not, however, prove to be the final word.

How can patients identify the best course of treatment?

Doctors continue to look at the results of the newest mesothelioma treatment. When that research casts doubt over some earlier expectations, it’s important to carefully review all the relevant factors.

Your best course of treatment will account for your unique situation. You want your medical team to understand your medical condition and goals, as well as the general context of your life. You may also want to get multiple opinions. Mesothelioma is a rare cancer, and teams that work with the disease frequently may recognize options that other doctors won’t.

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