The second mesothelioma report, launched today by RCP London, demonstrates improvement in the number of people diagnosed with malignant pleural mesothelioma (MPM) surviving for more than 1 year*.
Despite this improvement, overall survival rates still remain poor, with only 43% of patients still alive at one year from initial diagnosis. Funded by Mesothelioma UK, the report uses data from over 2,000 patients diagnosed with MPM in England during 2014, the largest dataset for mesothelioma in the UK.
MPM is a type of cancer that develops in the thin membrane surrounding the lungs and the inside of the chest wall, over a long period of time. Approximately 90% of cases are linked to asbestos exposure and once diagnosed often progresses rapidly.
The Lung Cancer Audit Report for Mesothelioma also highlights regional variation in the treatments and interventions received by those suffering with MPM. In general, anti-cancer treatment and use of palliative chemotherapy has increased since the previous audit in 2014, with 36.5% of all patients receiving it compared to 34% in the last audit. Use of radiotherapy for MPM appears to have reduced since the last audit and was received by 16.5% of patients compared to 29% previously. Although surgical intervention is rare, the number of procedures taking place has increased since the last audit from 2.3% to 5.2%.
It is important for a mesothelioma diagnosis to be confirmed by a laboratory pathologist to ensure individuals receive appropriate care. This process is known as pathological confirmation. The report shows high pathological confirmation rates for mesothelioma with an increase in sub-classification since the previous audit, although this remains variable across regions. This more specific information about the exact type of mesothelioma an individual has, is recommended because differences in subtypes influence prognosis and response to treatment options, and can affect eligibility for clinical trials.
Recommendations in the report are aimed at trusts and relate to three key areas: process of care, treatment and outcomes.
- At least 90% of patients submitted to the audit should be discussed at an MDT meeting, ideally a mesothelioma specialist MDT
- Pathological confirmation rates should sit at a minimum of 95% and subtyping is strongly recommended
- More than 90% of patients should be seen by a lung cancer nurse specialist (LCNS) and at least 85% of patients should have a LNCS present at the time of diagnosis.
- Where appropriate patients should be offered active treatment, including palliative chemotherapy.
- High quality patient information should be available to patients in order to guide and support effective treatment decisions.
- All patients should be offered access to relevant clinical trials, regardless of geographic location.
Dr Susan Harden, clinical oncologist at Addenbrooke’s Hospital and clinical lead for the National Lung Cancer Audit said:
We are delighted to publish the second national pleural mesothelioma audit report in collaboration with Mesothelioma UK.
We encourage all clinical teams involved in caring for patients with mesothelioma to critically review these results and identify areas where further improvements could be made.
The RCP has a long history of working to improve the quality of care across health services, and would like to thank Mesothelioma UK for its support in facilitating and partnering this invaluable audit.
Liz Darlison, Mesothelioma UK Director of Services said:
Mesothelioma UK is delighted to be supporting the national audit in mesothelioma. This report is a perfect example of what can be achieved when experts and charities work closely together.
Insight into the treatment and care received across the UK is vital if we are going to work toward a nationwide equitable service. With so many advances in our understanding of cancer and in the clinical trials and treatments available it is vital that we keep fully abreast of the standard and patterns of care being received.
Mesothelioma UK consider this report is just the start in what we hope becomes a very productive collaboration that sees ongoing improvement in the treatment, care and more importantly the outcomes of those living with Mesothelioma.
