MESOTHELIOMA POWERPOINT: NO LONGER A HOPELESS DISEASE

MESOTHELIOMA: NO LONGER A HOPELESS DISEASE

Gunnar Hillerdal

Karolinska University Hospital

Stockholm, Sweden

 

Malignant pleural mesothelioma

n  Rare disease

n  A cancer growing from the cells that cover the pleural space

n  Was difficult to diagnose

n  Used to be regarded as a hopeless disease

n  No treatment was available earlier

n  Earlier figures: mean survival time of six to seven months

 

AN EXCITING TIME FOR MESOTHELIOMA RESEARCHERS

PROGRESS THE LAST FEW YEARS IN…

n  Etiology

n  Pathology-Immunohistochemistry

n  Staging

n  Seromarkers

n  Biology

n  Treatment

 

 

 

 

The last decade: progress!

n  Diagnosis; new immunohistochemical methods; diagnosis much easier and more certain!

n  Etiology: not only asbestos? Hereditary factors and viruses?

n  Staging: PET-CT, other new methods

n  Biology: exciting new findings, but not yet any clinical importance

n  Seromarkers: have now reached the clinic!

n  TREATMENT: remarkable progress!

PROGNOSIS MUCH IMPROVED!

 

 

BETTER TO HAVE A MESO THAN TO HAVE NSCLC STAGE IV?

n  Median survival mesothelioma: should now be above one year!

n  Median survival non-small cell lung cancer, IIIB wet or IV, still struggling to reach one year!

 

 

 

”NON-EXPOSED”

n  23% MEN, 83% WOMEN

n  MEDIAN AGE NON-EXPOSED 60 YEARS, EXPOSED 62 YEARS

n  ”NON-EXPOSED” SEEM TO BE INCREASING RELATIVELY

?

n  ”Biological background level”, i.e. spontaneous mesothelioma

n  Other causes: Virus? Hereditary factors?

n  Environmental exposure

 

 

 

 

 

 

 

COMBINATION TREATMENTS

n  Surgery + cytostatics + radiotherapy under investigation

n  Unfortunately, most demanding treatment (fairly high risk of death from complications, severe side effects)

n  So far, no benefit proven

n  Should remain experimental treatment

n  Randomized studies necessary