Older Veterans With Mesothelioma At Risk of Not Receiving Life-Extending Treatment

3 Min Read

Elderly Couple Looking Sad

When faced with a mesothelioma diagnosis, many patients want to undergo aggressive treatments to fight the disease.

However, a new study has indicated that older patients are not offered as many life-prolonging mesothelioma treatment options compared to younger patients.

Researchers found that older pleural mesothelioma patients aren't always given the same treatment options as younger patients. Not receiving these treatments may put them at risk of lower survival.

Determining Mesothelioma Treatment Options for Older Patients

People who are diagnosed with mesothelioma are often in their 70s because of the long latency between asbestos exposure and mesothelioma diagnosis. It may be harder for medical teams to treat these older patients because there is an increased risk of complications and death.

When doctors speak with their patients about potential treatments, they need to make a judgment call about whether or not that patient is the right candidate for the treatment.

To determine the best treatment options, doctors will look at several factors, including:

  • How healthy are the patients?
  • Are the patients able to perform day-to-day tasks?
  • How well do they breathe?
  • What is their heart rate or blood pressure while they are exercising?
  • What are their red and white blood cell counts?
  • How strong is their heart?
  • Has the cancer spread too far?

As the recent study discovered, some surgeons use a patient's age as the determining factor.

One reason patient age is considered is that many older patients suffer "comorbidities" — additional underlying health issues due to aging.

Because of these other health concerns, doctors are worried older patients will not survive or thrive after different therapies.

There is some basis for these concerns. For example, older patients are more likely to die during an operation. They may need to depend on others after the surgery.

They are also more susceptible to postoperative complications, meaning they may need to stay in the hospital longer than a younger patient.

However, if the patient is healthy enough to undergo surgery, it’s unfair to deny them the option because of their age.

Lack of Treatment Reduces Survival Rates in Older Patients

The researchers looked at more than 4,500 senior patients. They discovered that 63% of them were just observed, meaning they didn’t get treatment. Only 2% received both surgery and chemotherapy, and 22% received chemotherapy alone.

Because mesothelioma surgery is one of the most effective treatments for extending patient survival, the lack of treatment in older patients is reducing survival rates in this demographic.

The median survival rate for patients who were only observed was 4.1 months. Those who received both therapies lived for an average of 12.2 months, and those who only received chemotherapy had a median survival rate of 9.5 months.

Doctors often claim elderly patients are not good candidates for chemotherapy and surgery because of the increased risk of complications or the more extended hospital stay.

However, the same study found that elderly patients who did receive surgery had 30- and 90-day mortality rates of 11% and 28.5%. These patients only stayed in the hospital for an average of 6 days post-operation and only 7.5% were readmitted to the hospital within 30 days.

Accessing Treatments for Older Veterans

Because older veterans make up a large portion of mesothelioma patients, they should take note of the study's findings. These patients may be denied access to the best mesothelioma treatment options possible simply because of their age.

Many veterans don’t have access to the resources and information they need to understand or question their doctors' decisions. They also may not know to ask for second opinions or actively participate in their own treatment path.

These factors, combined with their age, are putting veterans at risk of not receiving life-extending treatments.

Older veterans deserve access to the best possible treatment options. Treatment plans should always be assessed case by case. Seeing an experienced mesothelioma specialist can help you get the personalized treatment plan you need to extend your survival.

There is still hope for life-extending treatment and a better prognosis, even in older veterans with mesothelioma. Contact the Mesothelioma Veterans Center to learn about VA benefits and legal compensation options that can pay for essential treatments.

Veterans Support Team
Christopher Dryfoos PhotoWritten by:

Contributing Author

Christopher Dryfoos is a journalist and member of the American Medical Writers Association (AMWA). As the grandson of the U.S. Navy’s first forensic pathologist, he aims to help veterans with mesothelioma access needed care.

  1. Datta A, Smith R, & Fiorentino F, et al. (2014). Surgery in the treatment of malignant pleural mesothelioma: recruitment into trials should be the default position. Thorax, 69(2), 194-197.
  2. Overcash, J., Ford, N., Erdeljac, H. P., Fugett, S., Knauss, B., Kress, E., … Noonan, A. (2018). Comprehensive Geriatric Assessment in Oncology: Best Practices in Caring for Older Patients. Journal of the advanced practitioner in oncology, 9(6), 640–644.
  3. Torrance, A. D., Powell, S. L., & Griffiths, E. A. (2015). Emergency surgery in the elderly: challenges and solutions. Open access emergency medicine: OAEM, 7, 55–68. doi:10.2147/OAEM.S68324
  4. Verma, V., Wegner, R.E., & Ludmir, E.B. et al. (2019). Management of malignant pleural mesothelioma in the elderly population. Annals Surgical Oncology, 26(8), 2357-2366. https://doi.org/10.1245/s10434-019-07351-6