The perception that many chemotherapy-eligible patients with malignant pleural mesothelioma (MPM) are not receiving such treatment was revealed in a survey study of health professionals involved in the treatment of these patients, according to researchers from Australia. This study was published in Supportive Care in Cancer.

Surveys consisting of demographic and multiple choice questions, including perceptions of clinician- and patient-related barriers to treatment of MPM, involvement in treatment decisions, and participation in multidisciplinary team meetings for patients with MPM, were administered.

Surveys were completed by 126 health professionals, including 107 specialist doctors and 19 specialist nurses. Overall, 43% of doctors and 26% of nurses believed that more than 20% of patients with MPM who are candidates for chemotherapy do not receive such treatment. Doctors most frequently selected clinician nihilism and nonreferral to medical oncologist, whereas nurses perceived delayed diagnosis and nonreferral to medical oncologist, as the most common clinician barriers to chemotherapy administration. 

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A higher level of involvement in treatment decisions for these patients was selected by doctors (56%) compared with nurses (26%), although more than 60% of both groups reported that their primary role in treatment decision-making centered on providing general support for patients and their families. The majority of doctors and nurses (85% and 74%, respectively) participated in regular multidisciplinary team meetings involving these patients, although doctors estimated a higher level of review for their patients at these meetings (75%) compared with nurses (29%). 

In summarizing the result of their study, the authors wrote that “caring for patients with MPM is challenging and complex.”

Warby A, Dhillon HM, Kao S, Vardy JL. Managing malignant pleural mesothelioma: experience and perceptions of health care professionals caring for people with mesothelioma[published online January 25, 2019]. Support Care Cancer. doi: 10.1007/s00520-019-4648-0