SMART TREATMENT FOR MALIGNANT PLEURAL MESOTHELIOMA

Spring 2016

How do you manage a rare, complex cancer that is difficult to diagnose? This is the question that Drs. John Cho and Marc de Perrot have attempted to answer using a multidisciplinary, collaborative approach and the Surgery for Mesothelioma After Radiation Therapy or “SMART” treatment program at the Princess Margaret Cancer Centre. The SMART program aims to optimize treatment and prolong life for patients with malignant pleural mesothelioma (MPM), a rare thoracic cancer.

MPM is most commonly caused by occupational or environmental exposure to asbestos and affects the lining of the lungs (pleura). Symptoms are often non-specific and include progressive shortness of breath, cough, and chest wall pain. The diagnosis is challenging; patients typically undergo a series of tests and referrals, which may delay treatment.

In addition, the aggressive nature of MPM necessitates intensive treatment,
which invariably increases the side effects and complications that patients
experience. Due to these diagnostic and treatment challenges, the prognosis
for patients with MPM remains poor, with a median survival of 12 months after
diagnosis and rare long-term survival. Consequently, the management of MPM
requires novel treatment options, multidisciplinary collaboration, and efficient
coordination between medical specialties