← Back to Search
Malignant Pleural Mesothelioma: Between Pragmatism And Hope.
Published 2020 · Medicine
Although malignant pleural mesothelioma (MPM) is a rare tumor, it is among one the most discussed tumor in the industrial world. Mesothelioma represents 0.3% of all number of deaths for cancer in the recent GLOBOCAN study (1). The incidence is projected to increase in the next two decades, and the reported dismal 5-year survival rate of less than 5% makes MPM one of the deathliest worldwide tumor (2,3). Some Scientists suggest that the asbestos promotes a chronic pleural inflammatory that after years stimulates the development of a malignant mesothelioma in up to 5% of exposed individuals (4). Patients but also physicians/surgeons are sometimes found lost in the numerous confusing articles on MPM which can be easily taken from internet. Certainly, the source from where the information have been extrapolated is of paramount importance to obtain reliable scientific data on survival and quality of life (5-10), and this should be taken in consideration by the “modern” patient who goes in internet to take information about his/her surgeon and proposed treatment. Nevertheless, although the modern patient is becoming more and more exigent, the mesothelioma patient’s dream, isn’t about which kind of treatment will be used, but about simpler pursuits: patients want undergo to the treatment, surgical or non-surgical, which gives them long term survival, and good quality of life. In the modern real-life it is usual to find patients with MPM who are conducting a battle between the desire to live (hope) and the cruelty given by the large amount of data available on internet saying that the survival is poor (pragmatism) (11). For surgeons and oncologists, although at a different level of sadness, things are similar as we experience the contrast between the scientific evidence that surgery or other treatment does not “cure” MPM but in the same time we feel uncomfortable to deny hope to our patients. So, what is the right thing to do? My personal opinion is that that a more profound dialogue is necessary to understand the pragmatism and hope in MPM in such a way to know where the scale should hang.