Essential Questions to ask if you or a loved one has been diagnosed with Mesothelioma ***IMPORTANT***

Surgery for Mesothelioma After Radiation Therapy (SMART) Protocol

Posted on: October 17, 2023 *Updated on: May 27, 2024

SMART protocol (Surgery for Mesothelioma After Radiation Therapy) used in the treatment of malignant pleural mesothelioma. Here’s a more detailed breakdown based on the information you’ve given:

  1. Mesothelioma and its Challenges: Malignant pleural mesothelioma is a cancer of the lining of the lungs (pleura) most often caused by exposure to asbestos. It’s known for its aggressive nature and has historically had limited treatment options, leading to poor prognosis for many patients.
  2. SMART Protocol: The Surgery for Mesothelioma After Radiation Therapy (SMART) approach is an innovative method used to treat this type of cancer. The primary idea behind SMART is to intensify the radiation therapy to a short duration, targeting the affected region just before surgery. This approach aims to shrink the tumor and reduce the chances of cancer cells spreading during surgery.
  3. Median Survival of 24.4 months: This suggests that, on average, patients who underwent the SMART protocol lived for about 24.4 months after the treatment. It’s important to compare this figure to median survival rates of other treatments for mesothelioma to gauge its relative effectiveness. For many patients with mesothelioma, increasing survival and improving quality of life are significant goals.
  4. Origin in Toronto: The protocol began in Toronto, Canada, indicating that the city’s medical researchers and institutions have been at the forefront of developing this treatment approach.
  5. Expansion to U.S. Cancer Centers: Its adoption by multiple cancer centers in the U.S. suggests a growing acceptance of the method, highlighting its potential as a treatment option for mesothelioma patients in different parts of North America.
  6. EPP (Extrapleural Pneumonectomy): This surgical procedure is a major surgery that involves the removal of the affected lung, parts of the diaphragm, the pleura, and sometimes portions of the pericardium (lining around the heart). While it’s a radical approach, it’s often used in patients who are deemed suitable candidates, with the aim of removing as much of the tumor as possible. The SMART protocol typically involves using EPP as the surgical step following radiation.

It’s important for patients and families to discuss the potential risks, benefits, and alternatives of the SMART protocol with their oncologist or thoracic surgeon. Each patient’s condition, health status, and stage of cancer can influence the best treatment choice.