A national telephone consulting service helped U.S. military veterans who believed they had mesothelioma gain timely access to experts in Boston who could treat them as well as any mesothelioma center in the country, according to a new study.
In cases where veterans were being treated for the disease locally, their travel to Boston led to many having their treatment changed, the research indicated. A key reason for the new regimens was that local doctors lacked access to surgeons with the malignant pleural mesothelioma (MPM) expertise that the Boston physicians had.
The study, “Open access phone triage for veterans with suspected malignant pleural mesothelioma,” was published in The Journal of Surgical Research.
Although malignant pleural mesothelioma (MPM) is rare, it is diagnosed in about 2,500 people a year, 88% of whom get it through exposure to asbestos. Because many veterans served in asbestos-handling occupations in the military, then did similar work upon discharge, healthcare specialists believe about 30% of new MPM patients are veterans.
In 2011, the Veterans Administration’s Boston Healthcare System started a national mesothelioma telephone consulting service for veterans who wanted MPM treatment advice.
The Boston facility, which has top mesothelioma doctors, did a review of those who used the service to obtain treatment from 2011 to 2015.
Goals of the review were to determine whether a telephone consulting service was effective, to assess whether veterans obtained timely access to mesothelioma experts regardless of where they were located, and to determine how many veterans had their treatment regimens altered in Boston.
Three-fourths of the veterans who used the phone service did so after reading about it on the internet. Only 24 percent were referred by a healthcare provider.
All 60 veterans in the study were men, with an average age of 68. The average time between the veterans’ initial phone call and a face-to-face evaluation was 14 days.
During this time, healthcare specialists collected patient data, confirmed previous patient MPM diagnoses, and excluded patients who were non-surgical candidates. The remaining 38 patients were invited to Boston, traveling an average of 997 miles.
The Boston doctors changed the treatment regimens of 71% of the patients, using International Mesothelioma Interest Group guidelines.
Twenty-one of the 38 patients’ initial treatment consisted largely of chemotherapy. Four were receiving palliative treatment to relieve symptoms but not treat the disease, and four were receiving a combination of therapies.
The Boston medical team put 29 of the patients on combination therapy. Doctors came up with entirely new diagnoses for four patients.
The study concluded that veterans with mesothelioma could obtain excellent treatment entirely within the Veterans Administration healthcare system and that the telephone consulting service helped veterans obtain timely access to treatment.
The researchers concluded that “a multidisciplinary team of experts (within the Veterans Administration system) can be assembled and motivated to deliver” the kind of care “possible only in a handful of elite teaching hospitals.”