What follow-up protocols should be in place for patients with a history of asbestos exposure, considering the risk of mesothelioma?

Follow-up protocols for patients with a history of asbestos exposure to monitor and detect mesothelioma should include:

• Offering an urgent chest X-ray within 2 weeks if the patient is aged 40 or over and presents with unexplained chest pain, cough, shortness of breath, fatigue, weight loss, or appetite loss, as these symptoms may indicate mesothelioma.
• Ensuring prompt investigation of any respiratory symptoms or chest signs compatible with pleural disease, with an urgent chest X-ray recommended for those aged 40 and over with asbestos exposure.
• Providing regular follow-up appointments rather than relying on patients to request appointments when symptoms arise, to facilitate early detection of mesothelioma.
• Offering protocol-driven follow-up led by a lung cancer clinical nurse specialist for patients with a life expectancy of more than 3 months, to monitor ongoing care and symptoms.
• Ensuring patients know how to contact their lung cancer clinical nurse specialist between scheduled visits for any new or worsening symptoms.

These measures aim to detect mesothelioma early in patients with asbestos exposure by vigilant symptom monitoring and timely imaging investigations.

References: ¹, ²