Mesothelioma Treatment Guide
Some of the first questions newly diagnosed mesothelioma patients will ask usually concern the treatment of their disease�and rightfully so. Prompt treatment of this cancer is necessary in order for the patient to have as favorable a mesothelioma prognosis as possible.
Historically, treatments for mesothelioma have been fairly limited and have not exhibited a lot of success in slowing the progression of the disease. However, as the plight of sufferers has become more visible - thanks to numerous mesothelioma advocacy groups - and more and more dollars are spent on research of this aggressive cancer, the number of options for treatment are growing and treatments are becoming more successful. Nevertheless, there’s still a long way to go in discovering the ideal therapy that will cure mesothelioma.
Exactly what mesothelioma treatment is recommended will vary with each patient. In many cases, especially when treatment occurs at a designated cancer center, a “medical team” will convene to assist each other in determining what is best for the patient. This might include not only an oncologist but also a pulmonologist, thoracic surgeon, and radiologist. These medical professionals are all experts in their particular field and can work together to design the ideal treatment regimen. During the treatment period, these individuals will meet weekly to determine whether the regimen is proceeding successfully or if they need to make changes in the treatments.
A patient’s doctor(s) may consider several options for mesothelioma treatment including:
Surgery
The earlier mesothelioma is diagnosed, the more likely it is that the patient will be a candidate for mesothelioma surgery. The patient must also be in relatively good health and free of other issues that may complicate these surgeries, which are long and have the potential for a number of complications. In some cases, these surgeries might be considered “curative”, but this is unlikely for most mesothelioma patients. Instead, the object of these surgeries is to remove as much of the disease as possible or to reduce the debilitating effects of the disease, most of which will severely impact the patient’s ability to live a somewhat normal life. Surgeries may include:
- Pleurectomy - This surgery involves the removal of the lining of the lungs, including both the visceral and parietal layers and, in some cases, the lung tissue beneath the pleura. This is an inpatient procedure that will require a hospital stay of about a week, sometimes longer.
- pneumonectomy - A pneumonectomy is a procedure that removes the diseased lung of the mesothelioma patient. It is performed on patients whose cancer is limited to just one lung. It is a long and serious surgery which requires that the patient be in relatively good health with no co-morbidity issues. This procedure requires approximately a 2-week hospital stay and a recovery period of up to six months.
- extrapleural pneumonectomy - The most serious of all mesothelioma-related surgeries and one that is generally used in only rare cases, this procedure involves the removal of not only the diseased lung but also the areas surrounding it. Complications are commonplace and the recovery period is very lengthy. However, a successful surgery of this type can add months or more to the patient’s life expectancy.
Chemotherapy
Chemotherapy for the treatment of mesothelioma can be used as a primary form of therapy or as an "adjuvant" therapy after surgery. Chemo after surgery is used to kill any cancer cells that remain after the operation is complete. Chemotherapy may be recommended in hopes of shrinking the tumor and killing cancer cells or it may be suggested for palliative purposes in order to lessen the symptoms of the disease and make the patient more comfortable.
A number of different chemotherapy drugs have been used to treat mesothelioma. Currently, the most successful drug is Alimta®, the only FDA-approved chemo drug specifically for the treatment of pleural mesothelioma. It is usually combined with another chemotherapy medication, generally a platinum agent like Cisplatin, for best results. There are a number of additional chemo medications that have also been used to treat mesothelioma, including gemcitabine, navelbine, onconase, and carboplatin. The treating oncologist will decide which is best for the patient. Often, two are used together and it may take some time to determine the right combination.
Radiation Therapy
Radiation may be recommended as an adjuvant therapy after surgery or may be used on its own or in tandem with chemotherapy. It may also be used as a palliative treatment to relieve pain or other symptoms of the disease.
- External beam radiation - Radiation can be delivered in the traditional manner by a machine that shoots a beam directly at the affected area. This form has been available since the 1940s and has shown some success in treating meso but also kills healthy cells as well as cancer cells.
- Brachytherapy - In many instances, radiation treatment for mesothelioma may include brachytherapy, which involves implanting tiny radioactive seeds directly at the site of the tumor. This method better targets the tumor and spares more healthy cells.
Clinical Trials
New treatments for mesothelioma are constantly being tested and patients can be part of the testing process by enrolling in clinical trials that may include newly-developed drugs or experimental therapies like immunotherapy or gene therapy. Many of these therapies are beginning to show promise in the treatment of mesothelioma.
Clinical trials may seem risky at first glance but all are very closely monitored. Should any adverse effects occur, the patient may be removed from the trial immediately. Though not all patients will benefit from the trials, most individuals who have opted to participate in them note that they were pleased with their decision to be a part of these trials.
Sources
www.cancer.org/cancer/malignantmesothelioma
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