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MESOTHELIOMA
TREATMENT OPTIONS
While there is currently no known
cure for malignant mesothelioma, treatments are available with
the most common being surgery, chemotherapy and radiation
therapy.
Your doctor will recommend one treatment or a combination of
therapies that are best for your situation. The course of
treatment will depend on a number of factors including the
location of the disease, the stage
of the disease, your age, overall health and your
preferences.
The information provided throughout this website is for your
information only, and should NOT take the place of a full medical
diagnosis.
Traditional Treatment Options
There are three traditional kinds of treatment for patients
with malignant mesothelioma:
Doctors will often use two or
more of these treatment courses jointly to provide the maximum
likelihood of success. This “multi-modal” approach holds
the most promise for survival of malignant mesothelioma
patients. Trimodality therapy, in which all three of these
modalities are used, is considered the most effective, and
aggressive, approach.
Surgery
There are several types of surgeries used to treat
mesothelioma and the disease type and stage will determine the
type of surgery. Mesothelioma tumors are usually large and
difficult to completely remove, so surgery is usually combined
with other cancer treatments to ensure the best results in
destroying the tumor.
There are generally two types of surgical methods for the
treatment of mesothelioma: Palliative Procedures and
Potentially Curative Procedures.
- Palliative Procedures
are those which treat the symptoms of mesothelioma,
providing relief for the patient, without aggressively
treating the disease itself.
Chest Tube Drainage and Pleurodesis
The goal of chemical pleurodesis is to cause an irritation
between the two layers covering the lung. This irritation
causes an obliteration of the space between the layers
where the fluid accumulated, and prevents further fluid to
be able to accumulate there. There are a variety of
agents, which can be used including talc and bleomycin. As
the pleural space is closed, fluid drains out of the chest
cavity using a chest tube.
Pleuroperitoneal Shunt
Pleuroperitoneal shunting has been used in patients who
have failed chemical pleurodesis, chemotherapy, or
radiation therapy. Pleuroperitoneal shunting can provide
effective palliation in patients with a trapped lung or
others who have failed treatment.
-
Potentially
Curative Options are medical procedures that attempt
to remove all gross disease with 'curative intent'.
Residual microscopic disease cells are then removed
through Adjuvant
therapy.
Pleurectomy/Decortication
A Pleurectomy/Decortication is a surgical procedure
where the pleura, the membrane lining the lungs and chest
cavity, is removed, without removing the entire lung. This
treatment option is usually performed on patients in the early
staging of mesothelioma.
Extra-Pleural Pneumonectomy (EPP)
EPP is the removal of the pleura, diaphragm,
pericardium, and the whole lung involved with the tumor.
EPP is considered a radical therapy and is not frequently
performed by most surgeons, patients are referred to
centers specializing in these treatments.
Both the above 'potentially curative' procedures are
typically used in combination with other treatment options
(multi-modal therapy).
Chemotherapy
Chemotherapy uses drugs to kill cancer cells and may be
used as the primary treatment to mesothelioma, or it may be
used as part of a multi-modal approach. Chemotherapy is
referred to as systemic treatment because the drug is
introduced into the patient’s bloodstream and travels
throughout the body killing cancer cells. The drugs may be in
pill form, or injected into the body through a needle.
In addition to killing cancer cells, chemotherapy drugs work
to restrict the uncontrolled spread of abnormal cancer cells -
preventing them from dividing and multiplying.
Chemotherapy is not considered a 'curative' approach for the
treatment of mesothelioma and instead focuses on shrinking
existing tumors (usually prior to surgery - neoadjuvant
therapy), controlling the spread of the cancerous cells, and
removing residual cancer cells following surgery (adjuvant
therapy).
To effectively treat mesothelioma, more than one drug may be
used in chemotherapy. Depending on the drugs, the amount taken
and the treatment period, there may be side effects.
Historically, doxorubicin has been the most widely used single
chemotherapy drug. Other newer drugs, including gemcitabine,
cisplatin, carboplatin, epirubicin, cyclophosphamide,
ifosfamide, vinorelbine, paclitaxel, and methotrexate, now are
often preferred and are usually given in different
combinations.
Radiation
Therapy
Radiation therapy uses high-energy x-rays help to destroy
cancer cells and shrink tumors. The radiation may come from
outside the body from a machine (external radiation) or from
radioactive materials placed directly in or around cancer
cells through thin plastic tubes (internal or implant
radiation).
In pleural mesothelioma, it is difficult to irradiate tumor
tissue successfully without injuring nearby organs like the
lungs, heart, and liver. However, radiation therapy can be
very effective in relieving pain in certain situations.
Factors which can impact the use of radiation treatment
include the volume of the tumor and how near it is to vital
organs.
Non-Traditional
Treatments
Photodynamic Therapy
Photodynamic therapy destroys cancer cells by using the
energy from light and may also be effective when combined with
surgery. Although this treatment is in the experimental stage
for mesothelioma, it has shown promising results in treating
other cancers. In the procedure, the patient receives a
photosensitizer (a drug which makes cells sensitive to
specific wavelengths of light) which collects in cancerous
cells but not in healthy cells. Once the cells have been
sensitized, fiber optic cables are placed in the body (usually
through open-chest surgery) so that the correct frequency of
light can be focused on the tumor. This causes the
photosensitizer drug to produce a toxic oxygen molecule which
kills the cancer cell.
Gene Therapy
This is a new treatment, currently in clinical trails.
This approach allows treatment to target tumors, rather than
destroying healthy cells which is the negative of traditional
chemotherapy. In gene therapy, cancer is treated by altering
genetic defects that allow a tumor to develop. A “suicide
gene” is inserted directly into the tumor, making the cells
sensitive to a normally ineffectual drug. The drug is then
administered to the newly sensitive cancer cells and it
destroys those cells while leaving the healthy cells unharmed.
Immunotherapy
Immunotherapy (or biological therapy) treats cancer by
using the body’s own immune system fight cancer cells.
Another name often applies to this therapy, biological
response modifiers (BRMs). Though not yet obtainable,
promising clinical studies are underway for immunotherapy.
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Our Mesothelioma Library and Latest News sections provide
access to many articles, abstracts and information regarding
recent treatment options and experimental therapies. Mesothelioma
Library | Latest
News
MesotheliomaHelp.net provides a thorough listing
of mesothelioma specialists, treatment centers and support
groups, click here.
If you have been diagnosed with mesothelioma, or are worried
that you might have mesothelioma, you may be eligible for
compensation. Medical treatment is your primary concern,
however, knowing your legal rights can help protect you and
your family. Click here to learn
more about your legal options.
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