Mesothelioma Treatments

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Malignant mesothelioma is a cancer of the lining of the lungs. It is a rare cancer, almost exclusively associated with long-term exposure to asbestos. As in all cancers, the cancer cells divide and multiply quickly, spreading the cancer to surrounding tissue.

The treatment options for persons diagnosed with mesothelioma depend on how far the disease has progressed when it is diagnosed. Although many doctors tell patients the average lifespan after a diagnosis of mesothelioma is less than one year, early detection and aggressive treatment by a doctor who specializes in the disease can substantially improve this prognosis. For example, there is a doctor in Boston who has about a 40 percent survival rate among his patients, though he only accepts new patients who have been diagnosed in the very early stages of the disease.

Asbestos Cancer There are three traditional methods for treating this asbestos cancer as well as other forms of cancer. The first traditional option is surgery to remove the cancerous tissue. This is most effective if the cancer is detected before it has metastasized, or spread throughout the body. The second traditional treatment is chemotherapy. Chemotherapy uses drugs to try to kill the cancer cells. The third traditional treatment is radiation. Radiation uses x-rays directed at the cancer cells to attempt to kill them. Many times, two or more treatment modalities are used in conjunction with one another to enhance the potential of success for each treatment.

The size and location of the cancerous tissue control how significant surgery must be. If the cancer is isolated to a small area of tissue, the doctor may be able to remove all of the cancerous cells without having to remove the entire lung. This procedure is known as pleurectomy or decortication. If the cancer is too large for only a portion of the lung to be removed, and the entire lung must be taken out, the procedure is called a pneumonectomy. The doctor may not know prior to beginning the surgery which of these two procedures will be necessary. Therefore anyone going in to surgery for pleurectomy should be prepared for the more serious option as well.

Chemotherapy drugs act to prevent cancer cells from multiplying. There can be several purposes in doing this. Chemotherapy is often used as a follow up to surgery to prevent the re-growth of any cancer the doctor may have missed. This type of chemotherapy is called adjuvant chemotherapy. Using chemotherapy to try to reduce the size of a cancer before surgery is called neoadjuvant chemotherapy. In February 2004, the Food and Drug Administration approved a new chemotherapy drug specifically developed for use in patients with malignant mesothelioma. The drug, pemetrexed disodium, also known by its trade name, Alimta, is not a cure for malignant mesothelioma, but used with other drugs, has lengthened the average life expectancy of patients who have tried it. As with many chemotherapy drugs, there are significant risks associated with Alimta, but also undeniable benefits.

IMRT Radiation, like chemotherapy, is used by doctors in several different ways in treating mesothelioma. One procedure is called intensity modulated radiation therapy (IMRT). IMRT is used in an attempt to damage the cancer cells as much as possible, while protecting nearby healthy tissue. IMRT is an advanced and precise radiation technique. It uses complicated computer algorithms to allow the radiation to conform to the precise shape of a tumor and delivers the radiation to that specific target, rather than bombarding the entire area. This allows much more control over which tissues are damaged. As a result, radiation can be used on tumors that in the past were untreatable because they were too close to internal organs that would have been damaged by general radiation. Helical tomotherapy combines the precision of delivery of radiation given by IMRT with the precision of CT scanning to allow radiation to be delivered to all sides of a tumor without as significant an impact on the surrounding tissue. Radiation is also used to help prevent or slow down metastases.

Another new treatment advance was approved in January of 2007. It relies on markers in the blood that show up when a person has malignant mesothelioma. Although at this time it has not been approved as an early detection technique, it does give doctors another means of monitoring a patient's reaction to treatment since the amount of marker in the blood is reduced as the cancer shrinks, or after it has been removed by surgery.

Since none of the current treatments typically cure mesothelioma most patients receive treatment for thier mesothelioma symptoms as well as treatment for the disease itself. Treatment for pain can be as simple as over-the-counter or low-level prescription pain medications, or as intensive as radiation. Pain medications may be taken orally, via transdermal (skin) patches, or injected. For advanced mesothelioma patients who have extreme pain, doctors may insert a device that puts medication straight into the spinal fluid where it takes almost immediate effect. Since all people's pain tolerance, and reaction to pain treatment are different, doctors develop a pain therapy that is individualized for each of their patients.

Experimental Mesothelioma Treatments Research into treatment options is going on constantly, and there have been a lot of new breakthroughs in the past few years. Two areas that are still being researched, but that do show promise for the future, are cancer vaccines and biologic therapy. These treatments are currently in the clinical trial stage. Doctors take sample cancer cells and, after eliminating the cells’ ability to reproduce, put them back into the body, thus causing the body’s natural defense mechanisms to attack the cells. Several different forms of vaccine with different ways of working are all under development, and it does appear that even if the vaccines are unable to completely protect a person from cancer, there will come a time in the not-too-distant future when they will play a large part in at least reducing the amount of invasive medical techniques that are currently necessary to treat and control cancer.

'Mesothelioma Treatments' Resources:
  1. "Mesothelioma Treatment Options", http://www.mesotheliomaweb.org/treat.htm, MesotheliomaWeb.org
  2. "Malignant Mesothelioma Treatment", National Cancer Institute
  3. Malignant Mesothelioma Treatment, National Cancer Institute.

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