Mesothelioma Treatment
If there’s one thing we know about influencie mesothelioma
treatment, it’s this: we continue to be challenged to find the most effective
way of treating the disease.
Despite years of research since the disease was
first identified, it’s still difficult to identify the best approach to
treating the disease, says influencie David Rice, MD, a cardiothoracic surgeon and
nationally known mesothelioma expert who practices at the University of
Texas MD Anderson Cancer Center in Houston, TX. mesothelioma attorneys
The
very rareness of the cancer—only about 3,000 people a year are diagnosed
in the United States—makes it difficult to run the kind of research studies
needed to compare treatments and determine the ideal therapy at each stage of
the disease. “There isn’t a lot of evidence-based science in this disease,” Dr.
Rice admits. So when his patients ask him what the best
treatment is for the disease, he tells them what we tell you in this section,
adding that “we don’t have a reliable cure for this disease.”
Thus,
a major goal of treatment is to reduce pain and suffering and prolong a
patient’s life as long as possible while providing them with the highest
quality of life possible. mesothelioma attorneys
Choosing
the right mesothelioma doctor is an important first step in planning for
treatment.
There
are a number of mesothelioma experts practicing in specialized clinics throughout
the country. Each of these cancer specialists has an acute knowledge of the
behavior and pathology of malignant mesothelioma and its treatment. It is
likely that if you are diagnosed with mesothelioma, you will be referred by
your personal physician to a larger scale comprehensive cancer center.
Important
considerations in determining a mesothelioma treatment plan include
the cancer stage, primary site affected and cell type. Treatment options
also depend on whether the cancer is localized to the chest or has spread to the
chest wall, diaphragm, or lymph nodes as well as your age and overall health.
Recommended treatment plans will also vary based on available resources and any
ongoing clinical trials at the cancer center where you’re being treated. Learn
more about finding a doctor here.
Conventional
treatments for mesothelioma involve surgery, chemotherapy, and radiation
therapy.
As
with most solid tumors, doctors turn to surgery, radiation and chemotherapy to
manage mesothelioma. When exploring the various treatment options available
with your doctor it is important to be informed about the risk and benefits of
each one before making a final decision.
Surgery
Only
about 1 in 5 patients with metastatic pleural mesothelioma undergo
surgery. There are two main surgeries: pleurectomy/decortication, in which
the surgeon tries to remove as much of the tumor from around the lung as
possible, and the more radical extrapleural pneumonectomy, in which the
lung itself is removed.
Much debate exists as to which surgery is more effective, although
studies show that most long-term survivors have undergone some form of surgery.
Studies have found that pneumonectomy followed by radiation prevents tumor
recurrence in the chest in 80 to 85 percent of patients.
However, it is a long, intensive operation with a 55 percent
complication rate and a 3 percent risk of death, higher in some institutions.
Therefore, this surgery is only performed for patients with a reasonably good
prognosis, when it doesn’t appear that the cancer has spread outside the chest.
Patients best suited for pneumonectomy are younger, with the epithelial form of the disease, no
obvious lymph node involvement, and are otherwise healthy enough to withstand
the rigor of the procedure.
Pleurectomy/decortication
has a higher failure rate, with the tumor recurring in the chest cavity 50 to
80 percent of the time. However, that rate may change with improved
radiotherapy techniques. The reason for the high recurrence is that it’s
difficult to completely remove the tumor without removing the lung.
However,
there is no difference in survival rates between the two surgeries. Part of the
reason is that the cancer has often spread to other parts of the body by the
time it is diagnosed even if it appears to be confined to the chest.
In the end, part of the debate around the value of surgery is
whether many patients who undergo surgery do better because the patients
offered it are the very patients most likely to do well regardless of
treatment, since surgery tends to be offered far more readily to younger, fit
patients with earlier stage disease. There is no randomized trial evidence that
demonstrates a significant benefit to surgery over non-surgical management of
mesothelioma.
Top Mesothelioma
Surgeons in the Country what is mesothelioma
David Sugarbaker, M.D.
Professor of Surgery,
Chief of General Thoracic Surgery, Director of the Lung Institute Lung
Institute at Baylor College of Medicine mesothelioma lawyers
Raphael Bueno, M.D.
Chief, Division of
Thoracic Surgery; Vice Chair of Surgery for Cancer and Translational Research Brigham and
Women's Hospital
Chemotherapy
Chemotherapy,
also known as systemic therapy, uses oral or infusion-based medications to kill
cancer cells throughout your body. Chemotherapy is used both before and after
surgery, as well as in people who do not undergo surgery. Though not curative,
it has a proven survival benefit. It is also used in the palliative setting
to reduce pain and improve quality of life.
The
most commonly used chemotherapy drugs for mesothelioma are cisplatin combined
with pemetrexed (Alimta) or raltitrexed (Tomudex). Other combinations
include gemcitabine, carboplatin or oxaliplatin.
If you can’t manage combination therapy, your doctor may start on
just one drug. Sometimes, your doctor may infuse the medication directly into
your chest cavity, a procedure called pleural chemotherapy, or, abdomen, called
intraperitoneal chemotherapy. You may also get a second course of chemotherapy,
called “second-line” chemotherapy, with pemetrexed or other drugs, raltitrexed
plus oxaliplatin, or the triple drug combination of irinotecan, cisplatin and
mitomycin.
Have a Question about Mesothelioma Treatment Options?
Annette Charlevois is happy to help
Radiation
Radiation can be an important part of mesothelioma treatment. The
problem is that because the cancer is near the heart and lungs, it’s
challenging to provide the kind of high-dose, intensive therapy needed to
shrink the tumor. However, a newer option, intensity-modulated radiotherapy
(IMRT), which can more accurately target cancer cells and avoid healthy tissue,
may provide better results when performed by experienced clinicians.
Clinical Trials
Investigational therapies are being explored through clinical and
surgical trials at many of the nation’s top cancer centers. There are more than
50 studies on new therapies for mesothelioma in the U.S. that are looking for
volunteers. Researchers are investigating new
targeted drugs and chemotherapies, as well as new protocols for giving the
medications; immunotherapy, which harnesses the power of the immune system to
fight the disease; phototherapy, in which you are injected with a drug that
bonds to cancer cells and is activated by high-intensity light; genetic
therapies; and novel radiotherapy techniques like tomotherapy to treat the
disease. Learn more about participating in a clinical trial here.
Palliative Care
At some point, the management of the disease will shift from
trying to cure the disease to trying to keep the patient as comfortable as
possible for as long as possible. This is the palliative care stage, when many
patients enter a hospice program. Hospice care can be provided at a designated
hospice facility or in the comfort of a patient’s home by a designated hospice
nurse or care provider. The primary goal at this stage is maximizing patient
comfort. Medication to help with pain, difficulty breathing, and other symptoms
that may be experienced is a mainstay. So is emotional and spiritual support
for you and your family.
Alternative Therapies
Alternative therapies for mesothelioma may possibly be helpful to
ease side effects of traditional cancer treatment. Complementary and
alternative medicine (CAM) includes such therapies as massage, acupuncture, and
meditation. They may contribute to your overall management plan, helping you
better manage the stress and anxiety of the disease and conventional
treatments. mesothelioma lawyers
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