The range of mesothelioma treatment options has gotten broader in the past decade, but an individual who has been diagnosed with mesothelioma must learn about the treatment options most appropriate for his or her unique case from the physician(s) providing medical care. The description here is merely a primer providing very basic information about asbestos exposure treatment and mesothelioma treatment options.
Traditional Mesothelioma Treatment Options
Five major approaches to mesothelioma treatments are surgery, radiation therapy, chemotherapy, palliative therapy, and biological therapy. Each method may be used alone, but often they are coordinated in combined programs to improve the overall treatment result. The extent of any treatment is always dependent upon a patient’s physical health condition, their age, the location and stages of mesothelioma (degree of disease) of the disease, and the extent of asbestos exposure.
Mesothelioma is a disease that attacks the lungs, the heart, and/or the chest lining (the mesothelium). A variety of mesothelioma treatment options are available, including:
- Surgery – A pneumonectomy or pleurectomy may be performed to remove diseased tissues.
- Radiation – Radiation therapy may be provided in lieu of or alongside surgery to kill off cancerous or abnormal cells in a specific target area.
- Chemotherapy – Chemotherapy is a more aggressive form of treatment used to kill cancerous cells throughout the body.
- Palliative treatments – Palliative treatments may be used to alleviate pain by draining excess fluid from the affected areas or by various other methods.
- Thoracentesis – Thoracentesis is the removal of fluid and/or air from the pleural space for treatment or diagnosis.
- A combination of two or more of the above therapies
Mesothelioma Surgery
Mesothelioma surgery occurs when patients are diagnosed with pleural mesothelioma and can be considered possible candidates for a surgical procedure known as pneumonectomy. This is the surgical excision (removal) of the diseased lung and, if need be, any affected parts of the surrounding diaphragm. In reality, pneumonectomy is considered a high-risk procedure, and eligibility is dependent upon the patient’s present state of health and extent of asbestos exposure.
Radiation Treatment of Mesothelioma
Radiation treatment, or radiation therapy, is the mesothelioma treatment of disease using either an external source of high-energy rays (x-rays or gamma rays) or internally implanted radioactive substances. These rays and substances are effective in destroying tissue and stopping the growth of malignant cells. In contrast to chemotherapy, radiation therapy is targeted towards a specific area and can treat the affected area without exposing the surrounding healthy tissue. Radiation can be used as a combination treatment along with surgery, or can be used alone to combat mesothelioma cancer. As with most treatments, a high dose of radiation can cause health complications.
Chemotherapy Treatments for Mesothelioma
Chemotherapy is the use of drugs in the cancer treatment. Standard chemotherapy treatments are either administered in the form of pills or injected medication, and may be used alone or in combination with surgery and irradiation. In chemotherapy, drugs are given according to a written protocol, or plan, that details exactly how the drugs will be given. Once these drugs are distributed in the body, however, both tumor cells and normal tissue cells are susceptible to their lethal effects, often making the patient very ill. Usually drug therapy is continued until the patient achieves a remission, which is the absence of all signs of disease. Common side effects of chemotherapy include nausea, vomiting, diarrhea, bleeding, weight loss, hair loss, and overall physical fatigue.
The main objective of chemotherapy is to destroy cancer cells and reduce the size of deadly tumors. Chemotherapy can be effective because it attacks the cells that are dividing and producing new cells, and interrupts the process of division. The problem with chemotherapy as noted above is that it can harm healthy cells. For example, hair follicles are some of the fastest growing cells in the body and are easily damaged by chemotherapy. That is why many patients with cancer have hair loss during treatment.
Chemotherapy can reduce the symptoms of this cancer by reducing the size of the tumors and may reduce the spread of the cancer and can in some cases extend your life expectancy. Of course, your chemotherapy treatment plan will vary depending upon the type of cancer. Note that pleural and peritoneal mesothelioma patients often get different drugs and differing ways of administering the drugs.
Chemotherapy Options
The length and type of chemotherapy received will depend upon the type, stage and growth of the mesothelioma. Also, the health of the patient and the type of drug that is given is very important. You may receive your treatments either systemically or directly into the part of the body where you have the cancer. Below is more information about how chemotherapy for mesothelioma is delivered:
- Systemic: Chemotherapy drugs are put into a vein or are given in the form of a pill. The medication goes through the blood and circulates all through the body.
- Intrapleural: The drugs are given via a small tube into the area of the body where the cancer is growing. Medication will still go into the blood, but the most concentration will be absorbed into the part of the body where the cancer is.
Chemotherapy drugs are given to the patient in cycles. The duration, total number of cycles and frequency will vary depending upon the type of cancer and other factors. Some of the ways that chemotherapy can be given include:
- Only chemotherapy, no other treatments
- Multimodal – Chemo may be combined with one or more treatments, such as radiation or surgery
- Neadjuvant – Before you have surgery, you will have chemotherapy to reduce the size of some tumors
- Adjuvant – A type of treatment that provides chemo after the surgery to reduce the chances of the cancer coming back
- Palliative – Attempts to relieve the major painful symptoms of mesothelioma and can be given along with radiation therapy
Types of Drugs for Chemotherapy
Chemotherapy drugs are often given in a combination. But in some cases where the patient is very sick, only one chemotherapy drug may be given at a time. The most common combination of chemotherapy drugs are Alimta and cisplatin given at the same time.
Other common chemo drugs are carboplatin, onconase, navelbine, and gemcitabine.
For people who are very ill, a single agent is often used. However, long term clinical trials suggest that patient response rate for single agent therapies are very low. In some cases, single agent treatments have a zero percent effective rate, but in some cases, effectiveness can be as high as 15%. In some specific cases with a very high amount of a single agent, response rates can be higher. Some of the most common single agents for mesothelioma are doxorubicin, carboplatin and cisplatin.
Combination therapy is the most common type of chemotherapy, where two or more drugs are given to the patient. Recent clinical studies suggest that there are positive results with mesothelioma patients who get this type of chemotherapy regimen. The cisplatin and pemetrexed combination seems to be especially effective for some patients.
First Line and Second Line Chemotherapy
First line chemotherapy treatments are the first tried and usually the option with the best treatment results. First line chemotherapy treatments for pleural mesothelioma is usually a mixture of cisplatin and pemetrexed. However, other drugs might be used depending upon several factors. If the first line chemotherapy plan does not work well, then a second line treatment option may be tried. The second round can involve a similar method as the first treatment, or may involve a totally different set of drugs.
Chemotherapy for Peritoneal Mesothelioma
Chemotherapy that is given for peritoneal mesothelioma is different than that given for pleural mesothelioma. This type of chemotherapy is referred to as intraperitoneal chemotherapy. This is a type of drug therapy that involves a high concentrations of drugs being put directly into the peritoneal cavity.
But the degree of penetration into the deadly tumors is fairly limited. Studies indicate that the absorption of drugs into the tumors is only a few millimeters deep. Thus, hyperthermic intraperitoneal chemotherapy or HIPEC, or heated chemotherapy, is often chosen as an option. The high temperature of the drugs increases the ability of them to be absorbed into the tumors, and this can often reduce pain and increase the lifespan.
Clinical Trials
Various clinical trials for combination chemotherapy have showed some positive results for people suffering from different types of mesothelioma. Many studies have shown there is an increase in five year survivability with the chemo drug combination of cisplatin and at least one other chemotherapy drug. More critically, clinical trials for various chemotherapy drug combinations indicate that the effectiveness and positive response rates for chemotherapy are getting better, and the knowledge of cancer specialists in mesothelioma is also increasing.
If you have mesothelioma and want to increase your treatment options, please consider participating in clinical trials. The National Cancer Institute states that less than 5% of all cancer patients are in a clinical trial at any one time. This makes it harder to find new treatments for some of the rarer cancers. Only 3,000 or so are diagnosed with mesothelioma in the US each year, thus it is very important for patients to volunteer for clinical trials to increase the possibility of finding good treatments.
The best news here is that patients with mesothelioma rarely have to wait to get into these clinical trials. There are dozens of mesothelioma and asbestos cancer trials going on all the time. Government regulations require years of testing before new cancer treatments can get approved by FDA. But if you volunteer for a clinical trial, you can receive a possibly life saving treatment almost right away.
Palliative Therapy Treatment
Palliative therapy is a relieving, but not a curative method for treating and controlling the symptoms of mesothelioma cancer. During palliative therapy treatment, mesothelioma patients experience some relief when a needle is used to drain and suction excess fluid from the affected tissue. Generally, post-palliative drugs are administered to the patient in order to prevent further accumulation of fluids.
Biological Treatment for Mesothelioma, Lung Cancer
Biological treatment is a more recent approach to all cancer treatments, including treatment of mesothelioma cancer. It is the use of the body’s own defense mechanisms to fight tumor cells. Medical experts are exploring how elements of the immune system can be restored, enhanced, mimicked, and manipulated to destroy cancerous cells. Substances produced by normal cells that either directly block tumor growth or stimulate the immune system and other body defenses are called biological response modifiers. Examples of these substances are interferon (made by lymphocytes, which are important in immune response), monoclonal antibodies (derived from mouse cells and capable of binding to human tumors in an immune response), colony-stimulating factors (CSFs) that stimulate blood-forming cells, and interleukins that stimulate the immune system.
New and Alternative Mesothelioma Treatments
The best way to learn about alternative treatments is to consult with your doctor and perform your own additional research. Most doctors will recommend that treatments considered to be alternative be used to complement, but not replace, traditional treatments that are already proven effective. For those diagnosed with mesothelioma, new treatment options may make treatment more effective.
Some examples of alternative treatments include:
- Immunotherapy or biological therapy, a type of treatment in which the patient’s own immune system is ‘tricked’ into killing cancer cells;
- Photodynamic therapy, a treatment involving the use of light energy to kill cancer cells;
- Intensity-modulated radiation therapy, an advanced mode of high-precision radiotherapy that utilizes computer-controlled x-ray accelerators to deliver precise radiation doses to a malignant tumor or specific areas within the tumor;
- Gene therapy, which involves using genetic material to specifically target cancer cells and make them more vulnerable to chemotherapy treatment;
- Alimta, an FDA-approved drug for treating malignant pleural mesothelioma; and
- New chemotherapy agents (new forms and variants of traditional chemotherapy have been developed, and your doctor should be able to explain the different types of chemotherapy that are available).
- See our Ultimate Guide to the best natural remedies and alternative treatments updated for 2016
Whatever treatments you choose, be sure to seek the council of a physician who specializes in mesothelioma cancer treatment before making any decisions. You may hear of things that promise a mesothelioma cure, but only your doctor will know the best course of action for your situation. These mesothelioma treatment options are often helpful and effective, but the prognosis for most mesothelioma patients is poor, and the life expectancy is not long. A diagnosis of mesothelioma is understandably devastating, but a patient and his or her family are not without options.
Become Informed on Mesothelioma Guidelines
Because mesothelioma is a serious, potentially fatal asbestos disease, determining what treatment to participate in can often be an overwhelming process. It can help to review a mesothelioma guide that explains treatment options. It is important to become as informed as you possibly can by:
- Seeking multiple medical opinions about treatments and their effectiveness.
- Asking doctors to recommend informational resources such as websites or books.
- Doing your own research, reading, and studying all you can about mesothelioma treatments.
- Staying informed to help you understand the reality of your situation and help prevent the tendency to feel overwhelmed.
Decisions about Mesothelioma Treatment
The choice of treatment for a mesothelioma patient is best arrived at as a result of discussion with the patient’s doctor(s). Some patients are “hardier” than others and more able to withstand and benefit from a given treatment. A good mesothelioma treatment guide will also mention the unfortunate reality that for some patients, there is no viable treatment, and he or she will benefit most from palliative care, designed to make the patient comfortable in his or her final days.
When deciding on treatments with your doctor, the following factors should be considered:
- Stage and location of the cancer
- Age of the patient
- Patient’s overall health
- Potential risks and benefits of the mesothelioma treatment
Next Steps
Concerns about the cause of the mesothelioma (which is nearly always exposure to asbestos) can be taken up with a law firm. Contact us today to schedule a free consultation with an asbestos/mesothelioma attorney in your area. An experienced attorney for mesothelioma patients will help you determine the cause of the mesothelioma and will fight to recover compensation for your losses.
