Mesothelioma Treatments 2019
Thousands of patients are diagnosed with mesothelioma annually. This requires them as well as well as their families to think about the best treatment options for their specific form of the disease. The life expectancy for many forms of malignant mesothelioma can range from mere months to possibly a year. But with constant research and advances in clinical trials, there is more hope for increasing treatment efficacy and finding new treatments that might even lead to a cure someday.
Setting Up a Treatment Plan
After getting a diagnosing and having initial tests, mesothelioma patients have to develop an effective treatment plan. This can offer the cancer patient and their loved ones peace of mind because it outlines the best treatment options for the individual.
The medical teams who are dedicated to providing all of the help and care to the patient comprise many people, including:
- The patient
- Nurses in the cancer facility
- Social workers
- Family and friends
- Home care or hospice
- Psychologist or psychiatrist
- Nutritionists and dieticians
Together, all of these people will make the best, informed decisions about what is best for the patient’s physical, mental and emotional health and well being.
Below are some of the current treatments for mesothelioma of various forms. Some are used in a combination for best effect and long term prognosis.
Treatments In This Section
- Radiation Therapy
- Multimodal Therapy
- High Dose Radiotherapy
- Palliative Radiotherapy
Immunotherapy is a new and somewhat experimental treatment option for mesothelioma. It is not yet the typical, first line treatment option, but research and clinical trials are ongoing and will make it a reality at some point.
Some immunotherapy drugs, especially Keytruda, have helped some mesothelioma patients to live for many years with the disease. Keytruda is now available to mesothelioma patients via clinical trials and some compassionate use programs. It is approved by FDA for treating any type of cancer that features a microsatellite instability high or mismatch repair deficient solid tumor.
The use of immunotherapy can boost immune system response to the cancer, but it does not cure it. Clinical studies are integrating immunotherapy as one piece in a multi-treatment plan to more effectively manage mesothelioma like it is a chronic illness.
The most promising immunotherapy agents today are Keytruda, Opdivo and Yervoy. (asbestos.com)
Chemotherapy is one of the major treatments for mesothelioma. Alimta and cisplatin is the most common combination to treat this disease. While it cannot ever cure mesothelioma and has several challenging side effects, it has the ability to kill mesothelioma cancer cells, which can reduce your symptoms and boost quality of life. It also can extend your life. Chemotherapy often is used as the first line cancer therapy for mesothelioma, or can be combined with surgery and/or radiation.
While chemotherapy is thought to be the standard of care for the majority of mesothelioma cases, patients generally see mediocre results. A recent clinical study found that of pleural mesothelioma patients who only got chemotherapy, just 20% survived two years after they were diagnosed. After five years, only 4% of these patients were still living. However, the study found that patients who received chemotherapy combined with cytoreductive surgery, which is a common multimodal therapy, got much better rates of survival. About 40% survived two years and 10-12% made it five years. (Cancer.org)
Chemotherapy drugs can be used to treat mesothelioma either systemically via pill or intravenously. Or, chemotherapy drugs can be injected straight into the site of your tumor. It saturates the part of the body with the cancer and kills cells that could be left after the surgery has been completed.
Radiation therapy utilizes high energy X-rays to kill cancer cells. Mesothelioma often can be difficult to treat with radiation alone; mesothelioma does not usually grow as distinct tumors so it can be challenging to aim high doses of radiation at them while not damaging normal tissues. That said, new technologies are giving more effective control of the radiation beams and can make this type of treatment more helpful for some people. (cancer.org)
Radiation therapy can be used in several ways to treat mesothelioma:
- After surgery to kill small cancer areas that cannot be seen and taken out during surgery. This is known as adjuvant radiation therapy.
- It also may used as a palliative treatment to make the symptoms of mesothelioma more bearable, including shortness of breath, bleeding, pain or difficulty swallowing.
Side effects of radiation therapy for mesothelioma include fatigue, sunburn-type problems, and hair loss where the radiation goes into the body. Also, chest radiation therapy can cause lung damage over time and lead to shortness of breath and breathing difficulties.
Multimodal therapy combines more than one type of treatment for mesothelioma. For example, surgery with chemotherapy and and radiation is one of the most common approaches to treat the disease. Immunotherapy and gene therapy also can be added for new multimodal therapies.
Many multimodal treatment approaches usually focus on a surgery that removes a major tumor, with radiation therapy and chemotherapy also used.
For cases of peritoneal mesothelioma, cytoreductive abdominal surgery that is combined with HIPEC or hyperthermic intraperitoneal chemotherapy is probably the most effective mode of treatment.
For cases of pleural mesothelioma, there is no one treatment plan that is better than the rest. It all depends on the specific circumstances of the patient and the professional opinion of their physicians. (NIH.gov)
Surgery is a main line treatment for mesothelioma patients. It is often used in conjunction with chemotherapy and radiation to increase the success rate for patients. In the early stages of the disease, surgery can boost survival times and some patients may even go into remission. In the late stages of the disease, surgery is used primarily for relieving pain and increasing comfort.
Some of the most common surgical options are:
- Extrapleural pneumonectomy (EPP): This method is often used on stage 1 and stage 2 patients. An EPP involves the total removal of the affected pleura, lung and some of the diaphragm.
- Pleurectomy/Decortication (P/D): This surgery is the removal of the lining of the lung and any tumors that are visible. Stage 1 pleural mesothelioma patients often receive a pleurectomy to remove the biggest tumors.
- Cytoreduction and HIPEC: This is the removal of the abdomen lining – the peritoneum. This surgery is often used with heated intraoperative chemotherapy (HIPEC).
There are several types of surgeons who specialize in various forms of mesothelioma. Patients with pleural or pericardial mesothelioma often are taken to a thoracic surgeon. Thoracic surgeons do surgeries on the heart, lungs and other chest areas. Meanwhile, patients who have peritoneal mesothelioma are taken to a gastrointestinal surgeon. (Cancer.org)
High dose radiotherapy is a common cancer treatment for mesothelioma. Patients often undergo radiation as part of a multimodal treatment plan with surgery and chemotherapy, which has shown better life expectancy for people with earlier stages of mesothelioma.
High dose radiotherapy can be used as one part of a curative treatment plan or just for palliative purposes. High dose radiotherapy can be used to get rid of remaining cancer cells in certain areas of the body. Sometimes, mesothelioma radiation many be used during an operation, which is known as intraoperative radiation or IORT. This application of high dose radiotherapy allows rays to be delivered straight to the cancerous area of the patient’s body after the tumor has been removed. (Medscape.com)
Palliative radiotherapy refers to treatment to shrink mesothelioma tumors, slow down growth or control symptoms that are caused by cancer. Palliative radiotherapy does not seek to cure mesothelioma, so lower radiation doses may be used safely without many side effects. The major purpose of palliative radiation is to control cancer symptoms, or to prevent them from occurring and give the patient a higher quality of life. (Targetingcancer.com.au)
Chemoimmunotherapy is a form of chemotherapy combined with immunotherapy. Chemotherapy uses several different drugs to slow the growth of cancer cells, while immunotherapy uses treatments to increase the ability of the immune system to fight mesothelioma cancer. (Sharecare.com)
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- Radiation Treatment. (n.d.). Retrieved from https://www.cancer.org/cancer/malignant-mesothelioma/treating/radiation.html
- Immunotherapy. (n.d.). Retrieved from https://www.asbestos.com/treatment/immunotherapy/
- Mesothelioma Treatment. (n.d.). Retrieved from https://www.cancer.org/cancer/malignant-mesothelioma/treating/surgery.html
- Chemotherapy. (n.d.). Retrieved from https://www.cancer.org/cancer/malignant-mesothelioma/treating/chemotherapy.html
- Palliative Treatment. (n.d.). Retrieved from https://www.targetingcancer.com.au/treatment-by-cancer-type/palliative-treatment/
- What Is Chemimmunotherapy? (n.d.). Retrieved from https://www.sharecare.com/health/chemotherapy-for-cancer/what-is-chemoimmunotherapy