Malignant mesothelioma is a cancer caused by exposure to asbestos that attacks the lining of the lungs, abdomen, heart, or in exceptionally rare cases, the testicles. Treatment options may include surgery, chemotherapy, radiation, and experimental treatments that are sometimes used separately, but more often combined in a comprehensive treatment plan designed to aggressively attack the cancer on several fronts. Generally, malignant mesothelioma has no symptoms and is extremely difficult to detect until the late stages of the disease when fewer treatment options are feasible.
On the bright side, recent scientific research is very encouraging. New therapies and treatments are making the news and previously unheard of successes are becoming more frequent. Clinical trials are available for many patients who might otherwise have little hope, and research is ongoing to study compounds in the blood of malilgnant mesothelioma patients that may soon lead to an early detection screening process.
Many factors help the oncologist and his team to determine a treatment plan best suited for each patient. Things considered include the stage of the cancer, the patient’s age and general health, the patient’s lifestyle choices—smoking, alcohol consumption, exercise habits—and other drugs or treatments the patient may already be on. The oncologist, along with the medical team and the patient, devises a treatment regimen that may include any combination of surgery, chemotherapy, radiation, palliative care, and lifestyle advice.
Malignant Mesothelioma Surgery
Three main types of surgery are used to diagnose and treat malignant mesothelioma.
Diagnostic Malignant Mesothelioma Surgery
Diagnostic surgeries are usually minimally or non-invasive, and are performed to help the medical team reach a definitive malignant mesothelioma diagnosis.
A biopsy is the collection of a small tissue sample used to confirm a malignant mesothelioma diagnosis. This non-invasive procedure uses a long, fine needle inserted into the area suspected to be cancerous to collect cells for examination. An excisional biopsy is a small incision used to take a slightly larger sample for testing. Biopsies help reveal important information of the cancer: what type of cancer it is, how far it has spread and the origin point.
Curative Malignant Mesothelioma Surgery
Curative surgery is performed to remove as much of the cancer as possible. Simply put, the surgeon opens the patient to expose the entire affected area and cuts away the diseased tissue. In recent years, this procedure has been followed immediately by filling the cavity with warm chemotherapy to kill any unseen cancer cells before the patient’s incision is closed. This is a highly effective combination of treatments, but it is not available to most patients. Most malignant mesothelioma is not discovered until it is too late to perform this aggressive level of invasive surgery.
Curative surgery may also include removal of the affected tissues or organs and replacement of linings with a man-made product, which can only be done if enough remaining tissue or organ is healthy and viable and the patient is healthy enough to recover.
Palliative Malignant Mesothelioma Surgery
Palliative surgery is used to lessen pain and usually involves draining fluids that typically build up in the affected area. Fluid that is drained from the patient often assists in diagnostic testing.
Palliative surgery is sometimes performed to ease patient suffering when tumors press on vital organs and interfere with breathing, press on nerves and cause pain, or restrict movement.
Chemotherapy
Chemotherapy is a term that describes hundreds of different medications used in the treatment of cancer and a few other diseases and conditions, specifically the chemicals designed to kill cells. Undergoing chemotherapy is not a pleasant experience. Typical side effects are nausea, vomiting, low white blood cell count, loss of appetite, constipation, fatigue, fever and chills, low platelet count, generalized aches and pains, tingling in the hands and feet, rash, and depression.
When discussing chemotherapy with an oncologist, it is important for the patient to disclose medical history and be honest about lifestyle, prescriptions, vitamins, supplements and over-the-counter medications, including herbal remedies. Undisclosed medicines may impede the chemotherapy, or worse, produce harmful side effects.
Radiation
Radiation is a number of procedures used to deliver radioactive material to the cancerous cells in the hopes of killing the cancer or slowing the rate of growth, either for curative or palliative purposes. The delivery method may be any of the following:
External beam radiotherapy is the most frequently used type of radiation therapy for malignant mesothelioma patients. The skin covering the cancerous area is externally irradiated, or bathed in radiation from the outside. External beam radiotherapy is not specifically targeted and is unlikely to kill all cancer cells, so it is not an effective cure, but like most malignant mesothelioma treatments, it can help relieve symptoms. The side effects are skin irritation, localized pain, and difficulty swallowing.
Another type of radiation therapy, brachytherapy, is used to implant tiny radioactive rods into the cancerous tumors. This method of delivery delivers a tiny dose of radiation right into the cancer itself. Surrounding healthy tissues are unaffected and there are fewer side effects.
A new procedure on the market is called intensity-modulated radiation therapy (IMRT), a procedure that uses a 3-D model constructed by computer imaging to precisely deliver a higher dose of radiation to cancerous areas with far fewer side effects and damage to surrounding tissues.
Experimental Therapies
Several exciting new therapies are currently in the testing stages that may lead to early detection, better treatment, and possibly even a cure for asbestos cancer, malignant mesothelioma and other deadly cancers and diseases. Clinical trials are being performed all over the world, and patients diagnosed with malignant mesothelioma are prime candidates to participate. Participating in clinical trials can be risky. Each patient must weigh the odds to decide whether the risks associated with experimental treatment is worth the possible gain.
A new drug called Alimta® is the first chemotherapy drug specifically developed to treat malignant mesothelioma. In clinical trials, the drug has been very successful in relieving malignant mesothelioma symptoms and decreaseing cancerous tumor size. Alimta® is usually administered in combination with cisplatin, another chemotherapy drug. Used together, these drugs have proven to extend the life of malignant mesothelioma patients by several months, and relieve pain, discomfort, and ease breathing difficulties.
Gene therapy is a ground-breaking treatment offering promising results for a number of diseases, including asbestos cancer, malignant mesothelioma and other cancers. Simply put, the goal of gene therapy is to replace malfunctioning cancerous genes with functioning genes. Clinical trials have been underway for some time, and the results have been encouraging.
Immunotherapy is a treatment that uses the immune system to help combat malignant mesothelioma. It can be administered by two different methods. Active immunotherapy enhances or stimulates the patient’s natural immune system to fight cancer. Passive immunotherapy uses man-made proteins that mimic the natural immune system functions for patients whose immune systems are compromised.
Photodynamic therapy (PDT) uses drugs that are photosensitizing agents along with light to activate them to kill cancer cells and stop the spread of malignant mesothelioma. This innovative treatment causes far fewer side effects than most malignant mesothelioma, asbestos cancer and other cancer treatments. Photosensitizing agents are chemicals that produce oxygen when exposed to a certain kind of light. The oxygen produced kills cancer cells without causing extensive damage to surrounding tissues and without causing debilitating side effects.
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