PLEURAL MESOTHELIOMA TREATMENT

Pleural mesothelioma, a type of malignant mesothelioma caused almost exclusively by exposure to asbestos, attacks the lining of the lungs, called the pleura. There are several treatment options, including surgery, chemotherapy and radiation, that can be used separately, but more often they are combined in a treatment plan called multimodality therapy. Since pleural mesothelioma has no symptoms and there is no effective screening procedure to detect it early, it is usually diagnosed in the late stages when treatment options are limited and often less effective.

The outlook for pleural mesothelioma patients is constantly improving with ongoing research providing new answers and, new hope. Pleural mesothelioma is by far the most common type of malignant mesothelioma and, as a result, more research dollars are spent looking for a cure.

Types of Pleural Mesothelioma Surgery

There are three main types of surgery used in the diagnosis and treatment of pleural mesothelioma.

• A biopsy is often required to confirm diagnosis of the cancer. This is a non-invasive procedure that involves removing a tiny piece of the infected tissue for testing.
• Curative surgery involves removing as much of the cancerous tissue as possible. This procedure is often followed by or combined with radiation therapy or chemotherapy.
• Palliative surgery is used to lessen pain. It also involves the removing of cancerous tissue, with the purpose of relieving pressure on the lungs and other organs to make the patient more comfortable and improve quality of life.

Diagnostic Pleural Mesothelioma Surgery

Several types of biopsy procedures are used to confirm a pleural mesothelioma diagnosis and determine how far the cancer has spread.

A needle aspiration biopsy is performed to take a small sample of tissue. The surgeon inserts a long needle into the chest and scrapes away a few cells from the area suspected to be cancerous. The cells are examined and tested to confirm a pleural mesothelioma diagnosis.

After the diagnosis is confirmed, the surgeon performs an excisional biopsy to remove additional tissue to determine how far the cancer has spread.

Thoracentesis is another minimally invasive surgery used to confirm diagnosis. It is also used to drain fluids to relieve pressure and make the patient more comfortable. Fluid tends to build up in the lungs of pleural mesothelioma patients, making breathing painful and labored. This condition is called pleural effusion. Thoracentesis is a long needle inserted into the lungs to drain away the fluid. The drained fluid is often sent to the lab for testing.

Pleural Mesothelioma Pleurodesis

Pleurodesis is a form of palliative surgery intended to relieve or prevent pleural effusion. Any fluid is drained and the area is treated with a powdery chemical that causes the cells to become inflamed. The pleural spaces swell and close, blocking fluid buildup and making it easier for the patient to breathe.

Pleural Mesothelioma Thoracotomy

Thoracotomy surgery removes part of a cancerous lung. There are three different types of thoracotomy surgeries: wedge resection, lobectomy, and pneumonectomy.

If the cancerous area is relatively small, the surgeon may opt for a wedge resection to remove only the tumors, leaving as much healthy lung tissue intact as possible.

Each lung is divided into five parts, called lobes. During a lobectomy, one or more of the lobes is removed, leaving the remaining uninfected lobes.

Some patients have pleural mesothelioma in only one lung. In that case, the surgeon may elect to perform a pneumonectomy. This involves removing the infected lung, along with the pleura and diaphragm. He then reconstructs the diaphragm using a man-made material called Gore-Tex, which is also used to make heavy outer clothing, like coats and gloves.

Patients who receive these types of surgery are the most likely to recover well and go on to live long lives free of cancer, but only a very small percentage of early-stage patients who are otherwise healthy qualify.

These surgeries have recently been successfully combined with an infusion of warm chemotherapy directly into the cavity immediately following surgery to kill any cancerous cells that may have been missed by the surgeon.

Pleural Mesothelioma Chemotherapy

Chemotherapy is a catchall phrase used to describe medications used in the treatment of cancer and a few other diseases and conditions, and refers to chemicals specifically designed to kill cells. Chemotherapy is a difficult course of treatment with many unpleasant side effects.

There are hundreds of chemotherapy options on the market, but only a few approved for pleural mesothelioma patients. A number of factors determine which therapy is best, including the stage of the cancer, the age of the patient, the patient’s general health, and other drugs and treatments the patient may already be on. The oncologist is most likely to prescribe a combination of chemotherapy drugs that will benefit the patient.

When discussing chemotherapy with an oncologist, it is vitally 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 and produce harmful side effects.

Pleural Mesothelioma Radiation

Ionizing radiation is a therapy used to kill existing cancer cells and prevent the cancer from spreading. Radiation therapy may be used by itself or in combination with chemotherapy of surgery. It can be curative, to try and kill the cancer, or palliative, to relieve pressure and pain. Two types of radiation therapy are used to treat malignant mesothelioma,:external beam radiotherapy and brachytherapy.

External beam radiotherapy is the most frequently used radiation therapy for malignant mesothelioma patients. It is an external treatment similar to an X-ray where the exposed skin covering the cancerous area, in this case the chest, is bathed in radiation. External beam radiotherapy cannot kill all cancer cells, and is usually used in conjunction with other forms of therapy to relieve common symptoms, like breathing difficulties that are caused by tumors pressing on the lungs.

During the procedure, healthy tissue around the affected area is also exposed, causing side effects including skin irritation, pain, and difficulty swallowing.

Brachytherapy involves implanting tiny radioactive rods in the cancerous area. This delivery method is specifically targeted to deliver a deadly dose of radiation directly into malignant mesothelioma tumors. It causes less damage to nearby healthy tissues and, as a result, fewer side effects. Brachytherapy may be temporary or permanent. During a temporary procedure, the radioactive particles are inserted and later removed. Permanent procedures leave the rods in place, where they degrade and eventually stop emitting radiation.