An Overview of the Treatment of Mesothelioma
Mesothelioma is an orphan disease. That means it is extremely rare. Only about 3,000 cases are diagnosed in the United States each year. If you have been diagnosed with any form of mesothelioma cancer, it is important to find specialists who are experienced at treating this rare disease. The leading cancer treatment hospitals are usually the best place to find doctors and other experts. These experts can determine how far along your disease is (its stage). They then use that information to outline your treatment options.
Supportive or palliative care
Some mesothelioma treatments are aimed at easing the pain and trying to extend a patient's life with the hope of someday curing the disease. Others, known as palliative treatments, are solely aimed at easing symptoms, and do not try to stop the cancer. Surgery, radiation and chemotherapy can be used both ways (either as treatment or as palliation of symptoms).
You may choose supportive or palliative care if the disease has progressed very far and your health is too fragile for surgery or chemotherapy, or if you decide that you simply don't want aggressive treatment. Mesothelioma patients given supportive care generally live four to nine months after they are diagnosed.
Sometimes supportive care seems like the only option, but if you want to try to beat the cancer and have been told that your options are limited, it is important to get a second opinion from another team of doctors experienced in treating mesothelioma. Although mesothelioma cancer is a very rare disease, new treatments are being developed. Be sure you know all your options.
Traditional cancer treatments
The methods used to treat disease, such as radiation and chemotherapy, are called modalities. Therapy that involves more than one form of treatment is called multimodality treatment. Multimodality treatment is believed to have the best chance of extending a patient's life. It is also the most aggressive and complicated.
For several years now, traditional cancer treatment, which combines surgery, chemotherapy and radiation, has more than doubled the mesothelioma survival rate to an average of 18 months. But let's face it - 18 months to live, even with aggressive treatment, is a very scary figure.
Thanks to strong lobbying by mesothelioma lawyers and others fighting for mesothelioma victims' rights, more money has gone into research lately. New chemotherapy drugs and other treatments are giving patients hope. Many mesothelioma patients are now living for four or five years. There is hope that longer survival rates are on the horizon.
Diagnosis methods
Some of the methods used to diagnose mesothelioma, such as paracentesis and thoracentesis, are also considered treatment methods because they drain fluid from the chest or abdominal cavity. This can help reduce swelling and pain and, in the case of a thoracentesis or thoracoscopy, ease shortness of breath.
Radiation
Radiation can be used to kill the cancerous cells; however, it's not possible to eradicate all the cancerous cells without endangering the patient by destroying healthy cells. The side effects of radiation therapy include fatigue, difficulty swallowing, shortness of breath, digestive problems, hair loss, skin irritation and stiffness.
Chemotherapy
In chemotherapy, the patient is given drugs that will kill the cancerous cells either by mouth or through intravenous injection. Treatment with traditional drugs alone has not been effective in prolonging the lives of patients with mesothelioma, but that may be changing. In 2004, the FDA approved the use of Alimta, a new medication, in combination with cisplatin. In clinical trials, the combination of Alimta and cisplatin was shown to prolong the lives of patients with mesothelioma by a median of three months.
Surgery
Like most cancers, mesothelioma is most treatable in the earliest stages, but it is seldom diagnosed until it has reached more advanced stages. When mesothelioma is discovered in the earliest stages, surgery is the most commonly recommended treatment option; however, that rarely happens. In fact, only about 20-30% of those with mesothelioma are candidates for surgery.
Complementary and alternative treatments
You probably remember that when Steve McQueen was diagnosed with malignant peritoneal mesothelioma back in the late '70s, he reportedly went down to Mexico to try untested "alternative" treatments, though, unfortunately, without success.
Some types of complementary and alternative treatments may be helpful and your doctor or hospital may be able to direct you to trusted practitioners. Others can jeopardize your health. So, it is very important to consult with your doctor before trying any of these treatments.
Complementary and alternative treatments refer to non-traditional approaches such as using holistic medicine, modified diets, acupuncture, herbs, meditation, or guided imagery to help fight mesothelioma cancer. Many patients with mesothelioma find some benefit in eating a healthy diet, including the suggestion by the American Cancer Society that patients with cancer eat at least five servings of fruit and vegetables daily. They may also find that relaxation techniques such as meditation can help alleviate stress and lessen the side effects of chemotherapy and radiation.
When these treatments are used alone or instead of traditional medicine, they are known as alternative treatments. When they are used in combination with more traditional medicine, they are known as complementary or integrative treatments.
Most people choose complementary therapies. Today, some hospitals offer complementary or integrative medicine along with traditional treatments.
You should always ask your doctor's advice before trying any type of complementary treatments, including over-the-counter herbs, vitamins, and nutritional supplements, because even these simple remedies might interfere with your current treatments. Sometimes certain herbs shouldn't be taken for a week or two before surgery, for example, or they might be safe once chemotherapy is over but dangerous while you're undergoing treatment. So, make sure your doctor knows everything you are considering. He or she can help you decide whether to try complementary therapies and at what point during your treatment they are safe to try.
The National Center for Complementary and Alternative Medicine (NCCAM), part of the National Institutes of Health, is beginning to study many of these practices in an effort to find ways to use proven complementary and alternative practices in combination with conventional medical practices and to encourage the study of proven practices in medical and nursing schools.
Promising new treatments and clinical trials
Clinical trials are one of the last testing steps a new cancer treatment must go through before it is released to the general public to use. They often use traditional cancer treatments - surgery, chemotherapy and radiation - but in different ways to try to find more effective remedies. Other clinical trials for mesothelioma include new drugs or experimental therapies such as photodynamic therapy, gene therapy or other experimental approaches.
Many leading cancer treatment centers and drug companies are conducting clinical trials in the hope of helping mesothelioma patients live longer. You might be eligible to participate in one. Ask your doctor about different experimental treatments at the cancer center where you are being treated, or at others across the country.
Clinical trials require you to meet certain eligibility requirements. For example, you might need to be at a certain stage of the disease in order to participate. It's important to research these trials as quickly as you can by talking to your medical team, searching for information on the web and calling cancer centers.
There are benefits and disadvantages in being involved in a clinical trial, but many people feel that the benefit of being able to try a new drug that is promising enough to merit a clinical trial outweighs the negatives.
New chemotherapy drugs
One new drug that has shown promise in early trials is coramsine. Animal studies have shown that coramsine is effective in both slowing the rate of tumor growth and preventing the growth of more cancerous cells. The company that makes coramsine is about to begin testing it in humans.
Immunotherapy
One of the more traditional treatments for cancer has been the use of chemicals produced by the body's immune system against the cancerous cells. The most common of these are interferon and interleukin-2. While they are often effective in treating other kinds of cancer, they've had only limited success in treating mesothelioma. Recently, however, researchers have found that introducing interleukin-2 directly into the space between the lungs and the ribs may slow the growth of tumors. There are a number of clinical trials ongoing.
Heat Therapy
Clinical trials have shown that mesothelioma cells are more susceptible to anticancer drugs that are heated to temperatures as high as 109 degrees. There are two ways that this is accomplished. The first is to heat the drugs themselves before injecting them. The other is to heat the pleural cavity before the drugs are injected.
Gene Therapy
There are a number of different kinds of gene therapy being investigated. One of the most promising involves genetically changing the structure of a virus so that the cells that are invaded by the virus become more susceptible to drugs used to treat cancer.
Photodynamic Therapy
Photodynamic therapy is being studied for use against several kinds of cancer, including malignant mesothelioma. It involves the injection of photo-sensitive substance into the pleural cavity. The molecules of this substance are absorbed by the cancerous cells, making them susceptible to light. They are then subjected to a low intensity laser or high-intensity light which kills off the mesothelioma cells.
