Mesothelioma is a very serious disease and patients and their families should have the support and resources they need to better deal with their diagnosis. The following information should aid patients diagnosed with mesothelioma in determining the best course of treatment:
Traditional Treatments
Surgery
A mesothelioma treatment used either to remove the tumor or to alleviate pain and suffering. If the cancer is relatively contained, surgery can be used to remove part of the lining of the chest or abdomen. The objective is to remove the cancer cells from the body by removing the tissues with large numbers of cancer cells. If the cancer has spread to several organs, it is impossible to remove all of the tissue infected with cancer. In this case, surgery can only be used to relieve pain and suffering. Types of surgeries incude:
Pneumonectomy - An aggressive surgery in which a lung is removed. It can be performed in two ways:
Traditional Pneumonectomy - Only the disease lung is removed.
Extrapleural Pneumonectomy - When the diseased lung, along with part of the pericardium, part of the diaphragm and the parietal pleura on the same side of the chest is removed.
Palliative Procedures - The goal of these procedures is not to cure the disease, but rather to relieve and/or control symptoms associated with mesothelioma:
Thoracentesis - A procedure where a needle is inserted into the chest cavity either to obtain a diagnosis or to drain the fluid to relieve breathlessness and pain.
Pleurectomy/Decortication - The surgical removal of the pleura which is performed to reduce pain caused by tumor mass or to prevent the recurrence of pleural effusion.
Chemotherapy
This treatment consists of using drugs to treat the cancer. The drugs can be swallowed in pill form or can be injected by a needle into a vein or muscle. Most of the drugs used in the treatment of lung cancer either directly kill cancer cells or stop them from dividing into new cells. The drug enters the bloodstream and circulates throughout the body to reach and destroy the cancer cells. Chemotherapy targets the entire body and can kill normal cells as well as the diseased cells, causing severe side effects.
Chemotherapy can be used in combination with a variety of drugs to increase the total effect and is often used in combination with other treatments, especially surgery.
Side effects can be wide ranged and include nausea and vomiting, loss of appetite, loss of hair, fatigue, constipation, coughing, decreased appetite and mouth sores. These side effects can be treated and they will usually cease after the treatment has ended.
Radiation
Radiation therapy is the use of high level radiation to kill cancer cells in a localized area. The radiation injures the cancer cells so they cannot divide or multiply further. With each treatment, more of the cells die and the tumor shrinks. The dead cells are broken down and excreted by the body. Most of the healthy cells are able to recover from this injury, but the damage to them is the cause for the side effects of radiation therapy.
Radiation may be used before surgery to shrink the tumor, after surgery to prevent the cancer from coming back, to prevent the growth of cancer, to treat symptoms, and also in combination with chemotherapy. Radiation therapy is sometimes used as the main treatment of Mesothelioma, especially patients whose general health is too poor to undergo surgery.
Side effects of radiation can be severe. They can include: fatigue, hair loss, skin irritation, nausea, and difficulty breathing.
The process of contacting your doctor in the off office hours needs to be simple and accessible. It should include coverage by a competent oncologist at all times, who can speak with you directly about your medical problem. Most office practices have a doctor on call to take calls from patients 24 hours/day.
Experimental Mesothelioma Treatments
Gene therapy
An experimental medical intervention that involves altering the patient’s genetic material of living cells to fight or prevent disease. The therapy involves injecting a modified gene directly into a patient’s chest cavity. The goal of gene therapy is to supply cells with healthy copies of missing or altered genes. Many different strategies are currently under study.
Immunotherapy
An experimental therapy that uses the body’s natural defenses to fight cancer. This can include stimulating your own immune system to work harder, or using an outside source, such as man-made immune system proteins. Immunotherapy is usually used in conjunction with another type of therapy.
Photodynamic Therapy
An experimental treatment which combines a photosensitizing agent (a drug activated by light) with a light source to destroy cancer cells. The theory is that the photosensitizing agent collects more readily in cancer cells than in normal cells. Thus, when the agent is subsequently exposed to light, it reacts with oxygen to create chemicals that can kill the cancer cells.
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