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Mesothelioma Treatment Options

While there is no cure for mesothelioma and asbestos cancer, specialists are continuing to innovate new and better treatments and utilize technology advances that allow patients to live longer than ever.

In some cases, radical surgery is an option. In other cases, palliative care and clinical trials are recommended. No matter the stage of the disease, only mesothelioma specialists can provide patients with the best course of treatment. Specialists not only have years more experience treating mesothelioma than general oncologists, many of them have led the most innovative mesothelioma treatments available today.

Common mesothelioma treatment plans includes surgery, chemotherapy and radiation based on the individual disease stage and prognosis. The best treatment options are tailored to the patient’s needs.

Deciding on a Treatment

When specialists decide on the best treatment plans, they do not just look at one variable involved in the cancer. They consider multiple aspects of the disease process before making recommendations to the patient. The considerations include:

  • Stage of the Disease – Early stage mesothelioma (stages I and II) includes tumors that are located in one area so they are easier to remove or treat. Stages III and IV mesothelioma have widespread tumors and cancer cells.
  • Type of Mesothelioma – Each type of asbestos cancer — pleural (lung), peritoneal (abdominal), pericardial (heart) and testicular (testes) – differs in treatment options. Pleural mesothelioma is the most common variety of the disease and has the most treatment options.
  • Cell Type – The cells that make up the tumors – epithelioid, sarcomatoid or biphasic – can greatly influence the response to treatment. Epithelioid cells are the most common cell variety and easiest to treat.
  • Patient’s Overall Health – Patients who are younger and generally healthy can withstand more aggressive treatment than older patients who have multiple co-occurring illnesses.

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Early Stages vs. Late Stages

Overall, mesothelioma responds best to treatment when it is diagnosed in the early stages of the disease because the tumors are located in one area of the body and the cancer cells have not spread.

However, most mesothelioma patients are not diagnosed early in the disease process. Mesothelioma takes up to 50 years to fully develop and once the symptoms are apparent, most patients are in the later disease stages.


Standard Mesothelioma Treatments

The gold standard for mesothelioma treatment is called multimodal therapy, which is a combination of surgery, chemotherapy and radiation therapy.

Multimodal treatment includes a primary treatment combined with other “helper” neoadjuvant and adjuvant treatments. For example, a multimodal treatment course may include:

  • Neoadjuvant therapy – Radiation to shrink tumors.
  • Primary treatment – Surgery to remove cancerous tissue.
  • Adjuvant therapy – Chemotherapy to remove remaining cancer cells.

Surgery for Mesothelioma Cancer

Surgical removal of diseased tissue or tumors is considered an aggressive form of treatment that is usually reserved for early stage cancer. In some cases, however, palliative surgery is used to alleviate pain and pressure from tumors in late-stage patients. The most common types of surgical options are:

  • Extrapleural Pneumonectomy (EPP) – The entire diseased lung, the lining around the chest cavity, some nearby lymph nodes and the diaphragm are removed. Used in pleural mesothelioma.
  • Pleurectomy/Decortication (P/D) – The lining of the lungs and all tumors found in the chest area are stripped away. Used in pleural mesothelioma.
  • Cytoreduction – The tumors in the abdominal cavity are pared down or debulked. Used in peritoneal mesothelioma.
  • Hyperthermic Intraperitoneal Chemotherapy (HIPEC) – Usually used following a cytoreduction procedure, HIPEC involves bathing the abdominal cavity with highly concentrated, heated chemotherapy. Used in peritoneal mesothelioma.
  • Pericardiectomy – The lining around the heart and all of the tumors are stripped away. Used in pericardial mesothelioma.
  • Pleurodesis – Removes fluid in the area near the membrane that surrounds the lungs and prevents further fluid build-up. Palliative only.
  • Paracentesis – Removes fluid accumulation in abdominal area, called ascites. Palliative only.
  • Pericardiocentesis – Removes fluid accumulation near the heart. Palliative only.

Chemotherapy

Chemotherapy drugs work by killing fast-dividing cells, such as cancer cells. When used in conjunction with surgery, it can kill any remaining cancer cells. When used alone, it can reduce or eradicate cancer.

  • Chemotherapy for Pleural Mesothelioma – The most effective combination of chemotherapy drugs are cisplatin and pemetrexed (Alimta) and pemetrexed and carboplatin.
  • Chemotherapy for Peritoneal Mesothelioma – A recent study found that 75 percent of peritoneal mesothelioma patients who received three types of intraperitoneal chemotherapy – HIPEC, Normothermic intraperitoneal chemotherapy (NIPEC) and early postoperative intraperitoneal chemotherapy (EPIC) – survived at least five years following treatment.

While the common chemotherapy side effects include hair loss, nausea, weight loss and fatigue, a growing number of medications can reduce the reactions. A mesothelioma specialist can help determine which medications can eliminate the unpleasant side effects.


Radiation Therapy

Targeted radiation uses beams of high-energy rays to shrink cancerous tumors to make them easier to remove during surgery. Radiation does not have the same side effects as chemotherapy and has known palliative benefits (such as reducing the pain associated with tumors).

Radiation is not an option in some mesothelioma cases because it can damage internal organs and DNA. Specialists use radiation therapy to treat pleural mesothelioma more than other types of asbestos cancer.


Innovative Treatment Options

In addition to multimodal treatment, new and emerging treatments are being innovated every day through research studies and clinical trials. Many patients are eligible for participation in these studies that may provide disease relief and offer hope for the future of mesothelioma treatment.

Our Patient Advocates put patients in touch with doctors who are pioneering clinical trials that may expand treatment options. Some of the newest treatment options include:

  • Immunotherapy – Uses the body’s immune system to fight cancer.
  • Photodynamic therapy (PDT) – Uses the light-activated drug photosensitizer to kill cancer cells.
  • Virotherapy and Gene Therapy – Uses engineered viruses to kill and sometimes repair cancer cells.

Complementary and Alternative Therapies

Complementary and alternative medicines (CAM) will not eliminate cancer cells or cure the disease, but they provide pain and stress relief to help patients recover from treatment.

Some of the leading CAM therapies, including yoga, acupuncture and massage, can help patients build a mind-body connection. All patients should consult their doctors before starting any CAM therapy.


Choosing a Specialist for Mesothelioma Care

Most general oncologists have never treated a mesothelioma patient because the disease is so rare. Mesothelioma specialist not only have experience in treating the asbestos cancer, many of them also work in large comprehensive cancer care centers that are specifically focused on cancers of the chest and stomach. Some cancer care centers are exclusively focused on mesothelioma treatment, such as:

Dr. David Sugarbaker

  • Baylor College of Medicine (Texas)
  • Professor and Chief, Division of General Thoracic Surgery
  • Director of the Lung Institute, where he leads the mesothelioma clinical and research program.
  • Pioneered the Extrapleural Pneumonectomy (EPP) procedure.

Dr. Robert Cameron

  • Ronald Reagan UCLA Medical Center (California)
  • Professor and Chief, Division of General Thoracic Surgery
  • Director of the Comprehensive Mesothelioma Program and the Pacific Meso Center at the Pacific Heart, Lung & Blood Institute.
  • Pioneered the Pleurectomy/Decortication (P/D) procedure.

Dr. Paul Sugarbaker

  • Washington Hospital Center (Washington, D.C.)
  • Professor and Chief, Division of General Thoracic Surgery
  • Director of the Center for Surgical Oncology at the Washington Cancer Institute.
  • Pioneered the Hyperthermic Intraperitoneal Chemotherapy (HIPEC) treatment.

Costs Associated with Cancer Treatment

Mesothelioma treatment, like other cancer treatments, can be expensive even with health insurance. Many of the variables – such as the extent of the disease, the amount of out-of-pocket expenses and the availability of health insurance – play a role in the final costs. Other expenses, such as experimental treatments and alternative therapies, may not be covered by insurance at all.

Several financial options are available for patients seeking treatment, including:

  • Travel grants to visit medical specialists.
  • Trust funds established by former asbestos-industry companies.
  • Compensation through personal injury legal action.
  • Veteran’s disability and service-connected claims. /li>

Contact us today for an appointment with a mesothelioma specialist near you and learn more about your financial options.

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