Mesothelioma Cancer
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| Medical Measures for Mesothelioma |
If diagnosed with mesothelioma, your doctor will suggest one or more treatment options for you to consider. Factors for consideration include your general health condition, stage of the cancer and your personal preferences. Since mesothelioma is a rare disease, limited information about the value of different treatment approach is available. In addition, doctors have little experience treating mesothelioma. They usually refer patients with mesothelioma to specialists who treat large number of mesothelioma patients in large medical centers.
Surgery
Surgery, either by itself or used in combination with pre- and post-operative adjuvant therapies has proved disappointing. The problem in treating mesothelioma is that it does not grow as a single tumor mass. It tends to spread along nearby surfaces, nerves, and blood vessels. Because of this it is almost impossible, except in rare situations, to completely get rid of it with surgery, radiation or both.
Surgery for pleural mesothelioma may be done for 1 of 2 reasons: to relieve pain and discomfort caused by the tumor (called palliation) or to cure.
Palliative surgery is typically done in cases where the tumor has already spread beyond the mesothelium and is difficult to remove completely, or if you are too ill to tolerate a more extensive operation. It is intended to bring comfort and relieve pain associated with mesothelioma but not necessarily to cure it.
Curative surgery is suggested if you are in otherwise good health and the tumor is thought to be localized and can be removed completely. In most cases it is not likely to cure you but may extend your life. Curative surgery is being done in some cancer centers and a few of the patients who have had the surgery are experiencing long remissions of mesothelioma cancer.
Chemotherapy
Chemotherapy is the use of drugs for treating mesothelioma cancer. Chemotherapy drugs are administered in pill form or they can be injected by needle into a vein or muscle. Chemotherapy works by making the drugs enter the bloodstream and circulates throughout the body to reach and destroy the mesothelioma cancer cells.
To the treatment of mesothelioma, chemotherapy drugs may also be given intrapleurally (directly into the chest cavity) or intraperitoneally (into the abdominal cavity). Based on the type and stage of mesothelioma, chemotherapy may be given as the primary (main) treatment or as an adjuvant treatment (treatment given in addition to the primary treatment) to surgery. Chemotherapy for this disease is palliative and not curative.
There are several chemotherapy drugs that are used to treat mesothelioma. The preferred combination of drugs for now is pemetrexed (Alimta), which is combined with cisplatin. Folic acid and vitamin B12, is also given to avoid side effects. Other combinations of chemotherapy drugs used to treat mesothelioma include:
- methotrexate and vincristine
- cisplatin, vinblastine and mitomycin
- cisplatin and doxorubicin
- doxorubicin, cyclophosphamide (or ifosfamide), and cisplatin
While chemotherapy drugs kill mesothelioma cancer cells, it also damage some normal cells, including blood producing cells of the bone marrow. This results to higher risk to infection, bleeding or bruising after minor cuts or injuries, fatigue, and shortness of breath.
Your doctor will pay careful attention to avoid or minimize chemotherapy side effects, which depend on the specific drugs, the amount taken, and the length of treatment. Temporary side effects might include nausea and vomiting, loss of appetite, loss of hair, and mouth sores.
Because chemotherapy can damage the blood-producing cells of the bone marrow, patients may have low blood cell counts. This can result in an increased risk of infection (due to a shortage of white blood cells); bleeding or bruising after minor cuts or injuries (due to a shortage of blood; platelets); or fatigue or shortness of breath (due to low red blood cell counts).
Most side effects disappear once treatment is stopped. Discuss with your doctor any side effects that you may have as there are remedies that can be done about it.
Radiation
Radiation therapy is sometimes used as the main treatment of mesothelioma in some patients, especially those whose general health is too poor to undergo surgery. In radiation therapy, a high-energy x-rays are used to kill cancer cells.
For mesothelioma cancer patients with localized disease, and who can tolerate a radical surgery, radiation is often given post-operatively as a consolidative treatment. This is often given simultaneously with chemotherapy. This approach of using surgery followed by radiation with chemotherapy has been pioneered by the thoracic oncology team at Brigham & Women's Hospital in Boston. Delivering radiation and chemotherapy after a radical surgery has led to extended life expectancy in selected patient populations with some patients surviving more than 5 years. As part of a curative approach to mesothelioma, radiotherapy is also commonly applied to the sites of chest drain insertion, in order to prevent growth of the tumor along the track in the chest wall.
Radiotherapy is also used as palliative treatment regimens to relieve symptoms arising from tumor growth, such as obstruction of a major blood vessel. Radiation therapy when given alone with curative intent has never been shown to improve survival from mesothelioma. The necessary radiation dose to treat mesothelioma that has not been surgically removed would be very toxic.
Immunotherapy
Treatment regimens involving immunotherapy have yielded variable results. Mesothelioma cells proved susceptible to in vitro lysis by LAK cells following activation by interleukin-2 (IL-2), but patients undergoing this particular therapy experienced major side effects. Indeed, this trial was suspended in view of the unacceptably high levels of IL-2 toxicity and the severity of side effects such as fever and cachexia. Nonetheless, other trials involving interferon alpha have proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumor mass combined with minimal side effects.
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| Alternative and Complementary Medicine for Mesothelioma |
Alternative and Complementary Medicine
Complementary and alternative therapies are a diverse group of health care practices, systems, and products that are not part of usual medical treatment. They may include products such as vitamins, herbs, or dietary supplements, or procedures such as acupuncture, massage, and a host of other types of treatment. There is a great deal of interest today in complementary and alternative treatments for cancer. Many are now being studied to find out if they are truly helpful to people with cancer.
You may hear about different treatments from family, friends, and others, which may be offered as a way to treat your cancer or to help you feel better. Some of these treatments are harmless in certain situations, while others have been shown to cause harm. Most of them are of unproven benefit.
The American Cancer Society defines complementary medicine or methods as those that are used along with your regular medical care. If these treatments are carefully managed, they may add to your comfort and well-being.
Alternative medicines are defined as those that are used instead of your regular medical care. Some of them have been proven not to be useful or even to be harmful, but are still promoted as cures. If you choose to use these alternatives, they may reduce your chance of fighting your cancer by delaying, replacing, or interfering with regular cancer treatment.
Before changing your treatment or adding any of these methods, discuss this openly with your doctor or nurse. Some methods can be safely used along with standard medical treatment. Others, however, can interfere with standard treatment or cause serious side effects. That is why it's important to talk with your doctor.
References:
- United States Department of Health and Human Services.
- "Cigarette smoking, asbestos exposure, and malignant mesothelioma" by Muscat JE, Wynder EL in Cancer Research (1991) volume 51 pages 2263-7 Entrez PubMed 2015590
- "Soluble mesothelin-related protein--a blood test for mesothelioma" by B. W. Robinson, J. Creaney, R. Lake, A. Nowak, A. W. Musk, N. de Klerk, P. Winzell, K. E. Hellstrom and I. Hellstrom in Lung Cancer (2005) volume 49, pages S109-S111 Entrez PubMed 15950789.
- "Malignant mesothelioma and occupational exposure to asbestos: a clinicopathological correlation of 1445 cases" by V. L. Roggli, A. Sharma, K. J. Butnor, T. Sporn and R. T. Vollmer in Ultrastruct Pathol (2002) volume 26 pages 55-65 Entrez PubMed 12036093.
- "Advances in Malignant Mesothelioma" by Bruce W. S. Robinson and Richard A. Lake in The New England Journal of Medicine (2005) volume 353 pages 1591-1603 Entrez PubMed 16221782.
- "SV40 in human tumors: new documents shed light on the apparent controversy" by D. S. MacLachlan in Anticancer Res (2002) volume 22, pages 3495-3499 Entrez PubMed 12552945.
- www.cancer.org
- en.wikipedia.org/Mesothelioma
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