After a thorough diagnosis made by an expert doctor, here comes the most crucial aspect of mesothelioma- the treatment. Unfortunately, most of the times, the cancer is diagnosed in an advanced stage. So, the cure is often impossible. The doctors try to establish a connection between many factors in order to arrive at a correct decision of the mode of mesothelioma treatment.
The decision depends on the following things-
1) Location of the cancer
2) Stage of the cancer
3) Spread of the cancer
4) Types of cancer cells examined under a microscope
5) Patients’ willingness and age.
The people diagnosed with the cancer are often told about a meager prognosis of the disease, stating a survival chance of 4 to 14 months. But nowadays, if detected in early stages, there is a 40% chance of surviving up to 4 to 5 years. This is possible according to Dr. David Sugarbaker from Brigham and Women’s Center at Boston.
Anyways, talking regarding your mesothelioma treatment goals with your doctor is an important phase. Some people try to do everything possible at the cost of certain unavoidable side effects, though there are portions of people who opt for a peaceful death and ask for mere palliative options. They want their remaining months as symptom free as possible.
What are the mesothelioma treatment options?
There are mainly three traditional types of treatments.
1) Surgery
2) Chemotherapy
3) Radiation
In addition, there can be a ‘Multi-modal Therapy’ combining all three.
Surgery
If the cancer is still in early stages, surgery is the better choice. If the malignant mesothelioma is in one part of the chest, doctors like to perform surgery by removing that part of the chest lining with cancer and some tissue around it. But if the cancer is found in more than one place, the treatment options are as follows-
1) Pleurectomy or decortication to remove the affected part with or without palliative therapy to improve quality of life.
2) Extrapleural pneumonectomy- here they remove the diseased lung, part of the pericardium (membrane covering heart), part of the diaphragm (muscle between lungs and abdomen) and part of the parietal pleura (membrane lining the chest)
3) In advanced stages, surgery is performed to remove the accumulated fluid in the chest to relieve the patient of breathlessness. Surgeons may inject medicine into the chest to prevent fluid from returning (pleurodesis).
4) Debulking is done by removing as much cancer as possible.
5) Surgeons can take chance by performing clinical trial and place anticancer drugs directly in chest after surgery to remove tumor.
Chemotherapy
The cancer cells are killed using chemotherapy. These drugs are rapidly spread into the body and kill rapidly growing cells. Mesothelioma treatment by chemotherapy may decrease the growth of mesothelium. For the peritoneal mesothelioma, the chemotherapy drugs may be injected directly into the abdominal cavity (intra-peritoneal chemotherapy). This prevents damage to the other healthy cells of the body. Pemetrexed is the first chemotherapy drug approved for mesothelioma treatment. It has prolonged the survival and improved the quality of life. Newer drugs like Raltitrexed and Ranpirnase are still in the experimental stage.
Platinum containing compounds like cisplatin, carboplatin can be used but the results are inconsistent. The patient should consult their doctor in advance regarding the side effects of chemotherapy like fatigue, exhaustion, hair loss, nausea etc. They can also tell you how to minimize these side effects.
Radiation
This mesothelioma treatment involves high intensity radiation to be given to localized tumors. Though the adjacent cells are also affected, they can recover faster as compared to chemotherapy. Radiation therapy can reduce both, the size of the tumor and symptoms like breathlessness. Doctors aim at radiation to the whole chest for better results but they have to use low intensity radiation to spare other vital organs like heart, lungs, spinal cord, etc.
Multi-modal Therapy
The combination therapy has been so far most promising mode of mesothelioma treatment. It combines the graded use of surgery, chemotherapy and radiation. However even after this aggressive treatment, many people suffer from recurrence of mesothelioma.
Clinical Trials
Besides the traditional treatment options, mesothelioma is treated by many different “clinical trials” conducted by qualified doctors. Though cure is not guaranteed, the patients usually experience a decrease in the symptoms. Your participation in the clinical trial may help the doctors to understand the mesothelioma treatment better in future. A typical trial includes studying the best way to administer a drug, its safety and effectiveness, dosage and any side effects if occur.
Pemetrexed or Almita is initially tested in clinical trials. It was approved as the drug of choice when it was combined with chemotherapy agent cisplatin. One needs to consider risks versus benefits while participating in the clinical trials.
Photodynamic Therapy
This treatment involves use of LASER light to kill cancer cells. It has been approved for use in non-small cell lung cancer and esophageal cancer but its use for mesothelioma treatment is still being researched. It is either combined with pleuractomy or extra pleural pneumonectomy.
It believed to prevent the recurrence of mesothelioma. The photosensitizer used is named Foscan. According to researchers, this therapy may prevent extensively invasive surgery and just pleurectomy may be sufficient.
Immunotherapy
This mode of mesothelioma treatment aims at building up your immunity to fight cancer cells. It may involve use of different therapies like gene therapy, monoclonal antibodies or cytokine proteins like interleukins and interferons.
Gene therapy includes inserting specific genes into the cells to restore their function. It may be used to block abnormal genes in the cancer cells.
Monoclonal Antibody Therapy (Passive Immunotherapy)
Monoclonal antibodies are prepared in the laboratory. These can recognize cancer cells. So, they may help immune system to seek and kill the cancer cells. This can be used for a mesothelioma treatment as an adjuvant to chemotherapy or radiation.
Cytokines
Interleukin-2 (IL-2) is a cytokine protein molecule. It is capable of increasing the growth of immune cells called T-cells. These T-cells search out malignant cells and kill them. So, IL2 can be used in the treatment to combat cancer cells.
Complementary Treatment
It is of utmost importance to improve the quality of life of mesothelioma patients. A combination of complementary therapies is used to have a better outlook to the gloomy situation.
Nutrition- Following are recommended- five or more servings of fruits and vegetables, whole grains, lean meat, fish and low fat dairy products. Avoid salt-cured, pickled and smoked food. The patients need to be given additional vitamin supplements.
Exercise- to cope up with the fatigue and keep a minimum fitness possible, patients can have short walks or light exercises, may be 3 to 4 times a week.
Alternative Therapy
Besides the above stated methods, alternative treatment options may be highly beneficial to the stressed out patients. It includes various herbal products, special diets, Homoeopathy etc.
Homoeopathy and mesothelioma
Homoeopathic medicines are dilute but potent forms of active ingredients and are used either in liquid or tablet forms. The treatment of mesothelioma by Homoeopathy is called “Immunoaugmentative Therapy”.
It involves extracting Iscador from mistletoe. Iscador is considered to be an herbal medicine that is claimed to boost body’s immune system. Many Homoeopathic doctors have used it in injection or tablet form to relieve the cancer patients. Though definitive evidence of effectiveness has not yet found with the mesothelioma, they work as an adjuvant to the traditional modes of treatment. They help to reduce the side effects of chemotherapy and help to have a better quality of life.
So, talk to your doctor, consult various faculties and decide the plan of mesothelioma treatment with confidence!
