9 Best Mesothelioma Treatment Options
Mesothelioma treatment options depend on the location of cancer, the progression of the disease, the age as well as the conditions of the patient’s health. The most common mesothelioma treatment involves the combination of surgery, chemotherapy and radiation therapy.
The supportive treatments can help relieve symptoms and improve the quality of life for many mesothelioma patients. The oncologist is those who specialize in the treatment of mesothelioma, they also decide on the line of treatments for the patients. Though, some people said mesothelioma is difficult to treat and in most cases the prognosis is poor.
The MesotheliomaTreatment options include
If mesothelioma diagnosis is done in the early stages
Surgery may be recommended to remove all the cancerous tissues. This means thoracoscopy, VATS or video-assisted thoracic surgery, mediastinoscopy (used for staging), or laparoscopy. Often, the doctors will advise palliative procedures like chest tube drainage and pleurodesis, thoracoscopy and pleurodesis, pleuroperitoneal shunt, or pleurectomy, which treat the mesothelioma symptoms rather than the disease.
Radiation can be prescribed aggressively for mesothelioma patients
This is often given in combination with surgery or to control the symptoms of mesothelioma palliatively. Research on using radiation therapy, using implants or UV light therapy is in progress as traditional radiation therapy damages surrounding healthy tissue.
Chemotherapy is another option
Around 12-20% of patients respond to the drugs. Anti-cancer drugs destroy cancer cells and prevent their spread. In mesothelioma, chemotherapy is not considered to be curative. The aim is to prevent the spread of the disease. The procedure to shrink the tumour before surgery is known as Neoadjuvant therapy which is used to annihilate any remains of the tumour in the body post-surgery, and to relieve pain and other discomforts.
Experts recommend prescribing pemetrexed along with cisplatin. These drugs have shown positive results and this is no standard cure for mesothelioma not treatable by surgery.
Biological therapy using interleukin 2 (IL-2)
The administration of interleukin-2 (IL-2) has shown some effects on malignant pleural mesothelioma (MPM) tumour regression. Interleukin-2 (IL-2) was first described as a pro-inflammatory cytokine produced by activated T cells whose main action is to promote proliferation, survival and differentiation of T cells.
Interleukin-2 can affect many different cell types, particularly cytotoxic CD8+ T lymphocytes and regulatory T (Treg) cells. The latter cells are a subset of CD4+ T lymphocytes defined by their constitutive expression of the IL-2 receptor α chain CD25.
The nuclei of these cells also contain the Foxp3 transcription factor that is reported to be a key regulatory gene for the development and function of Treg cells and the most specific marker of this type of cells. Interleukin-2 could also activate MCs and induce tumour rejection, inhibiting tumour-associated vascularity. read more
Mesothelioma Immunotherapy Treatment
This is a cancer treatment that stimulates the cancer patient’s immune system to kill mesothelioma cancer cells. This treatment has been successful for other cancers and is currently in clinical trials for its potential to treat mesothelioma. Mesothelioma immunotherapy drugs for mesothelioma cancer, such as pembrolizumab (Keytruda), have extended the life expectancy of some patients by almost a year.
Success rates for immunotherapy treatments vary for each patient. Keytruda was the first FDA-approved immunotherapy for mesothelioma patients with advanced or metastatic disease. Mesothelioma specialists use Keytruda as second-line therapy for these patients, meaning after the initial treatment has failed.
There are many types of immunotherapies, and researchers continue to uncover the best combinations and methods for treating all types of cancer. Aside from the ultimate advantage of potentially keeping cancer growth under control, the benefits of immunotherapy are many.
- Harnessing the natural processes of your immune system to fight cancer internally
- Taking a targeted approach that kills only cancer cells, whereas chemotherapy also kills healthy cells
- Immunotherapy side effects are fewer and often more manageable compared to other anticancer therapies
- It can create long-lasting protection against cancer for many years
- Immunotherapy available through clinical trials is paid for by the study sponsor
The use of Lovastatin
There is a report that pharmacologic concentrations of lovastatin, a 3-Hydroxy-3-Methylglutaryl coenzyme A (HMG CoA) reductase inhibitor, induced apoptosis in human malignant mesothelioma cell lines. Mesothelioma cell viability was decreased in a dose-dependent manner by lovastatin (5 to 30 microMeter).
These effects were not reversed by exogenous growth factors or cholesterol but were reversed by the addition of 100 microM mevalonate, confirming that lovastatin affected mesothelioma viability by inhibiting mevalonate synthesis. Lovastatin appeared to decrease mesothelioma viability by inducing apoptosis, as indicated by morphologic changes, histologic evidence of nuclear condensation and degeneration, and flow-cytometric analysis of DNA content.
Lovastatin’s effects on cell viability were partially reversed in the presence of farnesol, and treatment of mesothelioma cells with a specific farnesyl-protein transferase (FTP) inhibitor decreased cell viability and induced morphologic changes indistinguishable from those caused by lovastatin.
This is done by the use of a light-activated drug to kill cancer cells within the body. In most cases, PDT is recommended as part of a multimodal treatment plan in combination with mesothelioma surgery. The therapy is commonly used on mesothelioma patients whose cancer has yet to metastasize or spread.
Photodynamic therapy uses three non-toxic elements to create a cancer-killing effect. The therapy combines a photosensitizer, oxygen and specific wavelengths of light to eradicate cancer. Separately, these elements have no cancer-killing abilities, but when the photosensitizer is activated by light, the medication turns triplet oxygen into singlet oxygen, oxygen with much higher energy levels that enables it to kill cancer cells.
The photodynamic therapy is administered on an outpatient basis and begins with the patient receiving the photosensitizer in an IV. The medication is absorbed by both cancerous and healthy cells. The drug is not toxic when first administered and only gains the ability to cause cell death once activated with light.
To mitigate cell death of healthy cells, the light treatment is typically not given until two to three days after the photosensitizing agent is administered. Normal cells metabolize the photosensitizer more quickly than mesothelioma cells. After 3 days, most healthy cells will no longer contain the photosensitizer, and the light will only cause cell death in the cancerous cells. Read more
Draining of fluid in the chest or abdominal cavity
Fluid build-up happens because cancer cells make the pleura or peritoneum inflamed. If mesothelioma is the cause of the fluid build-up, the fluid may contain cancer cells. Many people with pleural mesothelioma have fluid around their lungs (a pleural effusion). This can make it difficult for them to breathe.
People with mesothelioma may have fluid in their tummy (abdominal cavity), which is called peritoneal ascites. This can make the abdomen feel swollen, tight and uncomfortable. Draining the fluid off, the doctor puts a small tube (a catheter) using a needle into the chest or abdominal cavity.
Having fluid removed from your tummy (abdomen) is called an abdominal paracentesis or peritoneal aspiration. Draining the fluid may be done at the same time as a thoracoscopy or laparoscopy. A sample of the fluid is sent to a laboratory for testing. This is to see if it contains cancer cells. If the sample does not contain cancer cells you might need to have fluid drainage again.
There was an investigation by the European Organisation for Research and Treatment of Cancer on the feasibility of trimodal therapy consisting of induction chemotherapy followed by extrapleural pneumonectomy and postoperative radiotherapy in patients with malignant pleural mesothelioma.
Induction chemotherapy consisted of 3 courses of cisplatin 75 mg·m−2 and pemetrexed 500 mg·m−2. Nonprogressing patients underwent extrapleural pneumonectomy followed by post-operative radiotherapy (54 Gy, 30 fractions). The European Organisation for Research and Treatment of Cancer (EORTC) initiated a phase II trial to evaluate the feasibility of trimodal therapy in a multicentre international setting.
The primary end-point was “success of treatment”, which is defined as a patient who received the full protocol treatment within the defined time-frames, and was still alive 90 days after the end of protocol treatment without progression or evidence of grade 3–4 toxicity. Secondary end-points included the toxicity of the trimodal treatment, overall survival and progression-free survival.
Trimodality therapy was completed in 37 (64.9%) patients and median treatment duration was 184 days. Median follow-up time was 19.3 months (95% CI 17.4–25.0). Grade 3–4 toxicity 90 days after the end of the treatment protocol persisted in three (5.7%) patients due to bronchopleural fistula (n = 2) and grade 3 radiation pneumonitis (n = 1). Recurrences detected during follow-up were locoregional in six (16.2%) patients and distant metastases in 10 (27%) patients. Source
Complementary medicines are also used. Termed to be holistic this kind of treatment focuses on a patient’s physical, mental, emotional, and spiritual well being. In the case of Mesothelioma which is untreatable one can opt for clinical trials of new treatments that are in progress in several research laboratories and centres. The best advice on the line of treatment would be that recommended by the oncologist or physician.
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