Friday, April 23, 2010

Ins and Outs of Treating Malignant Mesothelioma

    A type of cancer with a name most individuals don’t even recognize, mesothelioma – asbestos-caused cancer – is not only a rare disease but also one that is extremely difficult to treat. All cancers provide challenges when to comes to fighting the disease, but mesothelioma treatment is tougher than most.

The disease’s long latency period is the culprit. Often latent for as long as 50 years, when mesothelioma is finally discovered, it has usually spread from its primary location – which is usually the pleura (lining of the lungs) – to other parts of the body, generally the abdomen and other nearby organs. These metastases limits options and, traditionally, meso patients are in for a long fight.

    Most often, oncologists who are experienced in the treatment of this asbestos-caused cancer recommend a course of multi-modal treatment, combining a few different kinds of therapies to best address the growing tumor and the debilitating symptoms of the disease. Surgery, especially the curative type – including pneumonectomy, the removal of a lung – is rarely prescribed in the treatment of mesothelioma because of the advanced stage at which the disease is diagnosed. In addition, these surgeries are rigorous, ripe with complications and demanding long recovery periods. The patient must be in otherwise excellent health to withstand the procedures. Instead, surgery is more often offered for palliative reasons, including procedures such as a pleurodesis, designed to stop the build-up of fluid in the space around the lungs.

    More likely, treatment will consist of a combination of chemotherapy and radiation. These days, the chemo drug of choice is Alimta® (pemetrexed), the only FDA-approved drug recommended specifically for the treatment of pleural mesothelioma. Generally, this chemotherapy drug is combined with another, usually a platinum agent like Cisplatin®, for best results.

    Radiation therapy for mesothelioma can be delivered in a traditional manner via external beams or may take the form of brachytherapy, which involves the insertion of tiny radioactive rods or seeds directly at the site of the tumor. The latter allows the radiation to be better targeted and spares healthy cells that might be damaged by traditional radiotherapy. Indeed, brachytherapy has been proven more effective in many cases in the fight against mesothelioma.


    Unfortunately, neither of these conventional methods of treatment has proven to be terribly successful in treating mesothelioma. In some cases, they have been shown to add a few months to the patient’s life expectancy and, in other instances, they merely help to make the patient more comfortable, easing breathing or lessening other symptoms of the disease.

    That’s why, in many cases, patients turn to participation in mesothelioma clinical trials. These trials study promising new drugs or treatments for mesothelioma, and there are always a few taking place at any given time. The patient’s medical team can determine whether or not he/she qualifies for the clinical trial and can assist the patient in enrolling. There are certainly pros and cons to participating in these test trials but most patients who’ve enrolled in one agree that – in most cases – the advantages win. Nevertheless, patients should clearly understand the risks and responsibilities before enrolling.

    Please visit the Mesothelioma & Asbestos Awareness Center website for more information about treating this disease, including a list of top oncologists, leading cancer clinics and an up-to-date list of mesothelioma clinical trials. The MAA Center can also be found on Twitter: @MAACenter.

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