The treatment of pleural mesothelioma is constantly improving thanks to the dedication of specialists and the courage of clinical trial participants. Although there is no definite cure for pleural mesothelioma yet, an array of treatment options can extend patients’ lives and improve their quality of life.
The standard treatment options for pleural mesothelioma are surgery, chemotherapy and radiation therapy. Doctors have achieved the best results by combining two or more of these options to fit each patient’s unique situation, which is called a multimodal approach.
When mesothelioma is diagnosed in an early stage, major surgery supported by chemotherapy and radiation can enable a patient to live years beyond their initial life expectancy. However, these aggressive curative treatments will not benefit all patients. In many cases, doctors instead recommend palliative treatments, which aim to relieve cancer symptoms and improve quality of life.
Researchers are also developing experimental treatments, such as immunotherapy, photodynamic therapy and gene therapies, which have the potential to improve survival rates and minimize the side effects of cancer treatment. Eligible patients are encouraged to apply to clinical trials that study these new and innovative courses of treatment.
Multimodal therapy was linked to better survival rates in a 2014 study of 518 patients
|Treatment||1-Year Survival Rate||2-Year Survival Rate||3-Year Survival Rate|
|Surgery and Chemotherapy||56%||29%||17%|
|Surgery and Radiation||66%||39%||22%|
|Surgery, Chemotherapy and Radiation||76%||51%||37%|
Surgery has proven to be the best standard treatment option for long-term survival.
Specialists have developed two potentially curative surgical procedures for pleural mesothelioma:
There are also two palliative surgical options that focus on treating one of the most common symptoms of pleural mesothelioma. When fluid builds up in the space around the lungs, it can make breathing painful and difficult — this ailment is called a pleural effusion.
Chemotherapy involves the use of one or more drugs to kill cancer cells and shrink tumors. The drugs are usually delivered into a patient’s vein through an IV or taken orally as pills. The most widely used chemotherapy treatment for pleural mesothelioma is a combination of the drugs cisplatin and pemetrexed.
The debate over when chemotherapy is more effective in treating patients with pleural mesothelioma continues. The first randomized phase II clinical trial comparing the efficacy of chemotherapy delivered before or after aggressive surgery isn’t scheduled to conclude until April 2020.
Chemotherapy drugs damage cells that divide quickly, which is what makes chemotherapy an effective cancer treatment.
However, because there are also many normal cells in the body that divide quickly, chemotherapy usually has harsh side effects, including:
Radiation therapy uses high-energy rays to damage the DNA in cancer cells, which stops them from growing and dividing. Radiation can also harm healthy cells, especially lung cells, but fortunately for pleural mesothelioma patients, technological advances are making it easier for doctors to safely administer radiation near vital organs.
Radiation therapy is a painless outpatient procedure, but it can have some side effects, including fatigue, nausea and skin irritation near the application area (similar to sunburn). Depending on the dosage and frequency of the radiation, long-term radiation damage may also occur.
Pleural mesothelioma is rare compared to other forms of cancer. Most oncologists have never examined a patient with asbestos-related cancer, let alone tried to treat one. In fact, mesothelioma is so uncommon that it is frequently misdiagnosed.
For every pleural mesothelioma patient in the United States, there are more than 70 lung cancer patients.
A pleural mesothelioma patient’s best hope of improving their prognosis is to seek a team of medical professionals with experience treating this disease. There are several specialized cancer centers spread across the United States with expert staff dedicated to developing the best treatments for mesothelioma patients.
A patient’s treatment options will depend on the specifics of their diagnosis, and their out-of-pocket expenses will depend on their health insurance coverage. Any way you look at it, however, pleural mesothelioma treatment is expensive.
At the same time, however, there are unique financial resources available to many pleural mesothelioma patients:
Our team of Patients Advocates can provide you free guidance throughout the process. Whether it’s helping you select a pleural mesothelioma specialist or determining the best course of treatment, we are here to help.
Snehal Smart, M.D.
Research studies called clinical trials allow scientists and doctors to experiment with conventional drugs and therapies in different combinations and doses, as well as test the safety and effectiveness of entirely new methods of treatment.
The ultimate goal of these trials is to find new and improved treatment strategies the FDA can approve to treat a certain diagnosis.
Immunotherapy is a type of treatment that helps the body’s immune system fight cancer. The immune system is the body’s protection mechanism, designed to defend against bacteria, viruses and toxins, and it removes dead or damaged cells. When the immune system recognizes something that shouldn’t be in the body, immune cells attack the target.
However, because cancer cells appear very similar to healthy cells, the immune system may not recognize cancer cells as something dangerous, or the immune system may become too weak to fight the cancer on its own. This is where immunotherapy comes in.
Immunotherapy has been making strides in the fight against cancer. The FDA has approved immunotherapy to treat several types of cancers, including lung cancer. Immunotherapy is now the focus of some mesothelioma clinical trials. Immunotherapy is most successful when used in addition to standard treatments.
The targeted approach of immunotherapy can reduce the side effects patients experience during cancer treatment. Researchers hope that one day immunotherapy will be effective enough that patients won’t have to endure the vomiting and hair loss that typically accompany chemotherapy and radiation.
However, immunotherapy does have some side effects of its own, which are the result of kick-starting the immune system:
Photodynamic therapy (PDT) uses a special light-activated drug called a photosensitizer to kill cancer cells. The most common photosensitizer used to treat pleural mesothelioma is porfimer sodium, more commonly known as Photofrin.
Photodynamic therapy has shown the best results when used alongside surgery as part of a multimodal treatment approach. In a study published in 2012, a total of 38 pleural mesothelioma patients underwent a radical pleurectomy and intraoperative photodynamic therapy. The resulting median survival time after treatment was 31.7 months.
Viral diseases modify the DNA of the body’s cells, forcing host cells to stop their normal function and instead produce more copies of the virus. Though natural viruses can cause a variety of dangerous illnesses, some researchers are now trying to engineer viruses to cure cancer. In theory, a virus could be specially designed to do one of the following:
In each case, the treatment leaves healthy cells unharmed. The technologies of virotherapy and gene therapy are still highly experimental, but they offer the possibility of an effective cancer therapy with much less severe side effects than chemotherapy and radiation.
Many patients turn to complementary and alternative medicines (CAM) for help coping with the symptoms of pleural mesothelioma and the side effects of cancer treatments. CAM therapies cover a wide variety of practices — with some based in the life sciences or mystical belief systems, and others falling somewhere in between.
CAM therapies vary dramatically in terms of the scientific evidence supporting them. For example, yoga and massage have proven health benefits, but energy-healing techniques such as reiki remain a matter of faith.
Either way, the same general guidelines apply: Check with your doctor before beginning any CAM therapy, be skeptical of anyone who offers you a “miracle cure” for cancer and look for ways to reduce your stress and maintain a positive attitude.
If a certain practice brings you peace of mind, and your medical team has no qualm with it, then it may indeed help you heal.
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