Pleural mesothelioma specialists include medical oncologists, thoracic surgeons, radiation oncologists and many other types of health care professionals. There is no single doctor who can diagnose and treat this rare cancer on their own.
Treating pleural mesothelioma is a team effort.
Even doctors who have spent their careers studying pleural mesothelioma rely on experts with different training.
In CancerCare's 2018 teleconference, Advances in the Treatment of Mesothelioma, experts agreed that multimodal therapy — which combines more than one treatment — is the best approach for patients.
This is why the top cancer centers staff mesothelioma experts in every necessary subspecialty.
For example, surgery and radiology are separate skill sets. You would not want your surgeon planning your radiation treatment or your radiologist operating on you.
Understanding the roles these specialists play will help you understand your treatment plan and communicate with your health care team.
One of the specialists on your team will also function as the team leader. If you are eligible for tumor-removing surgery, your thoracic surgeon may play this role. They will coordinate with the rest of the team to make sure you receive the right adjuvant therapies and follow-up scans.
But if your treatment plan focuses on chemotherapy or immunotherapy, the team leader may be your medical oncologist.
Either way, communication between all your doctors and nurses is vital for managing side effects, preventing harmful drug interactions and monitoring how the cancer responds to treatment.
Medical oncologists specialize in treating cancer with medicines such as chemotherapy and immunotherapy.
Chemotherapy is the most common treatment for pleural mesothelioma, and immunotherapy holds great promise for treating the disease. Medical oncologists are almost always involved in pleural mesothelioma treatment.
Expert medical oncologists watch clinical trials of new drugs carefully. Specialized oncologists make sure their mesothelioma treatment recommendations are based on the latest evidence.
Thoracic surgeons are trained to operate on the vital organs in the chest.
Thoracic procedures are difficult for surgeons and potentially very dangerous for patients. Until the pioneering work of Dr. David Sugarbaker in the 1990s, treating pleural mesothelioma with surgery was considered all but impossible.
But Sugarbaker and many other expert surgeons have proved advanced surgical procedures can help certain patients live years longer with pleural mesothelioma. Patients may be eligible for surgery if they are in otherwise strong health and their cancer has not metastasized.
Radiation oncologists use beams of X-rays or charged particles to damage cancer cells. Radiation can shrink pleural mesothelioma tumors or kill cancer cells leftover after surgery.
Radiation can be very dangerous to the heart and lungs, however. It takes advanced equipment and expert training to hit a pleural mesothelioma tumor with radiation without damaging healthy tissue around it.
Radiation oncologists who specialize in cancers of the chest use cutting-edge techniques such as intensity-modulated radiation therapy and proton therapy.
Palliative care specialists focus on alleviating symptoms and treatment side effects for patients. Cancer patients can benefit from palliative care at every stage in their treatment plan.
Palliative care specialists can help pleural mesothelioma patients recover from surgery or deal with nausea during chemotherapy. Throughout the treatment plan, they can help patients manage cancer-related pain and breathlessness.
Working with a palliative care specialist from the beginning leads to better treatment outcomes for pleural mesothelioma patients.
Pulmonologists focus on the health of the lungs. These doctors usually play a role during pleural mesothelioma diagnosis if a patient has unexplained breathing problems. After diagnosis, pulmonologists can help patients keep their lungs as strong as possible to maintain quality of life.
Radiologists use imaging scans to see what is going on inside the body. These types of tests include X-rays, CT scans, MRI scans and PET scans. Pleural mesothelioma patients typically get regular scans during diagnosis and treatment.
A diagnostic imaging scan reveals the presence and location of tumors in the body. During treatment, further scans reveal whether tumors are shrinking or growing.
Pleural mesothelioma grows in a thin sheet rather than a solid ball like most other cancers. It is difficult to measure the size of pleural mesothelioma tumors, so having an experienced radiologist is vital.
Pathologists study cells under a microscope to identify them. Sending a biopsy sample of a tumor to a pathologist is the best way to confirm a pleural mesothelioma diagnosis.
Pathologists examine the shape of cancer cells to determine the cell type of the cancer. They also use immunohistochemical stains to differentiate between types of cancer. For example, certain antibodies react to mesothelioma cells but not lung cancer cells.
General practitioners provide routine medical care. They are the ones you call for regular checkups and typical aches and pains.
Pleural mesothelioma has vague early symptoms, and general practitioners often mistake it for the flu or pneumonia at first. They are not equipped to diagnose or treat this type of rare cancer.
Your family doctor or primary care physician still has an important role to play during your cancer treatment, however. They are familiar with the other health issues you have, so they should coordinate with your cancer treatment team to ensure consistent care.
Certain mesothelioma specialists have a “D.O.” after their name instead of an “M.D.” This means they are technically a “doctor of osteopathic medicine” rather than a “medical doctor.” But they are still fully qualified to provide medical treatment.
Osteopathic doctors receive the same training as medical doctors, plus an additional 200 hours of training in osteopathic manipulative medicine. They emphasize preventative medicine and take a more holistic approach to health care.
Doctors of osteopathic medicine can specialize in pulmonology, surgery and oncology just like other doctors.
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