If there's one thing we know about the treatment of mesothelioma, is this: we are always challenged to achieve efficiency.Despite years of research since the disease was first identified, it is still difficult to identify the best approach to treat the disease, says David Rice, MD, a cardiothoracic surgeon and nationally recognized expert mesothelioma who practice in University of Texas MD Anderson Cancer Center in Houston, TX.
The very rarity of cancer only about 3,000 people per year are diagnosed in the United States, it is difficult to carry out the type of research needed to compare treatments and determine the best treatment for each stage of the disease. "There are not a lot of science-based evidence in this disease," admits Rice. So when his patients ask him what is the best treatment of the disease, he said what we say in this section, adding that "we do not have a reliable cure for this disease."
Thus, a major goal of treatment is to reduce pain and suffering and prolong the life of a patient as long as possible while providing the best possible quality of life.
The choice of doctor of law mesothelioma is an important first step in the planning process.
There are a number of mesothelioma experts like Dr. Rice, practicing in clinics throughout the country. Each of these cancer specialists has an acute knowledge of the behavior and pathology of malignant mesothelioma and its treatment. It is likely that if you are diagnosed with mesothelioma, you will be referred by your personal physician in a center to fight against cancer on a larger scale.
The most important in the treatment of mesothelioma factor is the stage of the cancer and the type, Rice said. Treatment decisions also depend on whether the cancer is localized to the breast or has spread to the chest wall, diaphragm, or lymph nodes, your age and general health status and the center where you are treated. Learn more about finding a doctor here.
Conventional treatments for mesothelioma include surgery, chemotherapy and radiotherapy.
As with most solid tumors, doctors turn to surgery, radiotherapy and chemotherapy to manage mesothelioma. By exploring the different treatment options available with your doctor, it is important to be informed about the risks and benefits of each before making a final decision.
Surgery
Only 1 in 5 patients with metastatic pleural mesothelioma surgery. There are two main surgeries: Pleurectomy / decortication, in which the surgeon tries to remove as much of the tumor through the lungs as possible, and the more radical extrapleural pneumonectomy in which the lung itself is deleted.
There is much debate about what is "best," Rice said, although studies have found that most long-term survivors underwent surgery. He personally believes that pneumonectomy is best for tumor control if followed with radiation. Studies show it prevents recurrence of the tumor in the breast, in 80 to 85 percent of patients who have surgery.
However, Rice noted, this is a long and intensive process with a rate of 55 percent and a risk of complication than 3 percent of death, higher in some institutions. "So you do not want to do this if the patient has a fairly good prognosis," said Rice Translation:. It does not appear that the cancer has spread outside the breast.
Best suited for pneumonectomy patients are younger, with the epithelial form of the disease without lymph node involvement evident, and are otherwise healthy enough to withstand the rigors of the procedure. Rice actually waits until he opened the chest of the patient in the operating room and lymph node biopsies before deciding to perform the procedure.
Pleurectomy / decortication has a high failure rate, with the recurrent tumor in the chest cavity 50 to 80 percent of the time. However, this rate may change with improved radiotherapy techniques, Rice said. The reason for the high recurrence is that it is impossible to completely remove the tumor without removing the lung.
However, he noted, there is no difference in survival rates between the two surgeries. Part of the reason is that the cancer has often spread to other parts of the body when it is diagnosed, even though it seems to be limited to the chest.
Only 1 in 5 patients with metastatic pleural mesothelioma surgery. There are two main surgeries: Pleurectomy / decortication, in which the surgeon tries to remove as much of the tumor through the lungs as possible, and the more radical extrapleural pneumonectomy in which the lung itself is deleted.
There is much debate about what is "best," Rice said, although studies have found that most long-term survivors underwent surgery. He personally believes that pneumonectomy is best for tumor control if followed with radiation. Studies show it prevents recurrence of the tumor in the breast, in 80 to 85 percent of patients who have surgery.
However, Rice noted, this is a long and intensive process with a rate of 55 percent and a risk of complication than 3 percent of death, higher in some institutions. "So you do not want to do this if the patient has a fairly good prognosis," said Rice Translation:. It does not appear that the cancer has spread outside the breast.
Best suited for pneumonectomy patients are younger, with the epithelial form of the disease without lymph node involvement evident, and are otherwise healthy enough to withstand the rigors of the procedure. Rice actually waits until he opened the chest of the patient in the operating room and lymph node biopsies before deciding to perform the procedure.
Pleurectomy / decortication has a high failure rate, with the recurrent tumor in the chest cavity 50 to 80 percent of the time. However, this rate may change with improved radiotherapy techniques, Rice said. The reason for the high recurrence is that it is impossible to completely remove the tumor without removing the lung.
However, he noted, there is no difference in survival rates between the two surgeries. Part of the reason is that the cancer has often spread to other parts of the body when it is diagnosed, even though it seems to be limited to the chest.
Chemotherapy
Chemotherapy, also known as systemic therapy using oral medications or herbal based kill cancer cells throughout the body. Chemotherapy is used both before and after surgery, as well as in people who can not handle the surgery. It is also used in palliative care to reduce pain and improve quality of life.
The chemotherapy drugs most commonly used for mesothelioma are cisplatin combined with pemetrexed (Alimta) or raltitrexed (Tomudex). Other combinations are gemcitabine, carboplatin or oxaliplatin.
If you can not handle the combination therapy, your doctor may start on a single drug. Sometimes, your doctor may inject directly into your chest cavity, a procedure called pleural chemotherapy, or in the abdomen, called intraperitoneal chemotherapy. You can also get a second course of chemotherapy, chemotherapy called "second line" with pemetrexed or other drugs, raltitrexed plus oxaliplatin, or the combination of three drugs irinotecan, cisplatin and mitomycin.
Some centers have begun to offer intraperitoneal chemotherapy before surgery, followed by chemotherapy shortly after surgery. You can learn more about this approach here. There is also ongoing work to customize chemotherapy based on the genetic characteristics of the tumor.
Chemotherapy, also known as systemic therapy using oral medications or herbal based kill cancer cells throughout the body. Chemotherapy is used both before and after surgery, as well as in people who can not handle the surgery. It is also used in palliative care to reduce pain and improve quality of life.
The chemotherapy drugs most commonly used for mesothelioma are cisplatin combined with pemetrexed (Alimta) or raltitrexed (Tomudex). Other combinations are gemcitabine, carboplatin or oxaliplatin.
If you can not handle the combination therapy, your doctor may start on a single drug. Sometimes, your doctor may inject directly into your chest cavity, a procedure called pleural chemotherapy, or in the abdomen, called intraperitoneal chemotherapy. You can also get a second course of chemotherapy, chemotherapy called "second line" with pemetrexed or other drugs, raltitrexed plus oxaliplatin, or the combination of three drugs irinotecan, cisplatin and mitomycin.
Some centers have begun to offer intraperitoneal chemotherapy before surgery, followed by chemotherapy shortly after surgery. You can learn more about this approach here. There is also ongoing work to customize chemotherapy based on the genetic characteristics of the tumor.
Radiation
Radiation therapy can be an important part of treatment of mesothelioma. The problem is that because the cancer is close to the heart and lungs, it is difficult to provide the kind of high-dose, necessary to reduce the tumor intensive treatment. However, a new option, the intensity modulated radiotherapy (IMRT), which allows more precise targeting of cancer and avoid healthy tissue cells, may provide better results when performed by experienced clinicians.
Experimental therapies are being explored in clinical and surgical trials many of the best cancer centers in the nation.
There are more than 50 studies on new therapies for mesothelioma in the United States who are looking for volunteers. Researchers are studying new targeted chemotherapy drugs as well as new protocols to give medications, immunotherapy, which harnesses the power of the immune system to fight the disease, therapy, in which you are injected with a drug that binds to cancer cells and is activated by high light intensity, genetic therapies, and new radiotherapy techniques such as tomotherapy to treat the disease. Learn more about participating in a clinical trial here.
At some point, the disease management will attempt to cure the disease to try to keep the patient as comfortable as possible for as long as possible.
This is the stage of palliative care, when many people go into a hospice program. The main objective at this stage is to maximize patient comfort. Drugs to help with pain, difficulty breathing, and other symptoms that may be experienced is a pillar. So emotional and spiritual for you and your family support.
Alternative therapies for mesothelioma can be used to alleviate the side effects of traditional treatments against cancer.
Complementary and alternative medicine (CAM) includes therapies such as massage, acupuncture and meditation. They can be a powerful part of your overall management plan, to help you better manage stress and anxiety of the disease and conventional treatments.
Source: http://www.mesothelioma.com/treatment/
Radiation therapy can be an important part of treatment of mesothelioma. The problem is that because the cancer is close to the heart and lungs, it is difficult to provide the kind of high-dose, necessary to reduce the tumor intensive treatment. However, a new option, the intensity modulated radiotherapy (IMRT), which allows more precise targeting of cancer and avoid healthy tissue cells, may provide better results when performed by experienced clinicians.
Experimental therapies are being explored in clinical and surgical trials many of the best cancer centers in the nation.
There are more than 50 studies on new therapies for mesothelioma in the United States who are looking for volunteers. Researchers are studying new targeted chemotherapy drugs as well as new protocols to give medications, immunotherapy, which harnesses the power of the immune system to fight the disease, therapy, in which you are injected with a drug that binds to cancer cells and is activated by high light intensity, genetic therapies, and new radiotherapy techniques such as tomotherapy to treat the disease. Learn more about participating in a clinical trial here.
At some point, the disease management will attempt to cure the disease to try to keep the patient as comfortable as possible for as long as possible.
This is the stage of palliative care, when many people go into a hospice program. The main objective at this stage is to maximize patient comfort. Drugs to help with pain, difficulty breathing, and other symptoms that may be experienced is a pillar. So emotional and spiritual for you and your family support.
Alternative therapies for mesothelioma can be used to alleviate the side effects of traditional treatments against cancer.
Complementary and alternative medicine (CAM) includes therapies such as massage, acupuncture and meditation. They can be a powerful part of your overall management plan, to help you better manage stress and anxiety of the disease and conventional treatments.
Source: http://www.mesothelioma.com/treatment/
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