Mesothelioma treatment

Mesothelioma treatments have thus far been unable to limit the spread of the deadly cancer. Treatments for mesothelioma are divided into two categories; traditional mesothelioma treatments and new mesothelioma treatments.

Traditional mesothelioma treatments are the same as those used to treat most other cancers, and include:

* Surgery
* Chemotherapy
* Radiation therapy (radiotherapy)
Traditional mesothelioma treatments are often used in conjunction with one another in effort to provide the most thorough and effective method of treatment. For example, trimodality therapy combines all three traditional methods of treatment, where chemotherapy is administered first with the aim of slowing the growth of malignant mesothelioma. Chemotherapy treatments are followed by surgery designed to physically remove a mesothelioma tumor mass (extrapleural pneumonectomy is often performed as part of trimodality therapy). Postoperative radiation therapy is used for the final step, to target any lingering mesothelioma cells. Although trimodality therapy has been unable to eradicate malignant mesothelioma, it has proven to be effective in significantly prolonging patients’ survival time by as much as five years (the average post-diagnosis survival time is one to two years).

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New mesothelioma treatments have been researched and developed with the hope of succeeding where traditional methods have not. Mesothelioma researchers are optimistic that new mesothelioma treatment modalities will eventually prove to be successful, though they have yet to yield results that are any better than traditional methods.
New treatments for mesothelioma include:

* Development of new chemotherapy agents
* Intensity modulated radiation therapy (IMRT)
* Photodynamic therapy (PDT)
* Immunotherapy
* Gene therapy

The progression of mesothelioma, as with other cancerous diseases, is typically broken into stages, with the treatment options based on the stage of the disease. The commonly used staging for mesothelioma is the Brigham staging system and it is described as follows.
Stages of Mesothelioma

Stage 1 occurs when the tumor lies completely within the capsule of the pleura, without swollen lymph nodes (adenopathy).

Stage 2 has the characteristics of Stage 1, where the tumor has spread and there is presence of adenopathy. But in Stage 2 the boundaries of the tumor allow for a resection (removal of the tumor) without cutting into other organs.

Stage 3 includes extension of the disease into the chest wall or into the heart, through the diaphragm or peritoneum, or outside the pleura to involve the lymph nodes.

Stage 4 occurs when the cancer has formed in distant organs through metastases.

Treatment options for the management of malignant mesothelioma include:

* chemotherapy
* surgery
* radiation
* multimodality treatment

However, none of the treatment strategies have been shown to be particularly effective against the disease.

esothelioma Diagnosis and Treatment

Mesothelioma is diagnosed by pathological examination. Tissue is removed, put under the microscope, and a pathologist makes a definitive diagnosis, and issues a pathology report. This is the end of a process that usually begins with symptoms that send most people to the doctor: a fluid build-up or pleural effusions, shortness of breath, pain in the chest, or pain or swelling in the abdomen. The doctor may order an x-ray or CT scan of the chest or abdomen. If further examination is warranted, the following tests may be done:

Thoracoscopy

For pleural mesothelioma the doctor may look inside the chest cavity with a special instrument called a thoracoscope. A cut will be made through the chest wall and the thoracoscope will be put into the chest between two ribs.




This test is usually done in a hospital with a local anesthetic or painkiller. If fluid has collected in your chest, your doctor may drain the fluid out of your body by putting a needle into your chest and use gentle suction to remove the fluid. This is called thoracentesis.

Peritoneoscopy

For peritoneal mesothelioma the doctor may also look inside the abdomen with a special tool called a peritoneoscope. The peritoneoscope is put into an opening made in the abdomen. This test is usually done in the hospital under a local anesthetic. If fluid has collected in your abdomen, your doctor may drain the fluid out of your body by putting a needle into your abdomen and using gentle suction to remove the fluid. This process is called paracentesis.

Biopsy

If abnormal tissue is found, the doctor will need to cut out a small piece and have it looked at under a microscope. This is usually done during the thoracoscopy or peritoneoscopy, but can be done during surgery

What is the prognosis for mesothelioma?

Like most cancers, the prognosis for this disease often depends on how early it is diagnosed and how aggressively it is treated.

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