Mesothelioma Treatment Options

Presently there is no known or reliable cure for victims of malignant mesothelioma. However, if the disease can be identified at an early stage, several treatments are available. The most common are surgery, chemotherapy, and radiation therapy. Whether a New York patient is eligible for these and similar treatments will depend upon the patient’s age and overall health, as well as the extent of the disease. If a patient’s malignant mesothelioma has become too advanced for therapeutic treatment, then the physician may focus instead on making the patient comfortable by relieving some of the cancer’s painful symptoms.

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For more information, use our online contact form or call Belluck & Fox, LLP’s Buffalo, NY, mesothelioma lawyers toll-free at 877-MESOTHELIOMA (637-6843).

Traditional Treatment Options

The three traditional treatment options for Buffalo patients with malignant mesothelioma are surgery, chemotherapy, and radiation therapy. Physicians often will use a combination of these techniques to maximize a patient’s chance of success in recovering from the disease. “Trimodal” therapy, in which all of these techniques are employed, is deemed the most aggressive, and effective, approach.

Surgery involves physical removal of the patient’s cancer. The specific type of surgery performed depends upon the type of malignant mesothelioma afflicting the patient and its location in the body. Mesothelioma tumors usually are large and difficult to remove completely.

Curative Approaches

Any of a variety of surgical procedures may be employed in an attempt to remove all gross disease from a patient, depending upon the patient’s specific condition. These include:

Pleurectomy/Decortication: A Pleurectomy/Decortication is a surgical procedure where the pleura, the membrane lining the lungs and chest cavity, is removed, without removing the entire lung. This treatment option is usually performed on patients in the early stages of mesothelioma, and it is the most common form of curative surgery.
Debulking: Debulking is a surgical attempt to remove as much of the cancer as possible, even where it’s already known that not all can be removed.
Extra-Pleural Pneuomonectomy (EPP): EPP is the removal of the pleura, diaphragm, pericardium, and the whole lung involved with the tumor. EPP is considered a radical therapy and is not frequently performed by most surgeons. EPP patients are referred to centers specializing in these treatments.

These “potentially curative” procedures are typically used in combination with other treatment options (multi-modal therapy).

Palliative Approaches

Palliative procedures are used to treat the symptoms of mesothelioma, providing relief for the patient, without aggressively treating the disease itself.

Chest Tube Drainage and Pleurodesis: The goal of chemical pleurodesis is to cause an irritation between the two layers covering the lung. This irritation causes an obliteration of the space between the layers where the fluid accumulates and prevents further accumulation of fluid. There are a variety of agents which can be used, including talc and bleomycin. As the pleural space is closed, fluid drains out of the chest cavity using a chest tube.
Pleuroperitoneal Shunt: Pleuroperitoneal shunting has been used in patients who have failed chemical pleurodesis, chemotherapy, or radiation therapy. Pleuroperitoneal shunting can provide effective palliation in patients with a trapped lung or others who have failed treatment.

Chemotherapy

Chemotherapy uses anticancer drugs to kill cancer cells and may be used as the primary treatment for mesothelioma, or it may be used as part of a multi-modal approach. Chemotherapy is referred to as systemic treatment because the drug is introduced into the patient’s bloodstream and travels throughout the body killing cancer cells. The drugs may be in pill form or may be injected into the body through a needle.

In addition to killing cancer cells, chemotherapy drugs work to restrict the uncontrolled spread of abnormal cancer cells, preventing them from dividing and multiplying.

Chemotherapy is not considered a “curative” approach for the treatment of mesothelioma and instead focuses on shrinking existing tumors (usually prior to surgery, in what’s called neoadjuvant therapy), controlling the spread of the cancerous cells, and removing residual cancer cells following surgery (adjuvant therapy).

Chemotherapy drugs also can be injected directly into the chest or abdomen to treat cancer located there without spreading harmful effects to other parts of the body. In a procedure called heated intraoperative intraperitoneal chemotherapy, for instance, a chemotherapy agent is administered directly into the abdomen after surgical removal of as much of an abdominal tumor as possible. It is believed that the combination of the drug and heat aid infiltration of the drug into cancerous tissues, and that the heat itself also may damage cancer cells.

To effectively treat mesothelioma, more than one drug may be used in chemotherapy. Depending on the drugs, the amount taken and the treatment period, there may be side effects. Historically, doxorubicin has been the most widely used single chemotherapy drug. Other newer drugs, including gemcitabine, cisplatin, carboplatin, epirubicin, cyclophosphamide, ifosfamide, vinorelbine, paclitaxel, and methotrexate, now are often preferred and are usually given in different combinations.

Radiation Therapy

Radiation therapy uses high-energy x-rays to help destroy cancer cells and shrink tumors. The radiation may come from outside the body from a machine (external radiation) or from radioactive materials placed directly in or around cancer cells through thin plastic tubes (internal or implant radiation). In pleural mesothelioma, it is difficult to irradiate tumor tissue successfully without injuring nearby organs like the lungs, heart, and liver. However, radiation therapy can be very effective in relieving pain in certain situations. Factors which can impact the use of radiation treatment include the volume of the tumor and how near it is to vital organs.

Non-Traditional Treatment Options

Photodynamic Therapy destroys cancer cells by using the energy from light and may also be effective when combined with surgery. Although this treatment is in the experimental stage for mesothelioma, it has shown promising results in treating other cancers. In the procedure, the patient receives a photosensitizer (a drug which makes cells sensitive to specific wavelengths of light) which collects in cancerous cells but not in healthy cells. Once the cells have been sensitized, fiber optic cables are placed in the body (usually through open-chest surgery) so that the correct frequency of light can be focused on the tumor. This causes the photosensitizer drug to produce a toxic oxygen molecule which kills the cancer cell.
Gene Therapy is a new treatment, currently in clinical trials. This approach allows treatment to target tumors, rather than destroying healthy cells, which is the negative aspect of traditional chemotherapy. In gene therapy, cancer is treated by altering genetic defects that allow a tumor to develop. A “suicide gene” is inserted directly into the tumor, making the cells sensitive to a normally ineffectual drug. The drug is then administered to the newly sensitive cancer cells and it destroys those cells while leaving the healthy cells unharmed.
Immunotherapy (or biological therapy) treats cancer by using the body’s own immune system to fight cancer cells. Another name often applies to this therapy, biological response modifiers (BRMs). Though it is not yet obtainable, promising clinical studies are underway for immunotherapy. Problems have included harmful side effects in patients involved in clinical trials of immunotherapy treatment programs.

Contact Our Buffalo Mesothelioma Illness Attorneys Today

If you or a loved one in the Buffalo area has been diagnosed with mesothelioma, the asbestos injury attorneys of Belluck & Fox, LLP, can help. We handle mesothelioma cases from Buffalo and the surrounding communities. Use our online contact form or call Belluck & Fox, LLP’s mesothelioma lawyers toll-free at 877-MESOTHELIOMA (637-6843).

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