Malignant Pleural Mesothelioma Treatment
Pleural mesothelioma treatment depends on whether the tumour can be removed with surgery (is possible to remove) and the stage at which it is. Doctors also consider a person's health and whether the cancer has returned after previous treatments.
Immunotherapy drugs like pembrolizumab (Keytruda) and Nivolumab (Opdivo) aid immune cells to identify and destroy mesothelioma cell. Other immunotherapies are available through clinical trials.
Treatment Options
New treatment options continue improving the outlook of patients with mesothelioma. These treatments can prolong life and lessen the symptoms such as pain.
Mesothelioma specialists can develop an extensive treatment plan for every patient, which could comprise a variety of treatments. Many patients with mesothelioma also participate in clinical trials to test new therapies. These are typically offered at cancer centers that treat mesothelioma.
Surgery is the most effective option for treating mesothelioma because it removes tumors directly. To treat pleural cancer, doctors can use a number of surgical methods. Extrapleural pneumonectomy involves removing a portion of the diaphragm, pericardium, and the lining surrounding the lung. If needed, doctors can also remove organs.
Chemotherapy is used to kill cancer cells and prevent the growth or spread of cancerous cells. This type of therapy can be administered before or after surgery, as well as during or following it. In certain instances doctors may combine chemotherapy with radiation or other surgical procedures.
Radiation therapy can reduce discomfort by shrinking tumors that press on nerves, bones or major blood vessels. It can be administered prior to or after EPP surgery. Doctors can also administer radiation after a pleurectomy/decortication (P/D) surgery as an alternative to more invasive procedures.
Certain patients respond to treatment with interleukin-2. It is an antibody that works against malignant pleural mesothelioma cells. It can be injected into the chest cavity or given through an intravenous line (IV).
Palliative therapy is a form of treatment that aims at improving the quality of life of patients and minimize the adverse effects associated with mesothelioma. It may include medications to treat pain and other ailments such as nausea and vomiting. Alternative treatments like acupuncture or yoga are also available.
Chemotherapy
Chemotherapy is a type of systemic treatment that employs chemotherapy drugs to stop the growth and spread of tumors. Patients are usually given chemotherapy drugs that are a combination like cisplatin or pemetrexed, which combine to enhance effectiveness and outcomes. These medications may be given before, during or after surgery (neoadjuvant) or in addition to surgery (adjuvant).
Depending on the stage of your mesothelioma as well as other health conditions doctors may recommend a variety of treatment options. It is essential to discuss all of your options with your physician. This is referred to as shared decision making, and it lets you and your doctor to choose an appropriate treatment plan that is compatible with the objectives of your treatment.
Your doctor will perform the biopsy to determine the stage mesothelioma is in. A doctor will place a thin tube through the chest or abdomen and use special instruments to take a tissue sample. The tissue sample is then analyzed to determine if it has cancerous cells.
Asbestos fibers cause irritation to cells in the lungs, causing pleural mesothelioma. The mesothelial cell mutates and transforms into a tumor. The biopsy is the only way to determine whether or not you are suffering from mesothelioma.
If your pleural mesothelioma is in its early stages, surgery can help improve your prognosis. There are two surgical treatments that can be used: extrapleural lung pneumonectomy (EPP) and pleurectomy/decortication (P/D). In EPP, the surgeons remove the affected lung, and occasionally the diaphragm or a portion of it. P/D surgery involves the removal of pleura and, in most cases, also parts of the pericardium.
This procedure can be utilized for peritoneal cancer. Radiation and/or immunotherapy may also be beneficial for patients with unresectable mesothelioma pleural. Combining ipilimumab and nivolumab, also known as Opdivo and Yervoy together with conventional mesothelioma treatments can improve the chance of survival.
A new emerging mesothelioma treatment is epigenetic therapy. It aims to reverse asbestos damage and restore normal DNA expression. The drug tazemetostat, which targets BAP1 enzymes that play a role in epigenetic control, is in clinical trials at the stage 2. This is a promising treatment for people with recurrent mesothelioma.
Radiation
Radiation therapy can ease symptoms and extend the life of patients by shrinking tumors that alleviate pressure on the lungs. Mesothelioma specialists use a variety of treatments for radiation. Three-dimensional conformal radiotherapy (3DCRT) is one of them. It makes use of multiple beams of radiation to target the cancerous tissue from different angles. Doctors may also use intensity-modulated radiation therapy (IMRT) to specifically target the tumor, and decrease radiation exposure to healthy tissue.
Immunotherapy can enhance the efficacy of conventional treatments. This type of treatment boosts the patient's natural defences against mesothelioma. It can also reduce recurrence. It is available in clinical trials, or as a complement to conventional mesothelioma treatment. Two immunotherapy drugs, Opdivo (nivolumab) and Yervoy (ipilimumab), were approved by the FDA in 2020 to treat pleural mesothelioma. Other immunotherapy drugs have shown promise in clinical trials.
Surgery can alleviate mesothelioma symptoms and eliminate some. Pleurectomy and Decortication (P/D) is a typical procedure utilized by surgeons to treat mesothelioma of the pleural region. The lungs are not affected by P/D, which removes only the pleura where the majority cancer cells are found. It is most effective in early-stage mesothelioma. It is often performed in conjunction with chemotherapy prior to or following surgery.
In a less invasive procedure doctors can drain the chest of fluid to ease breathing issues caused by excess mesothelioma fluid. They can also inject drugs into the chest to stop fluid from accumulating (pleurodesis).
asbestos mesothelioma treatment doesn't provide an effective cure, but it can help reduce symptoms and improve the quality of life. Patients suffering from mesothelioma should discuss their treatment goals and expectations with a doctor.
Specialists in mesothelioma are able to provide a comprehensive treatment plan. They will look over the most recent research and your health history to formulate a treatment plan that will help you live longer and lessen your symptoms. Your mesothelioma specialist will collaborate with other health care professionals, including nurses, social workers, physician assistants and counselors, to ensure you get the best possible care. A mesothelioma team can also suggest clinical trials to evaluate new treatments.
Surgery
If mesothelioma is detected at a less advanced stage, surgeons can remove the tumor and relieve symptoms. Most mesothelioma is diagnosed at a later stage that is when the cancer is more advanced and unable to be removed by surgery. The goal is to reduce the symptoms and prolong survival.
Your doctor could suggest a variety of treatments to treat mesothelioma of the pleural region. Treatments include surgery, chemotherapy and radiation. Immunotherapy is a relatively new treatment that enhances the immune system of a patient to fight mesothelioma. These treatments may extend life and improve quality of living, but they won't end the disease.
To diagnose pleural mesothelioma your doctor will take an in-tissue sample to check for cancerous cells. The doctor will make a biopsy or a different procedure, such as bronchoscopy or video-assisted thoracic surgery (VATS) to collect the sample. A doctor can perform a lung function test to assess the ability to breathe, or a chest x ray to see how well the lungs function.
After your doctor confirms that you have pleural mesothelioma and has determined the cancer stage based on the place of origin and other factors. These stages are indicated by Roman numerals, with one being the least advanced and four being the most advanced.
The stage of a pleural cancer determines if it can be surgically treated. Stage I or II pleural cancers are the most curable since it isn't spreading beyond the pleura.
Doctors can perform surgery if your mesothelioma is in advanced stages. They can perform an extrapleural pneumonectomy (EPP), which removes the entire lung that is affected or a pleurectomy with decortication (P/D) that removes the visible tumor as well as the diseased pleura but doesn't remove the lung.
After the procedure, you'll likely spend time in the hospital or outpatient clinic. You may feel groggy, confused or chilly when the anesthesia wears off, however, your nurses will give you pain medicine to help you feel comfortable. If you are staying overnight the patient will be moved into a regular hospital bed. In other cases, you will be monitored at the outpatient facility up until the time you return home.