Malignant Pleural Mesothelioma Treatment
Treatment for mesothelioma of the pleural layer depends on whether the tumor is able to be removed through surgery (is surgically resectable) and the stage at which it is. Doctors also consider a person's health and whether the cancer has come back after previous treatments.
Immunotherapy drugs like pembrolizumab, Keytruda and Opdivo, nivolumab, aid immune cells to detect and eliminate mesothelioma cancer cells. Clinical trials can provide other immunotherapies.
Treatment Options
New treatment options continue improving the outlook of patients with mesothelioma. These treatments may prolong life and relieve symptoms such as pain.
Specialists in mesothelioma can design an individual treatment plan that incorporates multiple types of treatments for each patient. 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 mesothelioma treatment option since it eliminates tumors directly. To treat pleural cancer, doctors can employ a variety of surgical techniques. One procedure, called extrapleural pneumonectomy (EPP) involves the removal of the lung's lining and a portion of the diaphragm as well as the pericardium. If necessary, doctors may also remove organs.
Chemotherapy is used in order to destroy cancerous cells and prevent the growth and spread of cancerous cells. This kind of treatment can be administered prior to, during or following surgery. In some cases doctors may combine chemotherapy with radiation or other surgeries.
Radiation therapy can reduce pain by shrinking tumors which are pressing on bones, nerves or major blood vessels. It can be administered prior to or following EPP surgery. Doctors can also administer radiation after a pleurectomy/decortication (P/D) surgery as an alternative to more invasive procedures.
Some patients respond to immunotherapy with interleukin-2. The monoclonal antibody IL-2 that targets malignant pleural cells of mesothelioma. It can be injected into the chest cavity or given via an intravenous line (IV).
Palliative therapy is a form of treatment that aims at improving the quality of life for patients and reduce the side effects associated with mesothelioma. It may involve medications to manage pain, as well as other problems like nausea and vomiting. It could also involve alternative treatments such as yoga, acupuncture and meditation.
Chemotherapy
Chemotherapy, a systemic treatment makes use of cancer-killing agents in order to stop the growth of tumors. Patients are typically given chemotherapy drugs such as pemetrexed or cisplatin. These drugs are used in conjunction to enhance effectiveness and improve outcomes. These medications may be given prior to, during or following surgery (neoadjuvant), or in addition to surgery (adjuvant).
Doctors may suggest different treatments based on the stage of mesothelioma, and other factors. It is essential to discuss all your options with your physician. This is known as shared decisions, and it allows both you and your doctor the choice to select a plan of treatment that will meet your needs.
Your doctor will perform an examination to determine the stage of mesothelioma. treating mesothelioma will insert a ultra-thin tube into your chest or abdomen, and then make use of special tools to take tissue samples. The tissue sample will be examined to determine whether the cells are cancerous.
Asbestos fibers can cause irritation to cells in the lungs which can cause mesothelioma pleural. The mesothelial cells transform and grows into the form of a tumor. Only a biopsy can tell whether you have mesothelioma.
Surgery can improve your prognosis if you have pleural mesothelioma in its initial stages. There are two surgical treatments for lung cancer: extrapleural pneumonectomy (EPP), and pleurectomy/decortication (P/D). During EPP, doctors remove the lung that is infected and usually parts or the entire diaphragm. P/D surgery involves the removal of the pleura and in most cases also parts of the pericardium.
This surgical procedure may also be utilized to treat peritoneal cancer. Radiation and/or immunotherapy may also be beneficial to patients suffering from unresectable mesothelioma pleural. Combining ipilimumab and nivolumab, also known as Opdivo and Yervoy together with conventional mesothelioma therapy can increase the chance of survival.
A new mesothelioma treatment that is emerging is epigenetic therapy. It aims to repair asbestos damage and restore normal DNA expression. The drug tazemetostat targets BAP1 enzymes that play a role in epigenetic control, is currently in phase 2 clinical trials. This is a promising option for patients suffering from recurrent pleural mesothelioma.
Radiation
Radiation therapy can ease symptoms and prolong life by shrinking tumors, which alleviate pressure on the lungs. Mesothelioma specialists use a variety of radiation treatment. Three-dimensional conformal radiotherapy (3DCRT) is one option. It utilizes multiple beams of radiation to target cancerous tissue in different angles. Doctors may also opt for intensity modulated radiation therapy (IMRT), which targets specific parts of the tumour and reduces the risk of radiation to healthy tissue around it.
Immunotherapy can boost the effectiveness of traditional treatments. This kind of therapy enhances the body's natural defenses against mesothelioma cells, and may decrease the chance of recurrence. It is available through clinical trials or as an adjunct to standard mesothelioma care. Two immunotherapy drugs, Opdivo (nivolumab) and Yervoy (ipilimumab), were approved by the FDA in 2020 to treat pleural mesothelioma. Additional immunotherapy drugs show promise in clinical studies.
Surgery can reduce the symptoms and also eliminate mesothelioma. Pleurectomy and Decortication (P/D) is a standard procedure performed by surgeons to treat mesothelioma pleural. The lungs are spared by P/D, which removes only the pleura where the majority of cancerous cells are found. It is most effective in the early stages of mesothelioma and is sometimes performed with chemotherapy before or following surgery.
In a less invasive surgery doctors can drain fluid from the chest to ease breathing difficulties caused by excess mesothelioma fluid. They can also inject drugs into the chest to stop the accumulation of fluid (pleurodesis).
Palliative mesothelioma treatment isn't a cure, but it can reduce symptoms and improve the quality of life. Patients suffering from mesothelioma should discuss their treatment goals and expectations with a doctor.
Mesothelioma specialist doctors can provide an extensive mesothelioma treatment program. They will review your health history and the most recent research to develop an effective treatment plan that will assist you in managing your symptoms and live longer. Your mesothelioma specialist will collaborate with other health professionals, including nurses, physician assistants and social workers, to ensure you receive the most effective treatment. The mesothelioma treatment team may also suggest clinical trials to evaluate new treatments.
Surgery
If mesothelioma is detected at a less advanced stage, surgeons can surgically remove the tumor and relieve symptoms. However, most mesothelioma patients are diagnosed at more advanced stages, when the cancer has spread and cannot be surgically removed. The goal is to reduce the symptoms and extend survival.
Your doctor may recommend various treatments to treat your mesothelioma pleural. Treatment options include chemotherapy, surgery and radiation. A newer treatment option known as immunotherapy can boost a patient's immune system to help fight the mesothelioma. These treatments may extend life and improve quality of life, but they won't end the disease.
To diagnose pleural mesothelioma, your doctor takes an in-tissue sample to check for cancer cells. The sample is taken through a biopsy or through another procedure such as bronchoscopy, or video-assisted surgery (VATS). A doctor can also conduct a lung function test to determine the strength of breathing or a chest x-ray to examine how the lungs are working.
If your doctor has confirmed that you have pleural msothelioma, they will assign a stage of cancer based on the location and other aspects. The stages are identified by Roman numerals with one being the least advanced and four being the most advanced.
The stage of a pleural cancer decides if it can be surgically treated. Stage I or II pleural cancer is most curable as it isn't spreading beyond the pleura.
Doctors may perform surgery if you have mesothelioma in an advanced stage. They can either perform an extrapleural lung pneumonectomy (EPP), in which the entire lung is removed, or a pleurectomy and decortication (P/D), which removes only the visible tumor as well as the pleura affected by cancer.
After the procedure, you'll likely be in the hospital or an outpatient clinic. You may feel groggy and confused, or cold when the anesthesia has worn off, but your nurses will give you pain medicine to keep you comfortable. You will then be moved to an ordinary hospital room if you are staying overnight or you will remain in the outpatient facility until you can go home.