Malignant Pleural Mesothelioma Treatment
Treatment for mesothelioma of the pleural layer depends on whether the cancer can be removed with surgery (is surgically resectable) and the stage at which it is. Doctors also take into consideration a patient's health and whether the cancer has recurred after previous treatments.
Immunotherapy medications like pembrolizumab, Keytruda and Opdivo and Nivolumab help immune cells to detect and eliminate mesothelioma cancer cells. Other immunotherapies are available through clinical trials.
Treatment Options
New treatment options continue to improve the outlook of patients with mesothelioma. These treatments can prolong the life of patients and ease symptoms like pain.
Specialists in mesothelioma can design an individual treatment plan that incorporates various types of treatments for each patient. A lot of patients with mesothelioma participate in clinical research trials that test new treatments. These are typically available at cancer centers that specialize in treating mesothelioma.
Surgery is the best treatment for mesothelioma since it eliminates tumors directly. Doctors are able to use a variety of surgical techniques to treat mesothelioma that is pleural. One method, known as extrapleural pneumonectomy (EPP) involves the removal of the lining around the lung and a small portion of the diaphragm as well as the pericardium. If required, doctors may also remove organs.
Chemotherapy is a treatment that kills cancerous cells and prevent their growth or spreading. This kind of therapy can be administered prior to or after surgery, as well as during or following it. In some cases doctors may combine chemotherapy with radiation or other surgeries.
Radiation therapy can reduce pain by shrinking tumors which are pressing on nerves, bones, or major blood vessels. It can be given before or after EPP surgery. Doctors can also administer radiation after a pleurectomy/decortication (P/D) surgery as an alternative to more invasive procedures.
Immunotherapy with interleukin-2 (IL-2) appears to be active in a few patients. The antibody IL-2 works against malignant pleural mesothelioma cells. It is administered through an intravenous (IV) line or injected into the chest cavity.
Palliative therapy is a form of treatment that aims to improve the quality of life for patients and minimize the adverse effects of mesothelioma. It can include medications to manage pain, and other issues such nausea and vomiting. It could also involve alternative treatments such as acupuncture, yoga and meditation.
Chemotherapy
Chemotherapy, a systemic treatment that uses cancer-killing agents to stop the growth of tumors. Patients usually receive a combination chemotherapy drug like cisplatin and pemetrexed, which combine to enhance efficiency and results. These drugs can be administered before, after or during surgery (neoadjuvant) as well as in lieu of surgery.
Doctors may suggest different treatments based on the stage of mesothelioma and other factors. It is essential to discuss your options with your doctor. This is called shared decisions and gives both of you and your doctor the freedom to choose a plan of treatment that will meet your needs.
Your doctor will perform an examination to determine the stage of mesothelioma. A doctor will insert a ultra-thin tube into your chest or abdomen and employ special tools to collect tissues samples. The sample is then examined to determine if it contains cancerous cells.
Asbestos fibers can cause irritation to cells in the lungs which can cause mesothelioma pleural. Mesothelial cells transform and develop into tumors. A biopsy is the only way to determine for sure whether or not you suffer from mesothelioma.
Surgery can improve your prognosis in the event that you have pleural cancer in its initial stages. Two surgical treatments are available Extrapleural Pneumonectomy (EPP) and pleurectomy with decortication (P/D). In EPP, the surgeons remove the affected lung and sometimes part or all the diaphragm. P/D surgery involves removing the pleura and usually also parts of the pericardium.
A surgical procedure like this can be utilized to treat peritoneal mesothelioma. Immunotherapy and/or radiation therapy may be beneficial for patients suffering from mesothelioma that is not surgically resectable. Combining ipilimumab and Nivolumab also referred to as Opdivo and Yervoy together with conventional mesothelioma therapy can increase survival rates.
Epigenetic therapy is an innovative treatment for mesothelioma that aims to repair the damage caused by asbestos and restore normal expression of DNA. Tazemetostat is in clinical trials in the second phase and targets BAP1 enzymes that play a role in epigenetic regulation. This is a promising treatment for patients with persistent pleural mesothelioma.
Radiation
Radiation therapy can ease symptoms and prolong life by shrinking tumors, which reduce pressure on the lung. Mesothelioma specialists employ a variety of radiation treatments. Three-dimensional conformal radiotherapy (3DCRT) is one of them. It makes use of multiple beams of radiation to target cancerous tissue in different angles. Doctors may also opt for intensity modulated radiation therapy (IMRT) which targets specific areas of the tumor and decreases the radiation exposure to healthy tissue around it.
Immunotherapy may enhance the effectiveness of conventional treatments. This type of therapy boosts the body's natural defenses against mesothelioma cells and may decrease the chance of the recurrence. It is available through clinical trials or as an addition to conventional mesothelioma treatments. Two immunotherapy drugs, Opdivo (nivolumab) and Yervoy (ipilimumab), were approved by the FDA in 2020 to treat pleural mesothelioma. Other immunotherapy drugs are currently in development and have shown promise in clinical trials.
Surgery can remove some mesothelioma cells and relieve symptoms. For pleural mesothelioma surgery, surgeons often perform a procedure referred to as pleurectomy and decortication, also known as P/D. P/D helps protect the lungs by removing only the pleura where the majority of cancerous cells are found. It is most effective in early-stage mesothelioma. It is often performed with chemotherapy before or after surgery.
In a less invasive surgery doctors can drain fluid from the chest to ease breathing difficulties caused by mesothelioma-related fluid. They can also inject medicines in the chest to avoid the accumulation of fluid (pleurodesis).
Palliative mesothelioma treatment doesn't provide a cure, but it can alleviate symptoms and improve quality of life. Patients suffering from mesothelioma should discuss their treatment goals and expectations with a specialist.
Specialists in mesothelioma may offer a comprehensive treatment plan. mesothelioma life expectancy with treatment will look over the most recent research and your medical background to develop a treatment plan that will help you live longer and lessen your symptoms. Your mesothelioma specialist will collaborate with other health professionals, including nurses, social workers, physician assistants and counselors to ensure you receive the highest quality of care. The mesothelioma treatment team may also suggest clinical trials to evaluate new treatments.
Surgery
When mesothelioma has not spread, the surgeon can remove the tumor in order to relieve symptoms. However, most mesothelioma cases are diagnosed at more advanced stages, when the cancer has spread and can't be surgically removed. The goal is to reduce symptoms and extend the duration of survival.
Your doctor might suggest a variety of treatments for your mesothelioma pleural. Radiotherapy, chemotherapy and surgery are all possible treatments. A newer treatment option called immunotherapy can boost a patient's immune system to fight mesothelioma. These treatments could prolong the life of a patient and improve the quality of life however they cannot eliminate the disease.
The doctor will take an appropriate tissue sample and analyze it for cancerous cells to identify pleural mesothelioma. The sample is taken through a biopsy or by another procedure like bronchoscopy or video-assisted surgery (VATS). A doctor may also perform lung function tests to assess breathing capacity or a chest x-ray determine how the lungs work.
If your doctor determines that you have pleural msothelioma they will assign a stage of the cancer depending on the location and other factors. The stages are identified by Roman numerals and one is the most advanced and four being the most advanced.
A pleural mesothelioma's stage determines whether it is treatable with surgery. Stage I or II pleural cancer is most curable as it hasn't spread beyond the pleura.
If your mesothelioma is at a more advanced stage, doctors may perform surgery to ease symptoms. They can do an extrapleural pneumonectomy (EPP) which eliminates the entire lung that is affected or a pleurectomy with decortication (P/D) which removes the visible tumor and the diseased pleura, but does not remove the lung.
It is likely that you will be admitted to the hospital following surgery. Your nurses will administer pain medications to keep you comfortable when you feel tired or confused after the anesthesia has worn off. If you're staying for the night the patient will be moved to a normal hospital bed. If not, you'll be monitored at the outpatient facility up until the time you return home.