Mesothelioma Treatment
Selecting the right mesothelioma treatment for each patient requires careful consideration and an in-depth analysis of the patient's general health and the progression of the disease. Mesothelioma is a rare, aggressive and well-adapted form of cancer that is difficult to eradicate. Completing arduous treatment methods requires physical health and emotional strength, and some forms of mesothelioma don't respond to powerful treatment methods, including chemotherapy drugs and high-dose radiotherapy. For years, multimodality treatment options using a combination of radical surgery, preoperative chemotherapy and postoperative radiotherapy have been recognized as one of the most effective ways for removing malignant mesothelioma tumors, preventing cancer from spreading and reducing the possibility of a reoccurrence. Newer treatment methods being tested in clinical trials are exploring the effectiveness of immunotherapy agents and genetic vaccines that can alter the genes in cancer cells and make them more susceptible to other mesothelioma treatments.
Mesothelioma Research
In the 1980s, cancer researchers at the Harvard Medical School studied a group of mesothelioma patients treated with a trimodality method, including extrapleural pneumonectomy (EPP) or removal of the lung, postoperative chemotherapy and radiation. These early studies achieved a 48 percent survival rate at two years and a 22 percent survival rate at five years. All together, the 94 patients achieved a median survival rate of 23 months with low morbidity and mortality rates following surgery. Recently, scientists have adopted preoperative chemotherapy treatments incorporating cisplatin and complementary agents that slow tumor growth. This treatment is followed by an extrapleural pneumonectomy or EPP surgery or a less drastic but more time consuming procedure known as a pleurectomy/decortication, or P/D. Postoperative radiation is then applied to help kill any cancer cells that remain. In order to undergo radical lung surgery, such as an extrapleural pneumonectomy where one lobe of the lung is completely removed, patients must have excellent cardiovascular and respiratory health. Other common surgeries include re-sectioning where a slice of cancerous tissue is removed and a lobectomy where part of a lobe is removed. Less invasive procedures, such as resections and pleurectomies/ decortications where the lining of the lung is carefully removed, are suitable for a larger number of patients who are not good candidates for a complete extrapleural pneumonectomy.
When patients with aggressive forms of mesothelioma, such as biphasic and sarcomatoid cell tumors, don't respond to traditional treatment methods, they are often left with few options and may enroll in groundbreaking clinical trials that are experimenting with new treatment methods. In the 21st century, new mesothelioma treatment methods are emerging, including intensity modulated radiation therapy (IMRT), a 3D radiation device that delivers high-intensity radiation directly to tumors, photodynamic therapy (PDT), which uses light-activated drugs to kill cancer cells and genetic immunotherapy vaccines created from a patient's own DNA, which have the ability to alter the genes in cancer cells. Researchers have also found that immunotherapy medications containing viral agents such as measles, retroviruses adenoviruses, have the ability to produce spontaneous cell death and could increase the effectiveness of available mesothelioma treatments for all patients.
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