The Treatment Methods of Pleural Mesothelioma

The on-going development of new drugs and detection techniques is improving the outlook for patients with pleural mesothelioma. Since pleural mesothelioma is the most common form of the cancer, more research and knowledge about this type of mesothelioma is present to utilize when detailing a treatment plan.

In general, pleural mesothelioma patients have three options: surgery, chemotherapy and radiation therapy. Typically, patients will receive a combination of two or more of these types of treatment.

Understanding available treatment options is often very important to patients and their loved ones. We offer a complimentary informational packet detailing treatment options for pleural mesothelioma patients. Click here to receive your packet overnight or call 800-615-2270 to speak with a patient and family advocate available at no charge to answer questions and offer guidance.

Early detection of pleural mesothelioma can improve a patient's mesothelioma prognosis considerably, and these patients have more extensive treatment options. If the disease is diagnosed early enough, surgery to remove localized tumors, followed by chemotherapy or radiation therapy to kill any remaining cancer cells can be an effective treatment. Curative surgery candidates must be in a good general state of health, and their cancer must not have spread beyond localized sections of the lungs.

When mesothelioma is diagnosed before the cancer has greatly progressed, a patient is typically in the first stages of mesothelioma. Doctors typically address the seriousness of cancer in terms of stages ranging from one to four, with the level of the cancer’s progression increasing with each stage. Patients diagnosed with pleural mesothelioma in stage one or two generally have greater treatment options and a better prognosis.

According to some current studies, approximately 10 percent of all pleural mesothelioma patients will survive for three to five years following diagnosis, and about 5 percent will survive five years or more.

Pleural mesothelioma patients who are not diagnosed early enough for curative treatment have fewer treatment options, mostly limited to palliative treatments, designed to relieve pain and discomfort to improve a patient's quality of life, rather than their prognosis. Palliative treatments include removal of built-up fluid from the pleural spaces, and surgical removal of tumors to relieve pressure on the lungs.

The Diagnosis of Pleural Mesothelioma

As with other types of mesothelioma, pleural mesothelioma is difficult to diagnose since symptoms do not typically arise for some time after initial asbestos exposure occurs. Additionally, since the symptoms of pleural mesothelioma are typical of many illnesses, in the early stages of the cancer the symptoms are often mistaken for less threatening diseases such as influenza and pneumonia.

X-rays or CT-Scans are often used to diagnose pleural mesothelioma.
A pleural mesothelioma diagnosis is made partly on the basis of symptoms but additional diagnostic tests are needed to confirm the presence of cancer. Following a medical history review and physical examination, patients must typically undergo imaging tests, such as x-rays or CT scans, to confirm the location of cancer. A patient must also usually endure fluid and tissue tests, also known as biopsies, to confirm the type of cancer involved.

The Symptoms Of Pleural Mesothelioma

Once trapped in the body, asbestos fibers cause cancerous cells to divide abnormally, resulting in the thickening of the pleural membrane layers and mesothelial cells, causing build-up of fluid (called pleural effusion). The fluid begins to put pressure on the lungs and the respiratory system in general, preventing normal breathing. Symptoms of pleural mesothelioma are largely caused by these developments and may include the following:

Pleural Mesothelioma Diagram
Pleural mesothelioma specifically develops in the pleural lining of the lungs.
* Persistent dry or raspy cough
* Coughing up blood (hemoptysis)
* Difficulty in swallowing (dysphagia)
* Shortness of breath that occurs even when at rest (dyspnea)
* Persistent pain in the chest or rib area, or painful breathing
* Development of lumps under the skin on the chest
* Night sweats or fever
* Unexplained weight loss
* Fatigue

The History Of Mesothelioma

Malignant mesothelioma remains one of the sentinel malignancies of oncology. It has a breathtakingly rapid natural history with a median survival of 6 to 8 months when untreated, is environmentally related, and has such economic and social impact that attorneys specialize in representing only mesothelioma patients. Expert witnesses devote full time to testifying, and governments are forced to consider not only the banning of the environmental agent but also a reappraisal of the whole tort system for compensation to injured victims. Furthermore, its presence in certain populations has changed the mindset of whole communities, such as Libby, Montana, Cappadocia, Turkey, Sarnia, and Ontario. Because of its infrequent occurrence, malignant mesothelioma is considered an orphan disease and managed in an anecdotal fashion in most oncologic practices. Yet this disease has set new scientific paradigms— in the clinic, laboratory, and community.

Over the last ten years, data have accumulated indicating that mesothelioma is a cancer caused by the environmental carcinogens asbestos and erionite, which interact with genetic predisposition and viral infection during cardinogenesis. The outcome of these complex interactions determines who among exposed individuals will develop
malignancy. Moreover, mesothelioma has become the ideal model to study how genetics and viral infection influence environmental carcinogenesis, as well as to discover novel targets for early detection and therapy.

Few cancers have caused so much controversy as mesothelioma. For more than 40 years scientists have argued whether chrysotile asbestos does or does not cause mesothelioma.Besides these important causality issues, conflict exists regarding the best surgical therapy for the disease and the interpretation of novel trials for mesothelioma.

The proliferation of mesothelioma-specific knowledge has led to an increase in the number of global conferences devoted to mesothelioma, at which scientists present new and exciting findings. Asufficient quantity of mesothelioma-specific research now stands strong and is no longer the stepchild at meetings devoted to lung cancer or sarcoma. Clinicians and scientists alike are being identified as “mesothelioma
experts,” and their advice in preventing and detecting the disease early, as well as in the treatment of the disease, is being solicited not only by other physicians, but by a growing number of E-mails directly from patients and their families.

What is Mesothelioma ?

The U.S. government reports that 70% to 80% of all cases of mesothelioma occur in people with atraceable history of exposure to asbestos. These numbers are from epidemiological surveys. There is a good chance that many of the remaining mesothelioma cases are also due to asbestos, but that the patient could not identify exactly where or when the asbestos fiber exposure occurred. Mesothelioma is a very tough cancer. Most patients undergo surgery and chemotherapy.

Sometimes radiation therapy is employed, including innovative techniques such as tomotherapy and intensity modulated radiation therapy. Oncologists use Brachytherapy for targeted radiation treatment of the tumor. The antifolate drug pemetrexed (Alimta) in combination with cisplatin has been embraced by many mesothelioma specialists. Median survival time, even with good medical care, is fairly low. Effusions into the bodily cavities is a common symptom. The chest, or pleural cavity, gets effusions, as well as the peritoneal (abdominal) cavity, depending on the site and shape of the tumor. Mesothelioma is classified as either pleural (the most common type) or peritoneal, depending on the location of the disease.(There are other types, but pleural and peritoneal are the most common.) To diagnose mesothelioma, the doctor takes a sample, usually of the pleural fluid, and conducts a biopsy in a lab. Immunohistochemical markers are employed in biopsy to distinguish mesothelioma from adenocarcinoma. These markers are usually glycoproteins. Other markers can be detected in the blood to help identify mesothelioma. Soluble mesothelin-related (SMR) proteins released by mesothelioma cells are distinctive enough to show up in the blood, if the appropriate test is conducted. However, definitive diagnosis still requires a laboratory biopsy. Tests and trials with gene therapy and immunotherapy are sometimes done on mesothelioma cases, but the standard cancer treatment modalities of surgery, radiation, and chemotherapy remain the most used techniques in mesothelioma treatment.