Treatment of mesothelioma

The mesothelioma treatment option is right for you depends on many factors including your age, overall health status, cancer stage, cell type (which determines the aggressiveness of the cancer) and most importantly, your personal desires. To help you evaluate these options, you will have a multidisciplinary team (MDTs) of physicians who will discuss your case and give you the best treatment option. The members of this team may include a cardiothoracic surgeon, a medical oncologist, a radioncólogo, a specialist in pain treatment and a specialist in palliative care. Nurses and other health workers could also be involved in their treatment.

The conventional treatment of mesothelioma offers several options, and you have to discuss each with their EMD before making a treatment decision. Be sure to learn about risk factors, prognosis with treatment, possible side effects and quality of life offered by each option.

Surgery
There are two surgical methods for mesothelioma, the pleurectomía / decortication (P / D) and extrapleural pneumonectomy (NEP). These are highly specialized surgery and may not offer all the facilities. Not all the thoracic surgeons are experienced in these types of surgeries. The ultimate goal of these procedures is to remove most of the mesothelioma, in the certainty that the remains miscroscópicos disease. Adjuvant therapy, which uses additional forms of treatment with primary therapy, is usually to eliminate residual disease. The most common forms of adjuvant treatment is chemotherapy and radiotherapy.

The pleurectomía / decortication is considered the least radical of the two methods since it involves only the removal of the pleura (lining of the lung) without underlying lung resections. In some cases, can remove the pericardium and diaphragm, depending on the size of the tumor. The advantages of this procedure is usually a shorter recovery and utility in patients who can not tolerate the NEP. Disadvantages include a higher risk of recurrence of the disease by the inability to remove all the cancerous tumor and the impossibility of using adjuvant high-dose radiation on the potential risk to the underlying lung.

The extrapleural pneumonectomy is a radical procedure that involves removing the lung, the pleura (the lining of the lung), the pericardium surrounding the heart and the diaphragm. During surgery, the pericardium and diaphragm are reconstructed with materials similar to Gortex. Patients may be candidates for surgery only if they meet certain criteria of stages of cancer development and show the appropriate cardiac and pulmonary function to tolerate the procedure.

Chemotherapy

Chemotherapy involves using anticancer drugs that inhibit the multiplication of cancer cells. In most cases, combinations of drugs are used to increase efficiency. Chemotherapy can be used aggressively to shrink the tumor or palliative to relieve symptoms such as breathlessness or pain. The administration of chemotherapy can be by intravenous or intramuscular injection, oral medication or sometimes, may be administered directly into the pleural or peritoneal cavity. Some of the drugs that are used most frequently include:

* Pemetrexed (Alimta)
* Cisplatin (Platinol)
* Carboplatin (Paraplatin)
* Gemcitabine (Gemzar)
* Doxorubicin (Adriamycin)
* Mitomycin
* Raltitrexed (Tomudex)
* Vinorelbine (Navelbine)

Pharmaceutical companies are constantly researching new drugs, so you can always ask your doctor about the most promising new drugs. One such drug, Alimta (pemetrexed), was approved in Europe in September 2005.
Radiotherapy

Radiotherapy involves using high energy X-rays to kill cancer cells and shrink tumors. Can be used together with aggressive surgery to help eliminate microscopic metastases can cause a recurrence of the disease, and palliative to treat pain caused by tumors that are pressing the nerve ends or other body. Radiation therapy has also proven effective in preventing the spread of tumor biopsies or in areas of pleural drainage tube.
Clinical Studies

The purpose of clinical studies is to involve patients in finding new and better treatments for diseases. Several clinical studies have different objectives, which may include the study of new drugs compare different ways of treating a disease or the study of various techniques for cancer prevention. Clinical trials are divided into three phases. Here, we show brief summaries of the goal of each phase of the trial.

The Phase I clinical studies are the first stage of the clinical studies. At this stage, the drugs have only been tested in the laboratory, but have had an effect on the destruction of cancer cells. These trials enroll only a limited number of participants and are conducted only in limited centers specializing in the study of cancer. The objective of Phase I clinical studies is to find the maximum tolerated dose of the drug does not cause significant side effects, knowing the most common side effects and whether the drug continues to show anticancer activity when administered to humans. If it is demonstrated that the drug has an effect on cancer using a safe dose, then the drug is now considered in phase II clinical studies.

The Phase II clinical trials continue to study the safety of drugs or procedures, but also begin to study more closely its efficacy in specific types of cancer. These trials enroll a larger number of participants and may be in more schools. These trials may be “randomized”, which means that a computer, not a doctor, select different groups of participants.

The phase III clinical trials comparing new drugs or procedures with current standard treatment. In these trials enroll large numbers of participants from many areas and receive the new treatment or standard treatment. One of the primary goals of phase III clinical trials is whether the drugs have reduced or slowed the cancer, how long patients remain stable without progression of disease and drug treatment affects quality of life.