Treatment of mesothelioma
The choice of the type of care best for each individual depends on many factors, including the age, overall health status, the stage of disease, the type of cells (which determines the aggressiveness of the cancer), and especially by personal desires. For help in the evaluation of this choice will find a '"interdisciplinary team" (MDT) of doctors, who will discuss your case and suggest The strategy of care.Among the members of this team can be a cardiothoracic surgeon, an oncologist, a radiation oncologist, a specialist in pain control and a specialist in palliative care. They may also be involved nurses and other healthcare professionals.
The conventional treatment of mesothelioma has several options, which will be discussed in detail one by one with the MDT before making a decision about the treatment to be adopted. Make sure you are informed as to the risk factors, prognosis and therapy, potential side effects and quality of life that each alternative offers.
Surgery
There are two surgical approaches to mesothelioma: pleurectomy / decortication (P / D) and extrapleural pneumonectomy (EPP). It is highly specialized surgical interventions that are not performed in all facilities. Not all thoracic surgeons have experience in this type of intervention. The ultimate aim of these procedures is the removal of the disease at the macroscopic level, with the understanding that residual disease at the microscopic level will remain. An adjuvant therapy, in which you use other forms of care with the main therapy, is typically targeted the elimination of these residues. The most common forms of adjuvant therapy are chemotherapy and / or radiotherapy.
Of the two approaches pleurectomy / decortication is considered the less radical because it involves only the removal of the pleura (lining of the lung) without resection of the underlying lung. In some cases, you can remove the pericardium and the diaphragm, depends on the proportions of the tumor. The advantages of this procedure are generally faster recovery time, and benefit to the patients who could not tolerate the more radical EPP. Among the disadvantages, there is an increased risk of disease recurrence due to inability to remove all the cancerous tumor, and the impossibility of using high doses of radiation because of the potential damage to the underlying lung.
The radical extrapleural pneumonectomy is a procedure that involves the removal of the lung, pleura (lining of the lung), the pericardium that surrounds the heart and a part of the diaphragm. During surgery the diaphragm and the pericardium are reconstructed with material similar to gortex. Eligible patients for this-surgical are only those that meet certain criteria and which show an adequate pulmonary and cardiac function to be able to tolerate the procedure.
Chemotherapy
Chemotherapy involves the use of anticancer drugs that work by preventing the proliferation of cancer cells. In most cases, combinations of drugs are used to increase the effectiveness of therapy. Chemotherapy may be used aggressively to reduce the tumor or in the form palliative for symptoms such as shortness of breath or pain. The administration of chemotherapy can be injected into a vein or muscle, such as oral medication or can sometimes be administered directly into the pleural or peritoneal cavity. Some of the drugs most commonly used are:
Pemetrexed (Alimta)
Cisplatin (Platinol)
Carboplatin (PARAPLATIN)
Gemcitabine (Gemzar)
Doxorubicin (Adriamycin)
Mitomycin
Raltitrexed (Tomudex)
Vinorelbine (Navelbine)
The search for new drugs by pharmaceutical companies continues steadily, so it is best to ask your doctor about medications news most recent and promising. One of these drugs, Alimta (Pemetrexed), was approved in Europe in September 2005.
Radiotherapy
Radiation therapy involves the use of high energy x-rays to kill cancer cells and shrink tumors. It can be used aggressively to chirugia together, to help eliminate the metastatic dissemination at the microscopic level, which can lead to relapse of the disease, or as a palliative to fight the pain caused by the tumor pressing on the nerve endings or other organs. Radiation therapy has also proven effective in the prevention of dissemination of the tumors in the headquarters of the biopsy and chest tube drainage.
Clinical Studies
The purpose of clinical trials is to involve patients in the discovery of better treatments and innovative for their disease. The different studies have different purposes, which may include testing of new drugs, the comparison between different ways of treating a disease or experimenting with different techniques for the prevention of cancer. Clinical trials can be divided into three phases. Below is a brief summary of the aims of each phase of testing.
The phase I studies are the first phase of clinical testing of the system. At this point, the drugs have been tested only in the laboratory, but have proved effective in the destruction of cancer cells. For these studies, only available in a limited number of institutes of oncology, is recruited only a limited number of participants. The purpose of phase I trials is to find the maximum tolerated dose of the drug without serious side effects, to understand what are the most common side effects and if the drug continues to have anti-cancer action when administered to humans. If the drug proves to have an effect on cancer at a safe dosage, is being tested in phase II of the trial.
The phase II studies continue to verify the safety of medications or procedures, but also begin to look more closely to its effectiveness in specific types of cancer. For these studies, which are available in most institutions, is recruited a larger number of participants. These studies can be "randomized", or different groups of participants are chosen by a computer, rather than from a doctor.
The phase III studies comparing new drugs or new procedures promising with the current standard of care. For these studies is recruited a large number of participants from different areas, which receive either the new treatment or the standard one. One of the main objectives of the Phase III studies is to determine whether the cancer is reduced or slowed by the drugs, because the conditions of the patients remain stable without the disease progresses and what are the effects of therapy with the drugs on quality of life.
If you are interested / in participating in a clinical trial for mesothelioma, your doctor should be able to provide you all information about your suitability and availability of the study in your region.
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