Mesothelioma is a rare and aggressive type of cancer that affects the lining of the lungs, abdomen, or heart. It is usually caused by exposure to asbestos, a mineral once commonly used in construction, insulation, and other industrial applications. Mesothelioma has a poor prognosis, with a median survival rate of 12-21 months. However, there are several treatment options available that can help improve the quality of life and extend survival.
The choice of treatment for mesothelioma depends on several factors, including the stage of the cancer, the location of the tumor, the patient’s overall health, and their preferences. The main treatment options for mesothelioma include surgery, chemotherapy, radiation therapy, and immunotherapy.
Surgery:
Surgery is often the first-line treatment for mesothelioma, especially if the cancer is localized and has not spread to other parts of the body. The goal of surgery is to remove as much of the tumor as possible while preserving the surrounding healthy tissue. There are several types of surgery that may be used to treat mesothelioma, including:
Pleurectomy/decortication (P/D): This is a surgical procedure that involves removing the pleura, the thin membrane that lines the lungs and chest wall. During P/D, the surgeon removes the affected pleura and any visible tumors, but leaves the lung intact.
Extrapleural pneumonectomy (EPP): This is a more radical surgery that involves removing the entire affected lung, the pleura, the diaphragm, and any visible tumors. EPP is usually reserved for patients with early-stage mesothelioma who are otherwise healthy.
Cytoreductive surgery with heated intraperitoneal chemotherapy (HIPEC): This is a surgical procedure that is used to treat peritoneal mesothelioma, which affects the lining of the abdomen. During the procedure, the surgeon removes the affected tissue and then delivers heated chemotherapy directly into the abdomen to kill any remaining cancer cells.
Surgery can be a complex and risky procedure, especially for patients with advanced mesothelioma or other underlying health conditions. However, for patients who are eligible for surgery, it can provide a significant benefit in terms of reducing symptoms and extending survival.
Chemotherapy:
Chemotherapy is a systemic treatment that involves the use of drugs to kill cancer cells throughout the body. Chemotherapy may be used before or after surgery to shrink the tumor and prevent it from spreading, or it may be used as the primary treatment for mesothelioma in cases where surgery is not an option. There are several chemotherapy drugs that may be used to treat mesothelioma, including:
Cisplatin: This is a platinum-based chemotherapy drug that is often used in combination with other drugs to treat mesothelioma. Cisplatin works by damaging the DNA of cancer cells, preventing them from dividing and multiplying.
Alimta (pemetrexed): This is a chemotherapy drug that is specifically approved for the treatment of mesothelioma. Alimta works by blocking an enzyme that is necessary for the growth and division of cancer cells.
Carboplatin: This is another platinum-based chemotherapy drug that is sometimes used in combination with other drugs to treat mesothelioma. Carboplatin works in a similar way to cisplatin.
Chemotherapy can cause side effects, including nausea, vomiting, hair loss, and fatigue. However, these side effects can usually be managed with medication and supportive care.
Radiation therapy:
Radiation therapy is a local treatment that uses high-energy radiation to kill cancer cells. Radiation therapy may be used before or after surgery to shrink the tumor, or it may be used as the primary treatment for mesothelioma in cases where surgery is not an option. There are two types of radiation therapy that may be used to treat mesothelioma:
External beam radiation therapy: This is the most common type of radiation therapy for mesothelioma. During external beam radiation therapy, a machine delivers radiation to the affected area from outside the body.
Brachytherapy: This is a type of radiation therapy that involves placing radioactive material directly into or near the tumor. Brachytherapy is less commonly used for mesothelioma than external beam radiation therapy.
Radiation therapy can cause side effects, including skin irritation, fatigue, and nausea. However, these side effects are usually temporary and can be managed with medication and supportive care.
Immunotherapy:
Immunotherapy is a type of treatment that uses the body’s own immune system to fight cancer. Immunotherapy drugs work by targeting specific proteins on the surface of cancer cells, allowing the immune system to recognize and attack them. There are several immunotherapy drugs that may be used to treat mesothelioma, including:
Keytruda (pembrolizumab): This is an immunotherapy drug that is approved for the treatment of mesothelioma in patients whose tumors express a specific protein called PD-L1. Keytruda works by blocking PD-L1, which allows the immune system to attack the cancer cells.
Opdivo (nivolumab): This is another immunotherapy drug that is approved for the treatment of mesothelioma in patients whose tumors express PD-L1. Opdivo works in a similar way to Keytruda.
Immunotherapy can cause side effects, including fatigue, nausea, and loss of appetite. However, these side effects are usually less severe than those associated with chemotherapy.
In addition to these standard treatments, there are also several experimental treatments for mesothelioma that are currently being studied in clinical trials. These include gene therapy, targeted therapy, and photodynamic therapy. Patients may also benefit from supportive care, such as pain management, nutrition counseling, and emotional support.
In conclusion, mesothelioma is a rare and aggressive cancer that is often caused by exposure to asbestos. Although mesothelioma has a poor prognosis, there are several treatment options available that can help improve the quality of life and extend survival. The choice of treatment for mesothelioma depends on several factors, including the stage of the cancer, the location of the tumor, the patient’s overall health, and their preferences. Patients with mesothelioma should work closely with their healthcare team to develop a treatment plan that is tailored to their individual needs and circumstances.
