Mesothelioma is a rare and aggressive cancer that affects the mesothelium, the thin layer of tissue that lines the lungs, chest, abdomen, and heart. It is most commonly caused by exposure to asbestos, a naturally occurring mineral that was widely used in construction and manufacturing until the 1970s, when its harmful effects became widely known. Because mesothelioma is often diagnosed at an advanced stage, it can be difficult to treat. However, there are several potential treatments that may help improve patient outcomes.
Surgery is often the first line of treatment for mesothelioma, particularly 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 healthy tissue and organs. There are several types of surgery that may be used to treat mesothelioma, including:
Pleurectomy/decortication (P/D): This procedure involves the removal of the pleura, the thin membrane that lines the lungs, as well as any visible tumors. The goal is to relieve symptoms such as shortness of breath and chest pain, and to improve quality of life. P/D is typically used for early-stage mesothelioma.
Extrapleural pneumonectomy (EPP): This is a more radical surgery that involves the removal of the affected lung, as well as the pleura and any visible tumors. EPP is typically only used for younger, healthier patients with early-stage mesothelioma, as it carries a higher risk of complications.
Cytoreductive surgery with heated intraperitoneal chemotherapy (HIPEC): This is a combination of surgery and chemotherapy that is used to treat peritoneal mesothelioma, which affects the lining of the abdomen. The surgeon removes as much of the tumor as possible, and then delivers a heated chemotherapy solution directly into the abdominal cavity to kill any remaining cancer cells.
Radiation therapy is a type of cancer treatment that uses high-energy radiation to kill cancer cells. It may be used alone or in combination with surgery and/or chemotherapy to treat mesothelioma. There are two main types of radiation therapy:
External beam radiation therapy (EBRT): This involves the use of a machine called a linear accelerator to deliver radiation to the affected area from outside the body. EBRT may be used to shrink tumors before surgery, to kill any remaining cancer cells after surgery, or to relieve symptoms such as pain and shortness of breath.
Brachytherapy: This involves the placement of radioactive material directly into the tumor. Brachytherapy may be used to treat mesothelioma that has not spread beyond the lining of the lung or abdomen.
Chemotherapy is a type of cancer treatment that uses drugs to kill cancer cells. It may be used alone or in combination with surgery and/or radiation therapy to treat mesothelioma. 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.
Alimta (pemetrexed): This is a chemotherapy drug that is specifically approved for the treatment of mesothelioma. It is often used in combination with cisplatin.
Carboplatin: This is another platinum-based chemotherapy drug that may be used to treat mesothelioma.
Immunotherapy is a type of cancer treatment that works by boosting the body’s immune system to help it fight cancer. There are several types of immunotherapy that may be used to treat mesothelioma, including:
Checkpoint inhibitors: These are drugs that block certain proteins on the surface of cancer cells, which can help the immune system recognize and attack the cancer cells.
Adoptive cell transfer: This involves the removal of immune cells from a patient’s body, which are then modified in a laboratory to target cancer cells. The modified cells are then infused back into the patient’s body.
Vaccines: These are substances that stimulate the immune system to recognize and attack cancer cells. There are several experimental vaccines being developed for the treatment of mesothelioma.
Targeted therapy is a type of cancer treatment that works by targeting specific genes or proteins that are involved in the growth and spread of cancer cells. There are several targeted therapy drugs that are currently being studied for the treatment of mesothelioma, including:
Bevacizumab: This is a drug that targets a protein called vascular endothelial growth factor (VEGF), which is involved in the growth of blood vessels that supply oxygen and nutrients to cancer cells. Bevacizumab may be used in combination with chemotherapy to treat mesothelioma.
Crizotinib: This is a drug that targets a gene called ALK, which is involved in the growth and spread of cancer cells. Crizotinib may be used to treat mesothelioma that has a specific genetic mutation.
Clinical trials are research studies that test new treatments for cancer. They are an important part of the development of new therapies for mesothelioma, and may offer patients access to treatments that are not yet available to the general public. Patients with mesothelioma may be eligible to participate in clinical trials of new treatments, including new chemotherapy drugs, immunotherapy, targeted therapy, and other innovative approaches.
In conclusion, while mesothelioma is a difficult cancer to treat, there are several potential treatments that may help improve patient outcomes. These include surgery, radiation therapy, chemotherapy, immunotherapy, targeted therapy, and participation in clinical trials of new treatments. Patients with mesothelioma should work closely with their healthcare team to develop a treatment plan that is tailored to their individual needs and preferences.