Mesothelioma is a cancer of the tissues lining the lungs, heart, chest cavity, or testes. The causes are well known and documented, however there is no cure at this time. Most cases of Mesothelioma can be traced back to exposure to asbestos, which is present in many industrial and household products, such as building materials, insulation, fire retardant and fireproof compounds and coatings, and brake pads.
Cases of Mesothelioma have increased in the past 50 years, due largely to the high exposure to asbestos in the early part of the 20th century. The incubation of the disease is never shorter than 15 years, and often symptoms don’t appear for 20-50 years after exposure. Increasingly accurate diagnosis tools have also added to the increase in cases. Many cases of Mesothelioma were misdiagnosed as lung cancer in the early part of the 20th century.
Cancer Treatment
Mesothelioma is treated as most cancers are, with surgery, radiation, chemotherapy, or a combination of the three. The success of any one treatment in increasing life expectancy is negligible, however, when combined the treatments can produce positive results. Below is a summary of treatments as they are employed individually
Radiation
Although radiation has been shown to kill cancerous cells, it can also do damage to healthy cells in the long term. Radiation as a treatment for cancer is useful when the cancer cells, or tumors, are located in a single, identifiable location in the body. Mesothelioma patients can have localized tumors, however the structure can vary depending on the case. Because the cancer is effecting the lining of an organ, the cancerous cells can spread into the tissues in a similar shape as the lining. This makes radiation helpful only in certain cases. Furthermore, radiation has been found to help only when combined with other treatments, especially surgery.
Surgery
Surgery has been used to remove cancerous cells and tumors, however the likelihood of the cells returning is not affected. In other words, cancer is not cured by the removal of a tumor. In Mesothelioma patients, surgery can be very dramatic, as it often involves removing the entire lining of the heart, lungs,or chest cavity. Even if the tumor is localized, the chances of cancerous cells existing in other parts of the mesothelium are very high.
Because tumors do create problems and often cause most of the discomfort and symptoms of Mesothelioma, removal of tumors via surgery is almost always part of the treatment. However, the size and shape of the tumors can vary dramatically from patient to patient, and some patients will not be recommended surgery. This is due to the fact that the likelihood of any increase in survival time is very low with certain cases.
Those patients who do have positive prognostic factors and will respond to surgery will often undergo a combination of therapies, including radiation, chemotherapy, or both.
Chemotherapy
Most successful when treating Mesothelioma is chemotherapy combined with surgery and radiation. Chemotherapy uses chemicals that are taken via injection or intravenously that damage cancerous cells. There can be serious side effects to chemotherapy, and the duration and number of treatments can effect outcomes as well as quality of life.
When combined with surgery, chemotherapy can dispatch cells that were not removed during surgery, and reduce the likelihood of more cancerous cells being produced.
New Therapies and Treatments
Although no therapy has been proven to cure Mesothelioma, some newer procedures and treatments have shown positive results and continue to be tested. More work needs to be done to determine effectiveness on a wide variety of patients, however results may be applicable to some newly diagnosed patients.
Immunotherapy
While most cancer treatments attempt to eradicate the disease, immunotherapy attempts to boost the bodies own response to disease. Trials with immunotherapy to treat Mesothelioma have shown very mixed results. One trial was cancelled due to very strong side effects. However there has been some success with interferon alpha, which has aided in reducing the size of tumors.
Heated Intraoperative Intraperitoneal Chemotherapy
This procedure can increase effectiveness of a combination of surgery and chemotherapy, which has so far been most effective at prolonging life. After tumors are removed with surgery, but while the patient is still on the operating table, a dose of heated chemotherapy agent is put directly into the abdomen. This puts the drugs into direct contact with affected areas, and the temperature of the agents can have a stronger effect on cancer cells. The fluid is left for one to two hours and then drained. Heated Intraoperative Intraperitoneal Chemotherapy is used on patients who have positive prognostic factors in their favor.
Multimodal Therapy
Multimodal therapy is another way to say that doctors will use all available treatments to eradicate the cancer as best they can. A combination of surgery, radiation, and chemotherapy has shown the best results in treating Mesothelioma and continues to be the most used strategy. Surgery is still highly invasive and can only be tolerated by a proportion of patients, and chemotherapy and radiation can have extreme side effects. Prognosis is still not very good, and success depends on many factors, including the size, shape, and location of the tumor.
Complementary Therapies
Although mostly untested, some patients find that a combination of medical intervention and complementary therapies can help them outlive their prognosis and experience a better quality of life. There have been some books, written by relatively famous Mesothelioma patients, detailing their successes. Paul Kraus, the writer, and Stephen Jay Gould, the scientist and historian, both outlived their prognosis and recorded their stories in the hope that others can benefit from their experiences.
