Treatment for Mesothelioma
Every cancer treatment has the potential to cause side effects or also changes in the body and also mood. People do not experience the same side effects even when they get the same treatment for the same type of cancer for various reasons and circumstances. This can make forecasting or predicting how you will feel during treatment challenging.
It is very natural to be concerned about the treatment-related effects as you prepare to begin the cancer treatment. It may be comforting to know that your medical practitioner and your medical health care team will prevent and alleviate the side effects. Medical practitioners call this type of cancer treatment as palliative or supportive care. Regardless of the patient’s age or stage of the disease, it is a significant part of your treatment plan.
This section of the article describes and helps you understand the types of treatment commonly used to treat mesothelioma. Standard of care refers to the best suitable remedy that is available. When deciding on a treatment plan, you should consider clinical trials as an option. A Clinical Trial is a research study or experiment that puts a new treatment approach to the test. Medical practitioners want to know if the new treatment works safe, suitable, effective, and possibly superior to the standard treatment or further doses of standard drugs or other therapies. Clinical trials are an option to consider for cancer treatment and care at all stages of the disease. Learn and understand more about Latest Research
Different medical practitioners frequently collaborate in cancer care to develop a patient’s overall treatment and therapy plan, combining various treatment forms. In other words, multidisciplinary team. Other health care professionals on cancer care teams include physician assistants, oncology nurses, social workers, pharmacists, counsellors, dietitians, and others.
The following are descriptions of the most common types of treatments for pleural and peritoneal mesothelioma. The treatment plan will also include treatment for symptoms and side effects, essential for cancer care.
The type and stage of cancer, potential side effects, patients’ preferences, and overall health all add up and influence the treatment options and recommendations. Take the time to learn about all your treatment options, and also, don’t be afraid to ask clarifying questions. Discuss the goals and aims of each of the treatments with your medical practitioner and what you can expect during the treatment. In other words, shared decision making. Shared decision making is when you and your medical practitioner collaborate to choose treatments that meet your care goals. As there are various treatment options for mesothelioma, shared decision making becomes vital. Learn more about making treatment decisions.
The doctor removes the tumor and some surrounding healthy tissues during an operation. A surgical oncologist is a doctor who specialises in the surgical treatment of cancer. The stage of cancer and its location determines this type of surgery for mesothelioma.
Pleural mesothelioma – Mesothelioma of the pleura. The surgeon can remove the cancerous lining around the lung in the case of pleural mesothelioma. In other words, pleurectomy or decortication. In most cases, pleurectomy or decortication cannot altogether dismiss the tumor. Extrapleural pneumonectomy is a more aggressive pleural mesothelioma surgery. This procedure involves removing the lining of the lung, the entire lung, a portion of the diaphragm and in some cases, a portion of the lining around the heart. This is a complicated surgery that should be performed only after the doctor has considered several factors, including the patient’s overall health and the disease’s stage. Following surgery, doctors frequently recommend additional treatments such as chemotherapy and radiation therapy. The doctor can administer chemotherapy and radiation therapy before surgery.
Peritoneal mesothelioma – Mesothelioma of the peritoneum, Peritoneum mesothelioma patients are frequently subjected to a procedure known as omentectomy. The doctor removes lining around the abdominal organs during an omentectomy. As peritoneal mesothelioma patients often have tumors throughout their abdomen, it is complicated to remove all of them. The goal of the surgery is to remove tumors as small as possible. The doctor can directly administered chemotherapy into the abdomen following surgery.
The use of high energy x-rays or other particles to destroy cancer cells is radiation therapy. A radiation oncologist is a doctor who specialises in radiation therapy to treat cancer. External beam radiation, is the radiation from a machine outside the body. This is the most common type of radiation.
A radiation therapy regimen or schedule typically consists of a predetermined number of treatments administered over a predetermined period.
- Pleural mesothelioma – Mesothelioma of the pleura, Because of the risk of lung damage, treating pleural mesothelioma with radiation therapy is demanding and challenging. When one of the two lungs is surgically removed, radiation therapy to the chest cavity is frequently administered to reduce the risk of the mesothelioma returning to the chest. The doctor can use this approach following extrapleural pneumonectomy. Radiation therapy may be administered to a smaller area of some patients as supportive care to help relieve symptoms such as pain.
- Peritoneal mesothelioma – Mesothelioma of the peritoneum, Radiation therapy to the entire abdomen causes severe side effects in people with peritoneal mesothelioma and is used. Radiation therapy may be a supportive option for a patient experiencing pain in a specific area. Tiredness, mild skin reactions and allergies, stomach upset, and loss of bowel movements are all possible side effects that fade quickly after the treatment is completed. Discover more about the fundamentals of radiation therapy.
Therapies using medication
Systematic therapy is the use of medication to destroy cancer cells. This type of medication is given through the bloodstream to reach cancer cells throughout the body. Routine therapies are generally prescribed by a medical oncologist, a medical practitioner who is specialised in treating cancer with medications. The most common ways to give systematic therapies include an intravenous ( IV) tube placed into the vein using a needle or a pill or capsule swallowed through the mouth.
The types of systematic therapies used for mesothelioma include
- Targeted therapy
A person may receive a kind of systematic therapy or a combination of routine treatments given simultaneously. The use of medication to destroy cancer cells is systematic therapy. To reach the cancer cells throughout the body, doctors administer the medication through the bloodstream. A medical oncologist, a doctor who specialises in medications to treat cancer typically prescribe systematic treatments.
As we have a decent idea about systematic therapies, in brief, let us understand each of them individually. Chemotherapy is one of the most common types of systematic treatment in mesothelioma treatment. Chemotherapy helps limit the cancer cells from growing, dividing, and multiplying. A chemotherapy routine or a schedule usually consists of a specific number of cycles given over a set period. A patient may receive one drug at a time or a combination of different medications given simultaneously. Learn and understand more about the fundamentals of chemotherapy.
Pleural mesothelioma – If a patient hasn’t received any treatment or medication plan, one of the most recommended treatments is the combination of pemetrexed (Alimta) and cisplatin (Platinol) or carboplatin (Paraplatin). Doctors give these types of medication in periodic cycles. He or she gives this medication once every three weeks in this case. Every three weeks becomes a recurring cycle. Patients may receive four to six treatment cycles. After completing each treatment cycle, most patients get additional therapy, known as maintenance therapy. With the drugs comes side effects, and there can be significant side effects with the combination of the drugs. Some patients may receive a single pill if there are too many potential side effects from giving both the medicines. The doctor can add Bevacizumab (see Targeted therapy below) to chemotherapy for some patients.
Peritoneal mesothelioma – Often, the doctor gives chemotherapy directly into the abdomen after the surgery. He or she can also deliver chemotherapy through a vein; intravenously. Like pleural mesothelioma, the combination of drug pemetrexed with cisplatin or carboplatin is most often used for treatment.
The side effects of systematic therapies like chemotherapy can vary and depend entirely on the individual and the number of doses or pills used. These therapies can bring in fatigue, risk of infections, skin allergies, vomiting, hair loss, appetite loss, and diarrhoea. The most common side effects that are caused due to the usage of these drugs to treat mesothelioma are numbness, tingling sensation in the fingers or toes, rashes, damage to the kidneys, a higher risk of infection from a low white blood count, or anaemia. The patients may even experience other side effects as well.
Patients who receive these chemotherapy medication types are given vitamins, namely vitamin B12 and folic acid, to lower the risk of these side effects. Different medications such as those used to prevent vomiting are also available to relieve many of these side effects. The side effects usually go away after the completion of treatment. Consult your medical practitioner about the potential side effects of the chemotherapy plan. Also ask them about the management strategies for the same.
Targeted therapy is a type of cancer treatment that targets specific genes, proteins, or the tissue environment that contributes to cancer growth and its survival. This treatment inhibits cancer growth and spreads while causing minimal harm to the healthy cells. The targets of all the tumors are not the same. Your medical practitioner may recommend tests to identify the genes, proteins, and other factors in cancer to find the most effective treatment. This enables doctors to provide the most effective treatment whenever possible. Furthermore, research studies and clinical experiments continue to learn more about specific molecular targets and new therapies aimed at them. Discover more about the fundamentals of targeted therapies.
For patients with pleural mesothelioma who do not have any health problems that would prevent them from receiving it, the drug bevacizumab (Avastin) may be added to chemotherapy. Bevacizumab is classified as an anti angiogenesis therapy that aims to halt angiogenesis or the process of forming new blood vessels. As the tumors require the nutrients delivered by the blood vessels to grow and spread, anti-angiogenesis therapies aim to starve cancer. Please discuss with your medical practitioner the potential side effects of a specific medication and how the process of it to manage them.
For patients with pleural mesothelioma who do not have any health problems that would prevent them from receiving it, the drug bevacizumab, also known as Avastin, may be added to the routine with chemotherapy. Bevacizumab is classified as an anti-angiogenic targeted therapy. Anti-angiogenic therapy aims to halt angiogenesis or form new blood vessels. As the tumors require the nutrients delivered by blood vessels to grow and spread, anti angiogenesis treatments aim to starve the tumor. Consult and discuss with your medical practitioner the potential side effects of a specific medication and how to manage them.
Immunotherapy is in other words, biologic therapy. Doctors recommend this to boost the body’s natural defences against cancer. It employs materials created by the door or in the laboratory to enhance, target, or restore immune system function. The FDA U.S. Food and Drug Administration has approved a combination of the immunotherapy drugs ipilimumab (Yervoy), and nivolumab (Opdivo) as the first-line treatment for pleural mesothelioma is impossible to be treated surgically. This combination is approved for use in all types of pleural mesothelioma, but people with biphasic or sarcomatoid mesothelioma improved more in clinical experiments and research studies.
Pembrolizumab is also known as keytruda, and a combination of ipilimumab and nivolumab may be the options for patients who have already received chemotherapy for mesothelioma.
Different types of immunotherapy can result in a variety of side effects. Skin reactions, allergies, flu-like symptoms, diarrhoea, changes in weight, loss of appetite are all the common side effects. Consult your medical practitioner about the potential side effects of the treatment you are following. Learn and understand more about immunotherapy fundamentals.
Physical, emotional, and social effects of cancer
Cancer and its treatment are in line with the physical symptoms, side effects, and emotional, social, and financial consequences. Palliative care, also known as supportive care, is the treatment of all these side effects. It is an integral part of the treatment and medicines to slow, stop, or eliminate the disease. The main focus of palliative care is enhancing the quality of life during treatment by managing symptoms and assisting patients and their families with non-medical needs. This type of cancer care is available to anyone, regardless of age, cancer type, or stage. And it often works best when started immediately after a cancer diagnosis. People who receive palliative care and cancer treatment often have less severe symptoms and a higher quality of life. Palliative care encompasses various therapies, including medication, dietary changes, relaxation techniques, emotional and spiritual support.
Doctors may also give you palliative treatments like chemotherapy and radiation therapy to cure cancer. As previously stated, one can use radiation therapy to alleviate pain. Before beginning the treatment, discuss the goals of each treatment in the treatment plan with your medical practitioner and your health care team. It would help if you also discussed the potential side effects of the specific treatment plan and the palliative care options.
During treatment, your medical practitioner and the health care team may ask you to describe each problem you are going through and answer questions about your symptoms and side effects. If you have a problem, notify them immediately. This allows the medical team to treat any of the signs or side effects as soon as possible. It may also aid in the prevention of more serious problems and issues in the near future. In another segment of this guide to the types of treatment, you will learn and understand more about the significance of keeping track of the side effects.
Metastatic mesothelioma: Medical practitioners refer to cancer that has matured and spread to other parts of the body from where it began as metastatic cancer. If this occurs, it is advisable to consult with medical practitioners who have treated similar cases in the past. Different doctors may have differing views on the best standard of care and treatment plans. Clinical trials and research experiments are also a possibility. Learn and understand more about getting a second opinion before starting the treatment so that you are confident in the plan of the approach of the treatment.
The treatment and therapy plan will combine the aforementioned treatments, such as surgery, radiation therapy, and systematic therapy with medication. Palliative care will be essential to alleviate symptoms and side effects. A diagnosis of metastatic cancer is highly stressful and difficult to bear for most people. You and your family have to express your feelings to medical practitioners, nurses, social workers, and other members of your health care team. It may also be very beneficial to speak with other patients and share experiences through a support group.
Chance of recurrence
Recurrent cancer occurs when cancer returns after the initial treatment. It may return to the exact location, called the local recurrence; nearly recurrence, the regional recurrence; or elsewhere, the distant recurrence. When this occurs, a new testing cycle will begin again and learn as much as possible about the recurrence. After testing, you and your medical practitioner will talk about the treatment options. Often, the treatment plan will include the treatments described above, such as surgery, systematic therapy using a medication, and radiation therapy. Still, one may use them at a different pace. Your medical practitioner and the health care team may recommend that you participate in the clinical trials looking into new ways to treat this type of recurrence cancer, regardless of the treatment plan.
People who have recurrent cancer frequently experience emotions such as disbelief or fear. You have to open up about these feelings with your medical practitioner and the health care team and inquire about support services to help you cope with the emotions. Learn more about how to deal with cancer recurrence.
If treatment does not work
It is not always possible to recover from mesothelioma. Sometimes the cancer is not curable or there is a limit its control. Then, it is advance or terminal. This is a stressful diagnosis, and many people find it very hard to discuss advanced cancer. However, it is crucial to communicate openly and honestly with your medical practitioner and the medical health care team to express your feelings, preferences, and concerns. The health care team has specialised skills, experience, and knowledge to assist patients and their families in the cancer journey.
Ensuring that a person is physically comfortable, pain-free, and emotionally supported is critical. People with advanced-stage cancer who are expected to live for less than six months may wish to consider hospice care. Hospice care is intended to provide people nearing the end of their lives with the highest possible quality of life. You and your family are advised and encouraged to talk about hospice care options with your medical health care team, including hospice care at home, a particular hospice centre or other health care locations. Staying at home with quality nursing care and special equipment can be a viable option for many patients and their families.
EMERGING TREATMENTS FOR MESOTHELIOMA
Cryotherapy is one of the emerging treatments of mesothelioma. It is a minimally invasive surgical procedure that kills cancer cells by completely freezing them. Patients may receive this therapy before the surgery to shrink the tumors, after the surgery to treat recurrences or as a palliative treatment to control the symptoms.
One of the ways to help control cancer is genetically modifying cells and viruses. For example, repairing the defective tumour-suppressing p53 gene kills cancer cells before replicating out of control.
Photodynamic therapy is emerging cancer therapy. After injecting a light-sensitive drug into the patient, medical practitioners use laser light energy to activate the drug and kill cancer cells.
Virotherapy is an emerging cancer treatment that uses viruses to find, attack and destroy cancer cells. Some types of virotherapy involve gene therapy or immunotherapy to make the treatment more effective.
Diet & Nutrition
Following a proper nutrition plan, recommended lifestyle, and a therapy plan from a dietitian can improve a patient’s well-being and recovery time.
As a part of any therapy plan, patients should try to keep a balanced diet to maintain their appetite, weight and energy. Maintaining an appropriate weight before surgery can reduce the risk of infection and severe weight loss.
Diets rich in protein and calories can help every cancer patient before, during and after treatments such as chemotherapy and surgery.
Protein allows muscles to recover faster from damage during surgery. Increased caloric intake gives your body the energy to repair cells and tissues injured during chemotherapy or radiation.
However, some mesothelioma medications can make eating healthy and a balanced protein diet challenging.