What Kinds of Treatment are Available for Mesothelioma Patients?
While mesothelioma is an aggresive cancer that typically spreads quickly, new treatments have shown some success. If you have mesothelioma you should:
Mesothelioma Treatment Options
The treatment options for mesothelioma depend on many factors, including: where the cancer is, the stage of the cancer, how far the cancer has spread, how the cancer cells look under the microscope, and the patient's age and desires. Mesothelioma is more treatable when diagnosed early. Treatment options include tri-modality therapy, surgery, radiation therapy, chemotherapy, clinical trials, gene therapy, pain control and management, and miscellaneous treatments.
See the health professional information on perintoneal mesothelioma for treatment options on that specific disease as well as prognosis information. For mesothelioma in general see this treatment information from the NCI.
Tri-modality Therapy
Tri-modality therapy combines surgery with radiation and chemotherapy. It is being performed at major medical centers including:
Surgery
In the past decade, surgery has become an important tool for treating mesothelioma. Some surgical procedures doctors use to treat mesothelioma are:
These surgeries are accompanied by intraoperative radiation and multicycle postoperative chemotherapy (drugs that kill cancer cells). These are typically not considered experimental procedures and should be covered by insurance and Medicaid. The law firm of Paul & Hanley, LLP will be happy to work with you and your primary care physician, should you need more detailed information, and to refer you to one of the surgeons performing these procedures.
Radiation Therapy
Radiation therapy uses high-dose radiation (X-rays) to shrink the tumor by destroying cells at the tumor site. Once the size of tumor is reduced, the patient may feel better and be able to breathe more deeply. Radiation may also keep the cancer from spreading to other parts of the body. Side effects of radiation can include tiredness, skin rashes, and internal mucosa (throat) irritation or hoarseness. For more information on radiation therapy see:
Radiation Therapy for Cancer by the National Cancer Institute (NCI)
Radiation Therapy and You also by the NCI
Chemotherapy
Chemotherapy agents are medicines that kill cancer cells or stop them from reprocing by interupting their cell cycle. They may be used on their own, before or after surgery, or along with radiation. Chemotherapy is often used instead of surgery when a tumor is inoperable. To get chemotherapy, the patient usually goes to the doctor's office or the hospital, where s/he is either given medicine to take orally, or, more typically, the medicine is administered through an IV tube. Side effects of chemotherapy are common, and they include nausea, vomiting, weakness, and fatigue. The efficacy of chemotherapy as a single agent in the treatment of malignant mesothelioma has been limited. See the National Cancer Institute (NCI) publications Chemotherapy and You and also Helping Yourself During Chemotherapy for further information.
Alimta and Gemzar are examples of common chemotherpy drugs for mesothelioma. Chemotherapies are classified by their mechanism or action, or how they work.
Clinical Trials
Clinical trials (also called medical research) are research studies used to determine whether new drugs or treatments such as surgery are safe and effective. If you take part in a clinical trial, you might be given new medicines or other experimental treatments before they are widely available. There are many clinical trials of new and combination chemotherapy agents in process around the country.
For more information about clinical trials, please contact us today at (800) 933-2244, or see the NCI's information on clinical trials where currently (September 2009) there are 44 different active trials listed. The other trials are for supportive care, genetics, prevention and so on. 26 of the treatment trials are in the United States. Six trials are in Canada. No new trials have been added in the last thirty days. There are currently only three phase III trials and most sites are in Europe.
Drugs being used include Bevacizumab, Pemetrexed, AZD2171, bortezomib (Velcade), Carboplatin, Cisplatin, Vorinostat (MK0683, SAHA), Pazopanib, IPHC, NGR-hTNF, Dasatinib, Gleevec, gemcitabine (Gemzar), Vandetanib, Valproate, Gene Induction, Heated Cisplatin With Sodium Thiosulfate, Intraoperative Peritoneal Hyperthermic Chemotherapy (IPHC), FR901228, BS-690514, sunitinib malate (Sutent), CBP501, SU011248, Neoadjuvant Hemithoracic IMRT, Oral LBH589, SS1(dsFv)-PE38 Immunotoxin, CRS-207, Suberoylanilide Hydroxamic Acid (SAHA), and Azacitidine. Many of these are being used in phase I trials which are very early trials. The PhaseII/III Vorinostat trial is highly unusual in that some patients receive a placebo. This is not normally done in cancer clinical trials.
One example of a clinical trial for mesothelioma is Dr. Gill's antiangiogenesis work at the University of Southern California (USC). He is using Veglin combined with chemotherapy in phase II trials. Avastin and PXD101 and two other anti-angiogenesis drugs.
There are occasionally screening clinical trial for mesothelioma but currently there are none. These trials try to catch mesothelioma early and hopefully provide a better outcome.
Currently there are three supportive care clinical trials listed by the National Cancer Institute. And there are also seven diagnostic clinical trials.
And currently there are thirteen different active trials listed with the treatment modality of antiangiogenesis therapy which tries to block new blood vessel formation. In this way it starves the tumor. Most of these early studies are phase I and II.
Patients often believe that placebos are commonly used in cancer trials. This is almost never the case. Typically the new treatment is being compared to the standard best treatment of the day. However, the NCI recently listed a trial that very unusually does involve a placebo.
Gene Therapy
Gene therapy for mesothelioma is still being researched and is not yet readily available. Researchers are manipulating genes to make them more susceptible to certain anticancer drugs. It is possible that this therapy will destroy tumor cells while preserving healthy cells.
Other Drug Therapy
Antiangiogenesis
Antiangiogenesis is drug therapy that causes tumors to shrink or even disappear by depriving tumor cells of their blood supply and nourishment. As of September 2008 there were thirteen mesothelioma antiangiogenesis trials using drugs like Avasin, VEGF-Antisense Oligonucleotide, Bevacizumab, Bortezomib, AZD 2171, PDX101, Sunitinib and others. For more detailed information see this NCI information series.
Pain Control and Management
Whatever treatment option you choose, you must discuss pain management with your doctor. Your doctor has many pain remedies to choose from which, while they may not completely relieve the pain, they may make you more comfortable and improve your quality of life. Pain drugs range from asperin to narcotics. Some hospitals offer behavioral medicine programs for pain management, including training in meditation and biofeedback. Each time you see your doctor, you should tell him or her how much it hurts and how well the pain remedies are working. This allows your doctor to adjust the pain remedies to help you as much as possible.
Miscellaneous Treatments
This is a list of a few other treatments that have been used for mesothelioma:
Hemotherapy - is therapy through blood, serum, or plasma transfusion.
Centesis - Pleural, peritoneal, or pericardial fluid is tapped and evaluated. It is used both for diagnosis and to relieve pressure, pain, and fullness in the chest or abdominal areas.
Talc Pleurodesis - Inserting surgical talc in the pleural space, typically through a thoracotomy incision, to stiffen the pleura and prevent the fluid from re-accumulating. Used if pleural, peritoneal, or pericardial fluid continues to accumulate.
Financial Assistance
If you have questions about financial assistance, see our web page on that topic.
Supportive Care
Supportive care is when the doctor uses methods to help the patient feelbetter, and not to try to treat the cancer directly. The National Cancer Institute currently (June 2008) lists 7 supportive care clinical trials for mesothelioma patients.
Contact Us Today For A Free Confidential Consultation
The law firm of Paul & Hanley, LLP specializes in mesothelioma cases, and has offices located throughout California, including Berkeley, Westlake Village (Los Angeles), San Francisco, and San Diego. Our cancer attorneys handle malignant mesothelioma cases in courts throughout California, Nevada, Arizona, and across the United States. To learn more about mesothelioma, treatment options, or the California malignant mesothelioma cancer attorneys at Paul & Hanley, please contact us today for a free confidential consultation. For immediate assistance call us toll free at (800) 933-2244.