Mesothelioma

Malignant mesothelioma is the most serious of all asbestos-related diseases. Although uncommon, mesothelioma is no longer considered rare. Mesothelioma is a cancer that is particulary difficult for doctors to diagnose and one that does not respond well to therapy.
The chest cavity, abdominal cavity, and the cavity around the heart are surrounded by a a layer of specialized mesothelial cells. Most other internal organs are also covered by these cells. The tissue formed by these cells is called mesothelium.
A special protective lubricating fluid that allows organs to move around is produced by the mesothelium. This protective fluid helps the lungs to move without resistance inside the chest cavity while breathing. The medical name for the mesothelium of the chest is the pleura and the medical name for the mesothelium of the abdomen is the peritoneum. The mesothelium of the "sac-like" space around the heart is called the pericardium.
A malignant (cancerous) tumor of the mesothelium is called a malignant mesothelioma. As most mesothelial tumors are cancerous, malignant mesothelioma is often simply called mesothelioma. Tumors of the mesothelium can also be benign (noncancerous) but benign mesotheliomas are much more rare.
Mesothelioma was recognized as a tumor of the pleura, peritoneum and pericardium in the late 1700's. However it was not until much later, in 1960, that this particular type of tumor was described in more detail and even more importantly, its association with asbestos exposure was recognized. The first report linking mesothelioma to asbestos exposure was written by J.C.Wagner, and described 32 cases of workers in the "Asbestos Hills" in South Africa. Since than the relationship between mesothelioma and asbestos exposure has been confirmed in studies around the world.
The incidence of mesothelioma in the United States remains very low, with 14 cases occurring per million people per year. Despite these numbers the noticed threefold increase in mesothelioma in males between 1970 and 1984, is directly associated with environmental and occupational exposure to asbestos, mostly in areas of asbestos product plants and shipbuilding facilities.
Although the disease is much more commonly seen in 60-year old men, it has been described in women and early childhood as well. The cause of the disease is not so well understood in these latter two groups, but there is some evidence of possible asbestos exposure for some of these cases as well.
Malignant mesotheliomas are divided into three main types. About 50% to 70% of mesotheliomas are the epithelioid type. This type has the best prognosis (outlook for survival). The other two types are the sarcomatoid type (7%-20%), and the mixed/biphasic type (20%-35%). Treatment options for all three types are the same.
About three-fourths of mesotheliomas start in the chest cavity. They are known as pleural mesothelioma. Another 10% to 20% begin in the abdomen. These are called Peritone mesothelioma. Pericardial mesothelioma, starts in the cavity around the heart, and is very rare. The covering layer of the testicles is actually an outpouching of peritoneum into the scrotum. Mesotheliomas that affect this covering of the testicles are quite rare.

Mesothelioma Treatments

Messothelioma Treatemant:

There are several types of treatment available for patients with mesothelioma, some recommended more frequently than others. The most commonly used treatments are surgery, chemotherapy, and radiation therapy. In addition, some experimental treatments are becoming more widely used, or are showing some encouraging results in clinical trials. These treatments include photodynamic therapy, gene therapy, and immunotherapy, among others.

Most of these treatments are not used in isolation. In many cases, treatment may consist of a combination of therapies. For example, surgery to remove as much of the cancer as possible may be followed by radiotherapy or chemotherapy to remove residual cancer cells. This is one of the most common treatment options for mesothelioma among those who are candidates for surgery.

A number of alternative therapies can also be combined with traditional treatment options. Many patients choose to add alternative therapies such as massage, acupuncture, or TENS therapy to their conventional treatment approach in an effort to enhance or compliment the treatment process. A variety of alternative therapies, including aromatherapy, meditation, or yoga, are often added to a treatment regimen to provide pain relief and foster relaxation.

If you or a loved one have been diagnosed with mesothelioma it is likely you’re interested in the various treatment options available. Working with your doctor to create the best treatment plan is an important step. Knowing what the treatment plan will do to help treat the cancer often helps patients and their families understand the process and feel more comfortable. We offer a complimentary informative packet that includes all the information on our Web site and additional information about available treatment options that you may take with you continually educate yourself and those around you about mesothelioma. Click here to receive your packet overnight.



Mesothelioma Cure:

Mesothelioma is regarded as a highly aggressive cancer, as this disease is exceptionally resistant to current treatment methods. Though a number of treatments are available to mesothelioma patients, such as surgery, chemotherapy, and radiation, these options are known to only offer palliative relief - not a cure.
A number of scientific studies and clinical trials have worked tirelessly to find a cure for mesothelioma to no avail. Those versed in the politics of cancer research posit that since mesothelioma is such a rare cancer, little financial funding has been allotted to support the search for a cure. Hence, the hope for a mesothelioma cure is undeniably reliant upon increased funding to support research efforts.

Thankfully, the general public is becoming increasingly aware of mesothelioma. As more people and specific interest groups recognize the critical need to support research for a mesothelioma cure, funding will undoubtedly increase and this cancer may start to receive financial support that contends with the nation's most recognized forms of cancer. Once adequate funding for research becomes available, the hope for a cure will become a more tangible reality to mesothelioma sufferers across the globe.


Mesothelioma Surgery:

Surgical treatments for mesothelioma include three main types - diagnostic surgery, curative surgery, and palliative surgery. Some types of surgery fall into more than one category.


Surgery can only be performed during mesothelioma stages I and II.For example, thoracentesis may be used as a diagnostic procedure, and as a palliative treatment to provide symptomatic relief. Only curative surgery can potentially remove all cancer from a patient with mesothelioma.
However, for curative surgery to be effective, it is particularly important that mesothelioma be diagnosed as early as possible. Unfortunately, mesothelioma is not usually diagnosed until it reaches Stage III or IV, when surgery is not an option.



Chemotheraphy


Most forms of chemotherapy involve the intravenous administration of drugs such as Alimta and Cisplatin. Chemotherapeutic drugs are targeted to kill cells that are rapidly dividing by interfering with processes that occur during cell division.

However, while cancer cells themselves divide rapidly, so do some types of healthy cells, causing some of the unpleasant side effects that are often associated with this form of treatment. Though older chemotherapy medications seemed to do little to fight mesothelioma, newer chemotherapy drugs are showing much promise.
A relatively new form of chemotherapy called heated chemotherapy is an option for patients with peritoneal mesothelioma.
This treatment is carried out following surgery, and involves the perfusion of heated chemotherapeutic medications into the peritoneum.


Radiation:



Radiation therapy, or "ionizing radiation", is used to kill cancer cells and to limit the spread of cancer. For patients with mesothelioma, radiation therapy is most often used in conjunction with surgery.

However, in some cases radiation may be used as a stand-alone treatment to relieve pain and other symptoms associated with mesothelioma. In either case, it is rare for radiation therapy to provide more than short-term symptomatic relief.
Mesothelioma patients may receive one of two types of radiation therapies, depending on whether or not they are suitable candidates for either procedure.
External beam radiation therapy is the traditional type of radiation therapy, where tumors are bombarded with beams of radiation to kill cancer cells. Brachytherapy is a newer type of radiation treatment. It involves tiny radioactive rods which are implanted within a tumor to provide a strong, concentrated dose of radiation to tumors while doing very little damage to surrounding healthy tissue.


PhotoDynamic Theraphy


Photodynamic therapy is a highly specialized and specific form of treatment that is most often used to treat skin cancers, some types of lung cancer, and pleural mesothelioma.

However, this treatment is usually unsuitable for patients with metastasized cancer; it is most effective in patients who have localized disease.
This type of therapy involves the use of light energy to kill cancer cells. In photodynamic therapy treatment, the patient is given an intravenous solution of a medication that makes cancer cells highly sensitive to a particular kind of light.
One to three days after this treatment, the patient is exposed to the light, and cancer cells that have absorbed the medication are killed.


Gene Theraphy:

Gene therapy involves using genetic material to specifically target cancer cells and make them more vulnerable to chemotherapy treatment.

The main type of gene therapy being developed for use in mesothelioma patients is called "suicide gene therapy," because it forces cancer cells to produce substances that cause their death.
When undergoing this type of gene therapy, the patient is treated with a non-infectious virus that has been altered with genetic material that makes them produce a particular protein.
When undergoing this type of gene therapy, the patient is treated with a non-infectious virus that has been altered with genetic material that makes them produce a particular protein
Following this procedure, the patient is then treated with a chemotherapeutic medication that is specially formulated to be toxic only to cancer cells. This type of therapy has produced some promising results for mesothelioma patients, but it is still only available through clinical trials.
Immunotherapy is a type of treatment in which the patient's own immune system is 'tricked' into killing cancer cells. A healthy, normally-functioning immune system does not kill cancer cells, because even though these are diseased cells, the immune system is unable to recognize them as being harmful.
There are two main types of immunotherapy: active and passive. In active immunotherapy, mesothelioma cancer cells are removed from a patient and then treated in a laboratory to turn them into a vaccine. Following this laboratory treatment, the patient is injected with the vaccine and if the treatment is successful, the patient's immune system recognizes the vaccine as a harmful substance, thus recognizing the cancer as being harmful as well.
Passive immunotherapy is somewhat different in that it does not attempt to activate the patient's immune system. Instead, it uses substances such as cytokines (molecules that direct and regulate the immune system) and other agents to help boost the patient's immune response to their cancer

What is Mesothelioma?

Throughout the past decade, the term "mesothelioma" has become more and more recognizable. Once an obscure disease that meant little to the general public, mention of this disease now conjures up thoughts and pictures of factories and mines strewn with asbestos and the unfortunate workers who were employed in those dangerous places.

Thanks to concerned medical professionals, researchers, and watchdog organizations, we're learning more and more about mesothelioma and how it affects the lives of those who are afflicted. However, there's still far to go as both better treatments and a cure for the disease are sought.

About the Disease

Simply put, mesothelioma which is commonly referred to as asbestos cancer, is an aggressive cancer caused primarily by the inhalation of dangerous asbestos fibers. The disease attacks the mesothelium, a protective, two-layered membrane that covers the internal organs of the body including the lungs, heart and abdominal organs. Between these layers, the cells produce fluid, which allows easy movement of the heart and lungs within the chest cavity. The layer that covers the lungs is called the pleura, and the layer that covers the heart is called the pericardium. The peritoneum lines the abdominal cavity. Mesothelium also lines the male and female reproductive organs. Mesothelioma can affect any of these cells, but is usually seen in the pleural or peritoneal mesothelium. The most commonly diagnosed form of this cancer is pleural mesothelioma.

Mesothelioma takes anywhere from 20 to 50 years to develop, which is why older individuals are usually the victims. However, recent cases involving September 11th World Trade Center first responders and clean-up crews show that high concentrations of asbestos can cause the disease to develop much more rapidly. A few WTC workers have already died of the disease.

Effects of the Disease

The invasion of the mesothelium by cancer cells makes it very difficult for the patient to breathe, resulting in the need for oxygen, especially as the disease progresses. Those with the pleural form of mesothelioma may also suffer from pleural effusions. These effusions prevent the smooth movement of the lungs and other organs in the chest. Peritoneal mesothelioma also affects the stomach area and abdominal cavity, causing nausea, vomiting, or loss of appetite, which can result in dangerous weight loss. In addition to breathing difficulties and loss of appetite, mesothelioma victims also complain of excessive coughing, sleeping difficulties, persistent chest pain, fever, and pain in the lower back.

Mesothelioma, in general, is a very painful disease and because it is usually not diagnosed until it's in an advanced stage. For this reason, the symptoms are typically quite serious. Late diagnosis also means that the cancer is more likely to have metastasized, or spread, making successful mesothelioma treatment even more difficult.

Who Gets Mesothelioma?

Statistics show that, because of their work history, the disease most often affects men between the ages of 50 and 70 who were employed in an asbestos-laden environment before asbestos warnings and bans were in place in the 1970s. Though women still have a much lower frequency of the disease, cases of second-hand exposure to asbestos has prompted more diagnoses among women, especially those whose male family members worked with asbestos. The occupations most associated with mesothelioma are shipyard workers, electricians, plumbers, construction industry workers, pipefitters, boilermakers, and anyone subject to heavy exposure to dangerous asbestos and airborne asbestos fibers.

An abundance of cases have also demonstrated that mesothelioma can develop among people who lived in communities where asbestos factories or mines were located. In some instances, entire towns have been adversely affected by the presence of asbestos fibers in the air. For example, in Libby, Montana - site of a former vermiculite asbestos mine - hundreds have already died of mesothelioma.

Though still significantly rarer than other cancers, an estimated 2,000 to 3,000 new cases of mesothelioma are diagnosed each year in the United States. Other countries, notably the United Kingdom and Australia, report a much higher incidence of the disease. Nevertheless, the United States - like many other countries - has seen an increase in asbestos-caused cancer as men who worked in U.S. shipyards in the 1940s and 1950s, at the height of production, are now being diagnosed with mesothelioma.

Dealing with Mesothelioma

Mesothelioma is most often diagnosed in its late stages, and such a diagnosis is devastating to the individual and his/her family. Though research into the disease has been ongoing, there is currently no cure for mesothelioma. Some patients may be candidates for surgery to remove tumors or even an entire lung, but most are better treated with radiation or chemotherapy. More often than not, these treatments are palliative, serving to lessen the severity of the symptoms of the disease rather than offering a cure.

Medical professionals and research scientists, however, are constantly exploring new ways to combat the disease. For example, doctors know that some combinations of chemotherapy drugs work better than others and tests developed to ascertain earlier diagnosis of the disease or to monitor those most at risk have arrived on the scene.

Who's to Blame?

The reason someone develops mesothelioma is usually the lack of proper protection offered to those who worked with asbestos. Though the dangerous properties of asbestos and asbestos products have been evident for decades, many employers neglected to protect their workers from inhaling asbestos while on the job. It wasn't until public awareness of the dangers of the material were revealed in the 1970s that many employers began offering protective clothing such as respirators, gloves, aprons, and other such items to those working with asbestos on a daily basis.

Due to the negligence of employers, many companies who manufacture asbestos or products that contain asbestos have been subject to literally thousands of lawsuits filed by those who've been harmed by the material. Many of those lawsuits have come from individuals suffering from mesothelioma.

Chemotherapy

While the recommended mesothelioma treatment will no doubt vary from patient to patient and doctor to doctor, the form of cancer treatment most widely suggested is chemotherapy.

Dealing with the idea of chemotherapy can be equally as frightening as the initial diagnosis of mesothelioma. Chemo conjures up thoughts of treatments that cause horrible side affects and often leave the patient feeling worse than if they had no treatments at all. However, because advances in chemotherapy drugs and medications to lessen the side affects have decreased some of the unpleasant effects of chemo, patients should remain open to the idea of undergoing this type of treatment and should listen with an open mind.

How Does Chemotherapy Help?

Quite simply, chemotherapy - treatment with a specific cancer drug or combination of drugs - kills cancer cells. Unlike surgery and radiation therapy, which can destroy cancer cells in one particular location, chemotherapy can be used to destroy cells that have metastasized - or spread to other parts of the body.

There are currently about 100 chemotherapy drugs on the market. Though single chemo drugs are sometimes used to treat a particular type of cancer, more often a few of these drugs are used in tandem. This is called combination chemotherapy. Some combinations have proved more helpful than others in fighting mesothelioma and its troublesome symptoms. Because all of these drugs work a bit differently, your oncologist will determine which are best suited to treating your disease. The doctor will also be able to determine the length of your course of treatment as well as the frequency of treatments.

Types of Chemotherapy

Chemotherapy is received either by means of a pill or intravenously via a needle in the vein. Chemotherapy drugs may be administered 1) systemically - which means that the drugs are carried through the blood stream; or 2) intrapleurally - injected directly into the site of the tumor, with in the case of mesothelioma is usually the pleura, the lining of the lung. Doctors have had some success with both methods.

Chemo and Mesothelioma

Mesothelioma is a very aggressive form of cancer, so doctors treat it as aggressively as possible. That includes the use of highly toxic chemo drugs that will, hopefully, help destroy cancer cells while also providing some relief from the bothersome side affects of the disease, such as coughing, shortness of breath, and chest pain.

Years ago, doctors opted for single chemotherapy treatments for the disease. Unfortunately, they yielded little more than approximately a 15% success rate, providing minimal relief to the mesothelioma patient. More recently, oncologists and research scientists have determined that the best way to fight mesothelioma is through combination chemotherapy.

Currently, the drugs of choice are a newer drug, Alimta (pemetrexed), combined with Cisplatin, which has been on the market for some time. As a matter of fact, Alimta, when given with cisplatin, is the first and only chemotherapy drug to be approved by the Food and Drug Administration (FDA) for the treatment of patients with malignant pleural mesothelioma when surgery is not an option.

Other common chemotherapy drugs used to treat mesothelioma include gemcitabine, vinorelbine, and onconase. Researchers continue to experiment with new drugs and new combinations of chemotherapy medications in hopes that they can find the best available to treat the disease and its symptoms.

What to Expect

Chemotherapy is not a miracle drug, especially where mesothelioma is concerned, so it's necessary to be patient when dealing with the treatment. Most patients receiving chemotherapy for the first time will be especially concerned about side effects. Different chemo drugs have different side effects, but your doctor should be able to tell you what to expect.

Because your doctor has experience with specific chemo drugs, he/she may also be able to tell you when to expect the side effects, how long they'll last, and what to do about them. These days, there are many options available to help minimize or avoid these side effects so the chemotherapy of today is much different than that of decades or even years ago. Remember, also, that most of these side effects will disappear when the treatment has ended.

The most common chemotherapy side effects include:

• Nausea
• Vomiting
• Low white blood cell count (which leaves you prone to infection)
• Loss of appetite
• Constipation
• Fatigue
• Fever and chills
• Low platelet count (which may cause problems with clotting)
• Generalized achy-ness
• Tingling hands and feet
• Rash
• Depression

It's important to tell your doctor about any side effects you might experience, even if they are noted as "common" side effects of your chemotherapy. High fever, inability to eat or drink, blood in the stool or urine, and signs of infection should be addressed immediately. Your doctor will inform you about other side effects which he/she considers life-threatening.

Chemotherapy Drugs & Fact Sheets

• Alimta
• Carboplatin
• Cisplatin
• Gemcitabine
• Navelbine
• Onconase

Radiation Therapy

Radiation therapy is one of the oldest and most frequently prescribed treatments for a variety of cancers, including mesothelioma. The American Cancer Society reports that about 60% of all cancer patients receive some form of radiation therapy. Somewhat less frightening than chemotherapy and surgery, radiation may be prescribed for the treatment of the disease itself or to help lessen the troublesome symptoms of a cancer such as pleural mesothelioma.

How Does Radiation Work?

High dose radiation kills cancerous cells that are found in the body of a person suffering from mesothelioma or any other cancer. Technically, the radiation destroys cancer cells at the molecular level and keeps them from reproducing. It is especially adept at killing cells that replicate quickly, such as those associated with mesothelioma.

Unlike chemotherapy, however, radiation therapy is a localized mesothelioma treatment which kills only the cells in the area to which the radiation is applied. It is not helpful in treating cancer which has metastasized - spread to other parts of the body.

Types of Radiation

Traditionally, there have been two types of radiation therapy available to cancer patients.

External radiation

The most common form of radiation therapy, external radiation is achieved by means of an x-ray machine which aims radioactive waves at the tumor or affected portion of the body. The procedure is fairly quick and is accomplished on an outpatient basis. How many radiation treatments a patient requires will depend on individual cases and include factors such as stage of the disease and size and location of the tumor.

Internal radiation

Also known as Brachytherapy, this type of radiation involves planting radioactive material into the cancerous tissue. It allows for the implementation of higher doses in a single treatment or is suggested for patients with tumors that are located deep inside the body and are unable to be reached by traditional external radiation. Patients must be admitted to the hospital for internal radiation, and because exposure to the patient may cause danger to others due to radioactivity, visitors will be limited for the first few days. Implants such as these may be temporary or permanent.

Radiation and Mesothelioma

Some mesothelioma patients are not candidates for radiation therapy while the treatment may be suggested for others. If also may be offered in tandem with other treatments, like surgery or chemotherapy.

While it is impossible for radiation to cure mesothelioma, doctors often suggest it as a palliative measure in order to relieve some of the uncomfortable side effects of the disease. Radiation therapy has proven quite successful in relieving pain as well as reducing instances of shortness of breath in mesothelioma patients.

Oncologists experienced in the treatment of mesothelioma will be able to determine if and how a particular patient might benefit from radiation therapy. If it is prescribed for you or a loved one, it is essential to stick to the schedule so that the patient receives the most benefit from the treatment.

What to Expect

Once your doctor has determined that you are a candidate for external radiation therapy, he/she will suggest an outpatient facility where you can receive the treatment. If internal radiation therapy is in order, you may be sent to a consult with a surgeon before you receive the treatment. He/she will set up a schedule of treatments as well. The schedule may involve days, weeks, or even months of radiation therapy.

While you will suffer the unpleasant side effects of surgery after Brachytherapy as well as some traditional radiation therapy side effects, the side effects of external radiation are quite mild compared to most other cancer therapies. The downside of radiation is that it can also destroy healthy cells along with cancerous cells. However, these cells will eventually begin to repair themselves.

The most common side effects of radiation therapy are:

• Extreme fatigue
• Redness near the treated area
• Nausea
• Vomiting
• Dry mouth
• Loss of appetite
• Diarrhea
• Hair loss (infrequent)
• Decrease in white blood cells (leaving patient prone to infection)

A Mesothelioma Cure

Following the backlash of asbestos-related exposures and illnesses, many people were wondering how scientific research was going to proceed. The response has been encouraging, with cancer specialists and other doctors working each day towards a cure for malignant mesothelioma. While a way to completely eliminate the cancer from the body does not presently exist, there are several successful mesothelioma treatment programs as well as clinical trials that are working towards developing a way to eliminate this unfortunate form of cancer.

Treatments for patients of malignant mesothelioma commonly fall in line with treatment of other lung and lung-related cancers. Curative treatments are those which remove the cancer from the body completely. While there are no cures for mesothelioma, any treatment could theoretically be curative, so long as it is successful in completely removing the cancer from the body. While the treatment may be curative, it is important to remember that curative treatments do not rule out the recurrence of the disease.

While curative treatments may not prevent the disease from recurring, it is important to be aware of current initiatives that are working towards a total cure for the disease. There have been instances of unique treatment programs that have prevented the recurrence of the disease for several years. Paul Krauss was diagnosed with mesothelioma in 1997 and given only a few months to live by his physician. Today, Paul Krauss is still alive and active and has dedicated himself towards spreading awareness of the disease and working with others in developing treatment programs that would be as successful as his has been.

Combination treatments, which integrate two or more different treatment options, such as surgery coupled with radiation, or surgery paired with radiation and chemotherapy have been successful in extending life expectancies. Researchers believe that when the right combination of therapies is found, prognoses will be far longer than anyone could have imagined when the disease first manifested. Technology has also afforded new possibilities to mesothelioma patients. CT (Computer Topography) scans have been able to map three-dimensional images of the body's internal organs for targeted chemotherapy or radiation therapy to be administered.

Another novel technique is being integrated with surgical resections of mesothelioma tumors. Heated chemotherapeutic agents have shown increased proficiency in the elimination of cancer cells. Side effects of chemotherapy have, in the past, prevented physicians from delivering an optimal dosage of the drug. However, a novel procedure known as intracavity heated chemotherapy treatment has integrated these two concepts into a successful program. Heated chemotherapeutic agent is administered directly to the affected area during the surgical removal, destroying any remaining cancer cells in the area and extending prognoses well beyond typical timeframs.

It is through technology and advancements such as these that cancer specialists and physicians are laying the groundwork for a cure.

A Patient's Options

Once an individual has been diagnosed with mesothelioma, the next step is to discuss mesothelioma treatment options with his/her physician. Recent scientific research has produced significant breakthroughs with regard to treatment protocols for mesothelioma patients and more options are now available for managing the disease and supporting improved quality of life. Newly diagnosed patients always have many questions about the treatment options that would be most effective for them, including questions about new treatment therapies like Alimta and Cisplatin and other chemotherapy drugs. In addition to these newer drugs that are being used to treat asbestos cancer, mesothelioma patients also have a number of "conventional" treatment options to consider, including chemotherapy, radiation therapy and surgery. Clinical trials and experimental treatments are still other options that some mesothelioma patients may be eligible to participate in. Our site features a comprehensive mesothelioma cancer treatment section that includes important information for patients and families. We’ve included resources on top mesothelioma doctors such as Dr. Sugarbaker, as well as a comprehensive list of questions that you may wish to discuss with your personal physician when preparing a treatment plan. We are always providing new and informative resources regarding mesothelioma treatment including: Clinical Trials, conventional treatments, experimental therapies, and more. Check back often for the most recent advances in mesothelioma treatments.