At Mesothelioma Circle, we get excited about the fast pace, twists and turns that scientific research can take. Scholars are trying to find a faster way to spot the development of mesothelioma. Experts in complementary medicine are evaluating the impact of approaches such as acupuncture and massage therapy. Additionally, nutrition researchers are determining which aspects of the diet are the most important for cancer patients.
With all that is going on, it can be easy for even the scientists themselves to get lost in the flurry. At times like this, it is useful to take a moment and review the latest literature that has already come out. For example, one team of researchers from Switzerland looked at all the current mesothelioma treatment options and discussed how they may be combined.
What individual options are there?
Before we can talk about the different combinations of treatment modalities that doctors may prescribe for mesothelioma, it is important to understand what the individual options are and how they work:
Surgery. Experts from the University of California, San Francisco describe different surgical options that can remove cancerous tissue from patients who have malignant pleural mesothelioma. A pleurectomy/decortication (P/D) excises the pleura covering the surface of the affected lung, as well as some other tissues. Extrapleural pneumonectomy (EPP) removes one diseased lung in its entirety, along with portions of the pleura, diaphragm and the pericardium that surrounds the heart.
Although there have been studies that compared the effectiveness of these two procedures, results were mixed. However, scientists generally chose P/D for earlier stages of the disease, and EPP for more advanced stages.
Chemotherapy. The most common regimen is cisplatin in combination with pemetrexed. Together, these medications help prevent the growth of mesothelioma cells.
Radiation therapy. Although this is a powerful tool that destroys cancer cells, researchers are trying to refine their techniques in order to preserve more healthy tissues.
Multimodality therapy tackles cancer in different ways
In order to maximize the effectiveness of treatment, doctors usually recommend more than one approach to patients’ mesothelioma. The questions that scientists are tackling, though, focus on how to administer these different options, as far as what patients can tolerate and in what order they should undergo the treatments.
For example, some researchers don’t know whether chemotherapy should start before or after surgery. In the former case, medication may shrink the malignancy and make surgical excision more effective. In the latter case, physicians would have a better idea of how advanced one’s mesothelioma is, and adjust treatment accordingly. However, there are no clear differences in survival time between the two strategies.
Similar questions exist about the application of radiation therapy, which can impact different surrounding organs before or after surgery.
“The challenge nowadays is therefore more in selecting the right patient for the procedure and a therapy that he benefits the most from. Patients with histologically proven mesothelioma and resectable tumor load who could tolerate the different treatment modalities (including surgery) should be considered for a multimodal approach and be included in a trial whenever possible,” the researchers wrote in the Annals of Cardiothoracic Surgery.
There are still more options
What makes research even more exciting is the fact that there are other treatment options for mesothelioma that are promising. Intracavitary chemotherapy delivers medication directly to the tissues during surgery, therefore decreasing the risk of systemic side effects. Meanwhile, photodynamic therapy uses light to stimulate tumor destruction during an operation.
Considering that experts predict that the incidence of mesothelioma won’t peak for another 10 years or so, the development of better treatment approaches is more important now than ever. This is why it is important to support the work of scientists, whether it be through funding or volunteering for clinical trials.