Pleural Mesothelioma

The best treatment option for you depends on many factors, including your age, overall health, stage of cancer, cell type (which determines the aggressiveness of the cancer) and most importantly, your personal desires. To help you evaluate these options will have a "multidisciplinary team (MDT) of physicians who will discuss your case and offer the best treatment option. The members of this team may include a cardiothoracic surgeon, a medical oncologist, radiation oncologist, specialist in pain management and palliative care specialist. The nurses and other health workers could also participate in treatment.

Conventional treatment of mesothelioma offers several options, and you should widely discuss each one with its EMD before making a treatment decision. Be sure to inquire about risk factors, prognosis, treatment, possible side effects and quality of life offered by each of the options.

Surgery

There are two surgical methods for mesothelioma, pleurectomy / decortication (P / D) and extrapleural pneumonectomy (NEP). These are extremely specialized surgeries and it may not all centers offering them. Not all thoracic surgeons have experience in these types of surgeries. The ultimate goal of these procedures is to remove most of the mesothelioma, with the certainty that will Microscopic traces of the disease. Adjuvant therapy, which uses additional forms of treatment along with the main therapy usually aims to eliminate residual disease. The most common forms of adjuvant therapy is chemotherapy and / or radiotherapy.

Pleurectomy / decortication is considered the least radical of the two methods just because it involves removal of the pleura (lining of the lung) without resecting the underlying lung. In some cases, it may be removed pericardium and diaphragm, depending on the extent of the tumor. The advantages of this procedure are usually a shorter recovery time and usefulness in patients who can not tolerate the NEP. Disadvantages include increased risk of disease recurrence by the inability to remove all the cancerous tumor and the impossibility of using adjuvant high-dose radiation by the potential risk to the underlying lung.

The extrapleural pneumonectomy is a more radical procedure that involves removing the lung, pleura (the lining of the lung), the pericardium surrounding the heart and part of the diaphragm. During surgery, the pericardium and diaphragm are reconstructed similar to Gortex material. Patients may be candidates for this surgery only if they meet certain criteria stages of cancer development and show appropriate to tolerate the procedure lung and heart function.

Chemotherapy

Chemotherapy involves the use of anticancer drugs that prevent the multiplication of cancer cells. In most cases, combinations of drugs are used to increase efficiency. Chemotherapy can be used aggressively to retract the tumor or palliation to relieve symptoms such as dyspnea or pain. The administration of chemotherapy may be by intravenous or intramuscular injection, oral medication or sometimes, may be administered directly into the pleural or peritoneal cavity. Some of the drugs used most often include:

Pemetrexed (Alimta)
Cisplatin (Platinol)
Carboplatin (Paraplatin)
Gemcitabine (Gemzar)
Doxorubicin (Adriamycin)
Mitomycin
Raltitrexed (Tomudex)
Vinorelbine (Navelbine)
Pharmaceutical companies are constantly researching new drugs, so you can always ask your doctor about the most promising new drugs. One such drug, Alimta (pemetrexed) was approved in Europe in September 2005.

Radiotherapy

Radiation therapy involves using high energy X-rays to kill cancer cells and tumors retract. You can aggressively used along with surgery to help eliminate microscopic metastases that can cause disease recurrence or palliation to treat pain caused by tumors pressing nerve endings or other body. Radiation therapy has also proven effective in preventing the spread of tumor biopsies areas or chest tube drainage.

Clinical Studies

The purpose of the trials is to involve patients in finding new and better treatments for their illnesses. Several clinical studies have different objectives, which may include the study of new drugs, comparing several ways to treat a disease or the study of various techniques for preventing cancer. Clinical studies are divided into three phases. Here, we show brief summaries of the objective of each phase of the trial.

The clinical phase I studies are the first phase of clinical trial system. In this phase, the drugs have only tested in the laboratory, but had an effect on the destruction of cancer cells. These trials enrolled only a limited number of participants and are only made ​​in limited centers specializing in the study of cancer. The objective of Phase I trials is to find the maximum tolerated dose of the drug does not cause significant side effects, know the most common side effects and whether the drug continues to exhibit anticancer activity when administered to humans. If it is shown that the drug has an effect on cancer using a safe dose, then the drug passes examined in phase II clinical trials.

The phase II clinical trials continue to study the safety of drugs or procedures, but also begin to more closely study its effectiveness in specific cancers. These trials enroll a larger number of participants and can be performed in most centers. These trials may be "randomized", meaning that a computer, not a doctor, selects different groups of participants.

The Phase III clinical trials comparing new drugs or procedures with the current standard treatment. In these trials large numbers of participants from many areas register and receive the new treatment or standard treatment. One of the first objectives of Phase III trials is to determine if the drugs have reduced or slowed the cancer, how long they stay stable patients without disease progression and drug treatment and affects the quality of life of patients.

If you are interested (a) to participate in a clinical study on mesothelioma, your doctor should be able to provide information about eligibility and availability in your area.