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Saturday, February 19

Mesothelioma Treatment Options

Surgery is often the choice when mesothelioma is diagnosed early enough, such as a stage I and stage II mesothelioma. In many cases with pleural mesothelioma this means a pleurectomy, a procedure where the entire pleura is removed. In cases where pleural effusion has been severe, the two surfaces of the pleura might be fused in a process called pleurodesis; generally this is a palliative treatment. Many procedures also take a piece of the lung. An extrapleural pneumonectomy removes part of the lung, part of the diaphragm, part of the pericardium and part of the parietal pleura, which is the tissue covering the chest wall.

Surgery with peritoneal mesothelioma follows a similar model, except that removing nearby organs is not always a viable option as it is with a pneumonectomy. Surgery on the pericardium often occurs on an emergency basis as mesothelioma causes the membrane to swell and put dangerous pressure on the four chambers of the heart.



The use of chemotherapy is widespread in mesothelioma treatment; in recent years it is almost always conducted in conjunction with a radiotherapy program. Most chemotherapy drugs have not proven to be terribly effective against mesothelioma; there are two that have been approved by the FDA thus far for mesothelioma treatment. Researchers are constantly searching for innovative methods to attack malignant mesothelioma cells and avoid damaging healthy cells in the mesothelium membrane. Often chemotherapy is used in tandem, especially when treating biphasic mesothelioma – a form of the disease that features two types of malignant cells. Surgery, chemotherapy and radiotherapy together are referred to as multimodality therapy.

Recently there has been some use of radiotherapy during the surgical process itself. Rather than target cancerous cells with radioactive ions the tissue is targeted directly while the patient is on the operating table. Chemotherapy drugs have been applied in a similar fashion, to give a more powerful application of the treatment than can be provided by intravenous delivery; one such procedure called Heated Intraoperative Intraperitoneal Chemotherapy used heated medication in a peritoneal mesothelioma surgery.

Other options include immunotherapy and other experimental concepts such as gene therapy. These concepts are creative efforts at attacking cancer cells in new and innovative ways. While they remain in the seminal state, hopefully continued research and trial activity will yield results.



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