Mesothelioma
Treatment Options
Treatment by stage & types
Mesothelioma is a terminal illness, yet treatment can not only prolong your life but make that time more comfortable. 'Treatment options' range from traditional cancer treatment options to more modern techniques and alternative therapies.
Treatment Options?
Traditional treatment for cancers range from chemotherapy drugs to radiation treatment. Surgery naturally accompanies these therapies, often as part of diagnosis and drainage of fluid. The exact type of treatment will differ between people dependent on what stage the cancer is at and type.
In most cases, treatment will focus on:
- Location of the tumour
- Size of tumour
- Degree of invasion into nearby organs
- Cancer staging
- Patient’s age
- Other medical factors
Cancer treatment focuses on eliminating malignant cells while preserving healthy ones. This can be conducted by chemical or physical means that destroy the tumour cells. These treatment options can be used alone, or in combination to have the strongest effect on the cancer. When an additional therapy is added to the main treatment for cancer it is called 'adjuvant therapy'.
Chemotherapy involves the use of very potent drugs to kill the tumour cells, but healthy cells can be affected too. Newer chemotherapy drugs have fewer side effects, and combinations of powerful drugs can also help reduce side effects. The FDA recently approved a combination of drugs called cisplatin and pemetrexed for patients with mesothelioma as it showed a significantly stronger effect on the tumour cells than a single drug.
Radiation therapy uses strong doses of radiation to destroy cancer cells. Radiation therapy is frequently used to shrink tumours prior to surgery or to help patients feel more comfortable. While advances in technology allow radiation to be very tightly focused, cells surrounding the treatment area do suffer some damage.
Tumours can also be removed surgically. In early stage disease, surgery can provide major improvement and disrupt the progression of the disease. If the cancer has spread beyond the chest cavity, surgery is much less effective in slowing down the disease, although it can be used in advanced cases to help patients breathe more comfortably.
Mesothelioma Staging
Staging is a method for doctors to determine how far or advanced the Mesothelioma has developed. There are three developed staging systems that stage the extend of the disease; the Butchart, TNM, and Brigham systems. The Butchart may be one of the most popular and consists of;
- Stage I: Mesothelioma is present in the right or left pleura (the thin, transparent membrane which covers the lungs and lines the inside of the chest walls) and may also involve the diaphragm (the muscle separating the chest from the abdomen) on the same side.
- Stage II: Mesothelioma invades the chest wall or involves the esophagus (food passage connecting the throat to the stomach, heart, or pleura on both sides. Lymph nodes in the chest may also be involved.
- Stage III: Mesothelioma has penetrated through the diaphragm into the lining of the abdominal cavity or peritoneum. Lymph nodes beyond those in the chest may now be affected as well.
- Stage IV: There is evidence of metastasis (the spreading of the Mesothelioma) through the bloodstream to other organs.
The TNM System looks at three components: the tumour (T), the lymph nodes (N), and the spreading of the disease, otherwise known as metastasis (M). It is also divided into four stages.
- Stage I: Mesothelioma involves right or left pleura and may also have spread to the lung, pericardium (the fluid filled sac that surrounds the heart), or diaphragm on the same side. Lymph nodes are not involved.
- Stage II: Mesothelioma has spread from the pleura on one side to nearby lymph nodes next to the lung on the same side. It may also have spread into the lung, pericardium, or diaphragm on the same side.
- Stage III: Mesothelioma has now invaded the chest wall, muscle, ribs, heart, esophagus, or other organs in the chest on the same side. It may or may not have spread to lymph nodes on the same side as the primary tumour
- Stage IV: Mesothelioma has spread into the lymph nodes in the chest on the side opposite the primary tumour, or extends to the pleura or lung on the opposite side, or directly extends into organs in the abdominal cavity or neck. Any distant metastasis is included in this stage.
The most recent system to be devised is the Brigham System. It stages the disease according to the ability to surgically remove the tumour (resectability) and the involvement of the lymph nodes. It, too, is divided into four stages.
- Stage I: Mesothelioma is resectable and no lymph node involvement.
- Stage II: Mesothelioma is resectable but with lymph node involvement.
- Stage III: Presence of unresectable Mesothelioma extending into the chest wall, heart, or through the diaphragm or peritoneum; with or without extra-thoracic lymph node involvement.
- Stage IV: Distant metastatic disease (widespread cancer throughout the body).
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