Mesothelioma Treatment Options
Mesothelioma is an aggressive disease that often requires an equally aggressive treatment strategy. However, mesothelioma is resistant to many standard cancer treatments, making it a difficult disease to manage.
Most often a mesothelioma treatment plan consists of chemotherapy. For patients who are candidates, surgery and radiation will also be used in a multi-modal approach. Patients should work closely with their medical team to develop a treatment plan that is tailored to their needs and treatment goals.
Even though there is no cure for mesothelioma, treatment strategies are referred to as either curative or palliative in intent. Our mesothelioma lawyers can help you find the best treatment options.
Curative treatments attempt to cure or control the disease, while palliative care is aimed at relieving symptoms and keeping the patient comfortable and surrounded by loved ones without treating the cancer itself.
If you or a family member has been diagnosed with mesothelioma, lung cancer, or another asbestos-related disease, you need to speak with our respected mesothelioma lawyers at Belluck & Fox, LLP today. You can visit our New York office address now.
Cure for mesothelioma includes:
Table of Contents
- 1 Cure for mesothelioma includes:
- 2 Mesothelioma Alternative Treatments
- 3 Q&A: Latest Treatments for Mesothelioma
Not all patients are good candidates for surgery. In addition to the patient’s general health, the stage and type of disease help drive the oncologist’s decision to operate. The two primary curative surgeries for mesothelioma patients are pleurectomy/decortication and extrapleural pneumonectomy (EPP).
- Pleurectomy/decortication (P/D). This surgery is sometimes referred to as the “lung-sparing” surgery. The surgery involves stripping away the diseased membrane lining the lung and visible mesothelioma tumors while saving the lung.
- Extrapleural pneumonectomy (EPP). EPP is the alternative to P/D for pleural mesothelioma patients. This surgery is considered a more radical procedure that involves removal of a lung, the diseased lining of the chest cavity and heart, and a portion of the diaphragm.
Palliative surgical procedures focus on relieving symptoms that are impacting a patient’s quality of life, but they do not focus on curing the cancer. Debulking pleurectomy and pleurodesis are two procedures often used in conjunction to improve the breathing for a patient. The pleurectomy eases pressure on the lungs by stripping cancer cells from the pleura. A pleurodesis is then performed to fuse the pleura and limit fluid build-up.
Chemotherapy is one of the primary treatment modes for mesothelioma. Chemotherapy, a strong medicine used to kill cancer cells, is delivered via an infusion in cycles over a period of several months.
Unfortunately, chemotherapy drugs don’t distinguish between cancerous and normal cells, and they kill off healthy cells as well. As a result, patients who undergo mesothelioma chemotherapy commonly experience side effects, including anemia, nausea or other digestive disruption, and hair loss.
The most common chemotherapy treatment for mesothelioma is the combination of Alimta (pemetrexed), which was approved by the U.S. Food & Drug Administration in 2004, and cisplatin, a long- standing staple of many chemo treatments.
Radiation therapy uses high-energy ionizing radiation to kill cancer cells. Ionizing radiation changes the structure of DNA in cells, thus inhibiting growth and division.
Radiation is used in most cases of mesothelioma. However, pinpointing the malignant cells is difficult, resulting in damage to healthy cells as well. The side effects of radiation are similar to those for chemotherapy and include hair loss, digestive problems, and anemia.
Recent breakthroughs in the use of proton therapy, which uses a beam of protons to irradiate the tumors, as opposed to X-ray beams used in conventional radiation therapy, are allowing physicians to target deep-seated tumors with greater precision, limiting damage to the surrounding tissue.
Mesothelioma Alternative Treatments
“Immunotherapy is a new class of cancer treatment that works to harness the innate powers of the immune system to fight cancer,” according to the Cancer Research Institute. Recharging the body’s own defense mechanism, the immune system, immunotherapy may hold greater potential than current treatment approaches:
- To fight cancer more powerfully,
- To offer longer-term protection against the disease,
- To come with fewer side effects, and,
- To benefit more patients with more cancer types.
Keytruda is one immunotherapy treatment that has led the news recently. Not only have several long-term mesothelioma survivors seen great benefits from this drug, but 91-year-old, former US president Jimmy Carter announced the drug helped him beat melanoma that had metastasized to his liver and brain.
The drug, developed by Merck, suppresses the PD-L1 biomarker found in cancer cells. PD-L1, or programmed death-ligand 1, is a protein that has been shown to play a role in suppressing the immune system during cancer and other diseases.
Opdivo, developed by Bristol-Myers Squibb, is another FDA-approved lung cancer, immunotherapy drug that works by blocking the PD-L1 protein and activating the immune system. Except for the dosing differences, Opdivo and Keytruda are comparable, according to reports.
SMART Treatment Promising
The ‘Surgery for Mesothelioma After Radiation Therapy’ study, conducted by researchers at Princess Margaret Cancer Center in Toronto, more than doubled three-year survival rates of mesothelioma patients who underwent radiation therapy followed within a week of an extrapleural pneumonectomy surgery to remove the lung.
The survival rates improved to 72%, from 32%, and the patients experienced “shorter treatment, fewer complications and speedier recovery,” according to Dr. John Cho, radiation oncologist and partner in the study.
The SMART approach also reduced the risk of recurrence, according to the researchers, because the radiation halted the mesothelioma cancer cells ability to seed itself elsewhere in the chest or abdomen during surgery.
“These research results offer real hope to mesothelioma patients who have too often been told in the past that they may have only six months to live,” say the researchers.
Since the study was published in 2014, the physicians have used the SMART approach to successfully treat at least 20 more patients.
Mesothelioma Clinical Trials
According to the National Institutes of Health, clinical trials are at the heart of all medical advances. Clinical trials serve to uncover better ways to treat, prevent, diagnose and understand human disease. They provide mesothelioma researchers with critical information needed to allow them to move their findings from the lab to patients. For some mesothelioma patients, clinical trials offer an opportunity to try a treatment that is not otherwise available.
There are benefits and risks to participating in clinical trials. In the U.S., clinical trials are closely monitored and are run according to strict guidelines. The NIH explains that federally funded clinical research has safeguards in place to protect the participants. Deciding whether to enter into a clinical trial is a patient’s personal choice, and the benefits and risks should be carefully weighed.
Mesothelioma patients are encouraged to work closely with their doctors to determine the best treatment plan for their needs. The treatment plan you and your doctor develop will depend on several factors, including the type and stage of disease, and your overall health.
Mesothelioma is one of the most aggressive cancers, and, as a result, is one of the most challenging to treat. Surgery, chemotherapy and radiation are the primary treatment protocols; however, while these treatments can relieve symptoms, they do little to improve survival. When patients are diagnosed with the terminal cancer, they are often given just a year to live.
Recent breakthroughs in cancer research in general have meant an improvement in survival of mesothelioma patients.
Patients in clinical trials often have higher survival as they benefit from the current research to bring new, effective treatments to patients. Mesothelioma patients in clinical trials have access to treatments that may not otherwise be available to them.
What is a clinical trial, and is it right for me?
The National Cancer Institute describes clinical trials as “the final step in a long process” that starts with a lot of research in a laboratory and tests on animals. The clinical trial portion of the process involves testing the treatment on real human patients to determine whether or not it is effective and safe. The hope is always that the treatment will help the patients, but there is a risk that it could be harmful or have no effect.
Mesothelioma clinical trials may include a variety of treatment options, and not all patients who participate will be trying a brand-new treatment. As ClinicalTrials.gov explains, trials may include:
- Testing new drugs or medical devices.
- Trying new medical procedures.
- Experimenting with changes to patients’ behavior, such as diet.
- Comparing a new medical approach to a standard one.
- Comparing a new treatment to a placebo (which contains no active ingredients).
- Comparing two treatments that are already available.
Talk to your doctor and medical team about the potential risks and rewards of participating in a mesothelioma clinical trial. Also consider talking to other patients who have participated in these types of clinical trials and research to get their perspectives.
Who pays for clinical trials? Are there costs for patients who participate?
In most cases, patients do not pay to participate in the trials themselves. The costs of the research done in the clinical trial are often covered by the government, nonprofit agency, or company that is sponsoring the mesothelioma clinical trial, according to the National Cancer Institute.
However, patients may still be on the hook for routine medical costs that they would have incurred even if they were not participating in a clinical trial, such as regular doctor visits and exams. The National Cancer Institute warns that patients should check with their insurance plans before participating in a mesothelioma clinical trial because some plans won’t cover routine medical costs if a patient is part of a trial. Patients also need to take into account the potential expense of traveling and lodging during a mesothelioma clinical trial.
What are the stages of a mesothelioma clinical trial?
The Food and Drug Administration (FDA) oversees the approval process for medical treatments in the United States. Once a drug has been developed and tested on animals, the drug’s sponsor submits an application to the FDA to start the clinical trial process, which includes four phases:
- Phase 1: About 20 to 80 healthy people are usually chosen for phase 1 of a clinical trial, where the goal is to identify common side effects and how the drug is metabolized and excreted. This phase focuses on safety.
- Phase 2: Hundreds of people are chosen to participate in phase 2 of a clinical trial, which focuses on the treatment’s effectiveness. In this phase, participants with mesothelioma receive the treatment and, in many cases, the effectiveness will be measured against other patients who are receiving a placebo or different treatment.
- Phase 3: At this stage, the clinical trial is expanded to include even more participants. The goal is to study the safety and effectiveness among various populations, using different dosages and testing the drug in combination with other drugs.
- Phase 4: This phase actually occurs after the FDA has approved a drug for marketing. Doctors and patients continue to report side effects, and the sponsor (which is usually the manufacturer of the drug) is required to provide updates to the FDA as new information about the drug’s effects is discovered.
How can a patient qualify for a mesothelioma clinical trial?
If you are interested in participating in a mesothelioma clinical trial,