As already discussed Pleural Mesothelioma is a rare cancer mostly affecting people who have been exposed to high levels of asbestos so now here is the Pleural Mesothelioma Treatment.

As already discussed Pleural Mesothelioma is a rare cancer mostly affecting people who have been exposed to high levels of asbestos so now here is the Pleural Mesothelioma Treatment.

Pleural Mesothelioma treatment options include:

  • Surgery for Pleural Mesothelioma Treatment
  • Chemotherapy for Pleural Mesothelioma Treatment
  • Radiation therapy for Pleural Mesothelioma Treatment
  • Multimodal therapy, combination of two or more of the above options
  • Palliative Treatment for Pleural Mesothelioma Treatment
  • Clinical Trials for Pleural Mesothelioma Treatment

Surgery for Plueral Mesothelioma treatment:

It is difficult to produce surgical resection in pleural mesothelioma patients if the disease is diagnosed in late stages because metastasis to other areas of the body has taken place. However, surgery can be utilized in the early-stages of pleural mesothelioma. Common surgery procedures utilized in the management of pleural mesothelioma include:

  • Pleurectomy- In this the tumor and affected pleura is removed.
  • Extrapleural pneumonectomy-In this the pleura, the entire cancerous lung, the diaphragm and the pericardium is removed.

Chemotherapy as Pelural mesothelioma treatment:

This is the most likely used treatment by the patients of malignant pleural mesothelioma. Chemotherapy involves using one or more drugs to kill cancer cells and shrink tumors. Chemotherapy cannot completely cure pleural mesothelioma disease but it can slow cancer progression and prolong survival. Most commonly used for pleural mesothelioma is a combination of Alimta and CisplatinThese drugs are more effective when used before or after surgery, as part of a multimodal approach. There are clinical trials to determine the effective of other drugs which include Gemcitabine, Onconase and Navelbine.

Radiation therapy as pleural mesothelioma treatment:

Radiation therapy is used for the treatment of many cancers including pleural mesothelioma. Radiation is not able to manage cancer all by itself and hence is used as multimodal approach, combined with either surgery, chemotherapy or both to help the treatment plan in general. Radiation therapy uses external beam radiation to mutate tumor cells within the body to slow their growth and spread. It is typically given to early-stage patients after surgery in order to prolong survival and prevent recurrence of cancer. For late-stage patients radiation therapy is palliative rather than curative. Radiation shrinks tumours relieving painful symptoms and discomfort caused by the growth of cancer.

Multimodal Therapy as pleural meothelioma treatment:

There is no single pleural mesothelioma treatment and majority doctors believe that survival is best when several treatments for pleural mesothelioma are used in combination. This approach is known as multimodal therapy. Researchers are experimenting continuously with the treatment options available to uncover the most effective combination and timings for the treatment of Pleural Mesothelioma.

Multimodal therapy for pleural mesothelioma could include any two or all of the treatment options available. One example includes surgery initially followed by radiation therapy to reduce the risk of recurrence of cancer along with chemotherapy to prevent distant spread.

Palliative as Pleural mesothelioma Treatment:

In situations where surgery or other curative options cannot be used for someone with pleural mesotheliomapalliative care is the best optionPalliative care is a multidisciplinary approach focusing on providing patients with relief from the symptoms, pain, physical stress, and mental stress of a serious illness—whatever the diagnosis. It is referred to as symptom management.

Palliative Care of pleural mesothelioma treatment focuses on symptoms, like shortness of breath, pain, fatigue, coughing, and weakness due to the pressure of tumor, pleural effusion or excess fluid buildup in the lungs.

The palliative treatment options include:

  • Surgery
  • Chemotherapy
  • Radiation therapy

Surgery:

Pleurodesis and thoracentesis are two palliative surgical options used to treat pleural effusion. Both the surgery options remove fluid and relieve pressure on the lungs. Pleurodesis is considered the best palliative treatment since along with other things it also closes the pleural space to prevent any further fluid breakup.

Chemotherapy:

Chemotherapy is generally used as a form of potentially curative treatment for pleural mesothelioma, it can also be used as a palliative treatment. The goal is to shrink the tumor to relieve pain and other symptoms, as well as increase quality of life.

Radiation:

Radiation therapy cannot cure pleural mesothelioma on its own, but it can be solely used as a palliative treatment. It can reduce the tumor size and reduce chest pain caused by the tumor. Side effects include skin irritation and pleural effusion. Pulmonary toxicity can occur if high dosage is used.

Clinical Trials

Clinical trials are being conducted to find successful treatment options. However, they are still in the early stages of their development and not approved. These include:

  • Immunotherapy
  • Immunotherapy Drug Amatuximab
  • Gene Therapy
  • Photodynamic Therapy

Immunotherapy for Pleural Mesothelioma Treatment:

Immunotherapy is a treatment that uses the body’s own immune system in fighting diseases like cancer. Immunotherapy allows the body to recognize cancer as a foreign body and hence specifically targets and destroys the cancers cells. This causes fewer side effects as against the standard treatment methods like chemotherapy, which attacks and destroys both cancerous and noncancerous cells. Immunotherapy proves to be more beneficial when used along with the standard treatments. There are studies that have involved the use of immunotherapy and chemotherapy indicating slight increase in survival rates. This also enhances the pleural mesothelioma prognosis.

This can be achieved by:

  • Introducing antigens
  • Using Laboratory Complements

Benefits of Immunitherapy for pleural mesothelioma Treatment:

  • Immunotherapy targets and destroys the mesothelioma cells, while helping healthy cells to flourish.
  • Patients experience fewer side effects unlike chemotherapy and radiation which includes side effects such as vomiting and hair loss.
  • It may be beneficial even in late-stages of pleural mesothelioma.

Possible Side Effects of Immunotherapy pleural mesothelioma treatment:

The side effects of immunotherapy for plueral mesothelioma treatment include:

  • Fatigue
  • Low grade fever
  • Flu-like symptoms
  • Rashes
  • Blood pressure problems

Immunotherapy Drug Amatuximab for pleural mesothelioma treatment:

It is an immunotherapy drug for pleural mesothelioma treatment. It targets and alerts the immune system to attack mesothelin, protein found on pleural mesothelioma tumor cells. In some studies, it has been seen that Amatuximab helps the immune system kill cells that have high levels of mesothelin.

Gene therapy as Pleural Mesothelioma Treatment:

Gene therapy manipulates the patient’s genes to treat or prevent diseases by repairing defective geners. In the case of pleural mesothlioma, the goal of this treatment is to shrink the tumor size.

Multiple ways to achieve gene therapy include:

  • Physicians introduce a genetically modified virus to a patient’s body which targets tumor cells. Virus attacks the cancerous cells and discharges a genetic material which destroys of kills the cells through apoptosis.
  • Introducing a specific gene into cancer cells that when combined with certain drugs give cancer cells the ability to create a toxic byproduct. As a result the cancer cells will be destroyed.
  • Genes may be introduced into the body to reduce or stop the growth of blood vessels that normally allows the cancer cells to grow and spread.

Early clinical trials have shown this may be safe and effective but further research is required to establish it as a perfect treatment technique.

Photodynamic Therapy for pleural mesothelioma treatment:

Photodynamic therapy uses photosensitizer to kill cancer cells. The most common photosensitizer used to treat pleural mesothelioma is porfimer sodium.

The drug is injected into a vein, allowing it to spread throughout the body’s cells. However, it remains in cancerous cells for longer time duration than in healthy cells. The treatment starts 2-3 days later, usually by this time the photosensitizer has left the healthy cells. The doctor then targets specific areas with light to activate the drug, inducing a chemical reaction that kills the cancerous cells without damaging the healthy cells. As a result, this pleural mesothelioma treatment has fewer side effects than standard chemotherapy.

Refernce:
Malignant Mesothelioma at cancer.gov

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