Mesothelioma Treatment: Diagnosis & Treatment Options & Finding The Best Oncologist

Waqar Ahmad December 28, 2021

0 14 6 minutes read

Is the mesothelioma treatment worth it? Surely it’s worth all your pain as it exponentially increases the life expectancy. However, you must consult with a professional team as their utmost care even in follow-ups will make you live at least a decade more than you could expect.

The best choice you can make while treating mesothelioma is choosing multimodal treatment as doctors use different therapies in a combo like radiation therapy, immunotherapy, chemotherapy, and surgeries.

Although these are typical choices, now with technological advancements, new approaches have been introduced, including proton radiation therapy, oncolytic virus therapy, and gene therapy. What if surgery isn’t possible? If surgery can’t be done, then a device has emerged and got approved by the FDA 5 years back called Optune Lua (NovoTTF-100L) which sends electricity waves through the chest and treats tumors and then further treat unresectable cases, two immunotherapy drugs i.e., Opdivo and Yervoy have been approved for mesothelioma treatment.

This guide will delve deeper into how mesothelioma is diagnosed and its treatment options.

Table of Contents

Diagnosis Before Mesothelioma Treatment

Although there are no proper methods that help diagnose mesothelioma by general inspection, routine checkups can easily detect symptoms. If there’s something unusual and suspicious going on, your physicians will do a complete physical examination which mainly includes a CT scan of the abdomen and a chest X-ray.

Is Biopsy The Only Way To Test Mesothelioma?

A biopsy is used to get samples for regular laboratory testing and might be the only way to accurately diagnose mesothelioma. It could be done either by injecting a needle or tissues are extracted during surgery.

Then these lab samples are properly tested and via a microscope, it’s tested whether the abnormal tissues are due to mesothelioma or not.

Best Mesothelioma Treatment Options

Mesothelioma can be cured by chemotherapy, surgeries, immunotherapy, radiation or maybe targeted therapies. These treatments are even approved by the FDA accompanied by advancements. There are even tumor-treating fields as well to get rid of Mesothelioma. Sometimes surgery and radiation are used in combination in some cases, physicians experimentally use chemotherapy and immunotherapy simultaneously.

Although it’s incurable, it can be easily managed by taking proper treatment and guidance.

Mesothelioma Surgery

Although it’s an invasive procedure, it is still marked to be effective in treating mesothelioma. The mesothelioma surgeries are of three malignant types, and target disease based on the stage and type, however, your type of mesothelioma decides which surgery you can have. However, your doctor may decide it for you as well.

Surgeries might not be an option for those in which cancer is widespread. The operation will reduce pain but won’t extend the survival rate much to the patients’ dismay.

Pleural Mesothelioma Surgeries

Pleurectomy with Decortication (P/D): This surgery aims to remove the pleura which is located between the chest wall and lung and extend the life expectancy rate to 2-3 years if combined with radiation and chemotherapy.

Extrapleural Pneumonectomy (EPP): It surely removes the pleura but it has a high impact on the lung and the diaphragm and increases the survival chance up to 18 months but exponentially increases the chances of complications.

Peritoneal Mesothelioma Surgery

Cytoreduction with Heated Intraperitoneal Chemotherapy (HIPEC): This treatment aims to remove the peritoneum which is the abdominal lining and also combines heated chemotherapy. It increases the survival rate up to 70% which is approximately more than 3 years.

Pain Relief Surgeries

It further comprises different types of mesothelioma, like:

Thoracentesis: It treats pleural mesothelioma Drains excessive fluids from the chest cavity and relieves pressure.

Paracentesis: It treats peritoneal mesothelioma and drains excess fluid from the abdominal cavity diminishing pain.

Indwelling catheters: If you have last-stage mesothelioma, then it gives comfort at home by draining fluids.

These surgeries aim to improve the quality of life and the survival rate and manage mesothelioma considering type and stage.

Mesothelioma Immunotherapy

Another mesothelioma treatment is immunotherapy which enhances immunity and helps to treat mesothelioma and other types of tumors. Mesothelioma spreads quickly and diminished immune activity lets tumors grow and even the outgrowth isn’t controlled.

Incorporating immunotherapy blocks the immune-suppressing proteins on cancerous cells, and pushes the immune system to the exact response as a virus to mimic. It even redesigns the T Cells to fight off mesothelioma.

Immunotherapy Drugs

Optivo & Yervoy: These drugs are approved by the FDA and are most suitable for treating unresectable cases of pleural mesothelioma.

Both these drugs act as immune checkpoint inhibitors. Their role is to sever the connection between mesothelioma cells and T-cells which diminishes the functioning of the immune system.

Both these drugs help to treat mesothelioma and enhance the survival rate up to 4 months. If both drugs are combined, then the life expectancy rate increases by 18 months but if chemotherapy is involved by 14 months.

Keytruda: It’s the generic name for pembrolizumab and is approved by the FDA to treat particular cases of pleural mesothelioma like it deals with patients who have a high count of PD-L1 protein.

Mesothelioma Chemotherapy

Whenever it comes to treating cancer, it’s always chemotherapy that gives promising results. Chemotherapy involves either one drug or a combination of drugs that helps combat cancerous cells. The FDA-approved drugs facilitated in chemotherapy are cisplatin and pemetrexed. Besides that, vinorelbine, Doxorubicin, carboplatin, and Gemcitabine can also be used for the treatment.

Types of Chemotherapy

Different types of chemotherapy are used in different of bodies using different kinds of drugs.

Systematic (IV) Chemotherapy

This type of chemotherapy cones with exceptional results as it works intravenously and travels to the bloodstream. It’s injected through IV and the drugs pass from the injection site to where the tumor is located.

It also has drawbacks like it may affect healthy blood cells and reduces appetite and strength and also causes fatigue and nausea.

Hyperthermic Intraoperative Chemotherapy (HIOC)

It’s another type of chemotherapy that is directly applied at the cancerous site right after surgery. Surgeons incised the tumor site to directly incorporate drugs into the tumor site, mind drugs are in liquid form and the doctor might rock your body so that the drugs will reach the entire area from the thorax to the abdomen.

Dwell Chemotherapy

It uses systematic and intraoperative chemotherapies in combination and sends drugs onto target sites by using two catheters. In this chemotherapy, drugs remain in the body for multiple days for better exposure.

Mesothelioma Radiation Therapy

It’s also called radiotherapy and targets high-energy particles at the tumor sites, your surgeon even uses a linear accelerator to transfer beans into target sites.

These radiation particles disrupt the cell structure and prevent further cell division, once proliferation is controlled disease is easily managed.

Radiotherapy is beneficial for pleural mesothelioma treatment and can be given either before or after surgery but remember it’s not suitable for peritoneal mesothelioma.

There are many advancements observed in radiotherapy that are more specific and induce less harm to healthy tissues. Mesothelioma has a particular growth pattern by which it triggers various small tumors that can be risky if radiotherapy is used, but with more precision in the latest techniques, it is possible and even poses limited drawbacks.

Photon Radiation Therapy: It targets the cancerous cells by external beam and is risky as it may harm healthy tissues.

Intensity-modulated Radiation Therapy (IMRT): It gives targeted beams from multiple angles and reduces the risk of damaging tissues.

Proton Radiation Therapy: The proton beams adhere to the tumor site and reduce healthy tissue damage.

Intraoperative Radiation Therapy (IORT): It targets tumor sites directly after surgery has minimal tissue damage risk and allows you to have higher doses.

How To Find An Oncologist For Mesothelioma Treatment?

You have to be careful with the doctor you choose for your mesothelioma treatment which must align with your plans and other follow-ups:

You must confide with your loved ones about a particular doctor you have selected and listen to all the advice and feedback.
Make sure you have found an oncologist who has sufficient experience and specifically treats mesothelioma or asbestos lung cancer. He must have enough credentials and certifications to get you through the toughest journey of cancer.
You must be comfortable with the doctor’s clinical setting and practice staff.

Bottom-line

In conclusion, mesothelioma treatment includes surgery, immunotherapy, and radiotherapy. Sometimes even the combination of treatments used to fight off mesothelioma. Different types combat diseases in different manners, like surgery removing either the pleura or peritoneum. Immunotherapy targets T-cells enhancing the immune system and blocking cancerous cells from spreading. While radiotherapy specifically hits target sites and treats the tumors.

Give it a thorough read and decide the oncologist who will diagnose the disease better and choose treatment. Are you feeling anything suspicious in your body lately?

FAQs on Mesothelioma Treatment

Can mesothelioma be cured if caught early?

Yes, if it’s diagnosed at an early stage then via surgery it can be treated and symptoms are reduced and in some miraculous cases, it can even be cured completely.

Does mesothelioma spread fast?

Yes, it tends to spread pretty quickly, therefore it’s known to be the deadliest type of cancer and it depends upon certain factors like the area where the tumors are located.

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