Pleural Mesothelioma Treatment

We recommend consulting both your family physician and a pulmonary (lung) specialist who has deal with pleural mesothelioma patients and is familiar with the problems of asbestos exposure.
Your choice of treatment for pleural mesothelioma will depend on a number of factors. These include:

• The stage of your cancer
• Any other medical conditions you may have
• Your general fitness

The Pleural Mesothelioma treatment options :

1. Chemotherapy. Chemotherapy uses anti-cancer drugs, which are usually injected into a vein. Depending on the type of chemotherapy drugs used, you may have treatment weekly, or every 2 to 3 weeks. Chemotherapy for mesothelioma is given to slow down the cancer and to control symptoms. If you have had surgery, you may be given chemotherapy afterwards. This is called adjuvant chemotherapy. It is given to delay the return of the cancer as much as possible.
2. Radiotherapy (Radiation). Radiation Therapy (or “radiotherapy”) involves the localized use of high–dose radiation on pleural mesothelioma cancer cells. It works by destroying the mesothelioma cancer cells in the treated area. Radiotherapy given after surgery is sometimes called adjuvant radiotherapy. The length of your treatment will depend on the type and size of your cancer and on why you are being treated. Radiotherapy is sometimes given after fluid has been drained from around your lung. This is to try to stop new growths of mesothelioma developing on your chest wall.
3. Surgery. Surgery can be used to remove localised mesothelioma, or to take out as much as possible so that other treatments have a better chance of working. This is sometimes called de-bulking. There are 2 major operations that can be done:
   

• Pleurectomy. This means removing the pleura. The lung is left behind. The pleural space around it is sealed so that no further fluid can collect there. If you have stage 1 mesothelioma, it may be done to remove the cancer. If you have a more advanced stage, it will not cure you but can delay the progress of the disease, and help to relieve symptoms such as pain and fluid collection around the lung (pleural effusion).
• Extrapleural Pneumonectomy (EPP). This operation has the best record for removing the maximum number of pleural mesothelioma tumor cells. It removes portions of the lung, the “parietal pleura” (the lining of the lung), the pericardium (the lining of the heart) and the diaphragm.
• Supportive care (Palliative surgery)
  Palliative surgery is typically done in cases where the tumor has already spread beyond the mesothelium and is difficult to remove completely, or in cases where the patient is too ill to tolerate a more extensive mesothelioma treatment. Your care will be managed by a palliative care team. This is a team of doctors and nurses who are expert in controlling symptoms of advanced cancer. The team may also include a physiotherapist and a dietician.
  
  If you are having trouble with fluid collecting around your lungs, you may be offered treatment to try to stop this from happening. Pleurectomy is one option. Another is thoracocentesis. This is often called a pleural tap.
  The fluid that has collected in the pleural space is drained off. Often sterile talc or an antibiotic is put in to seal the space and stop the fluid collecting again. This is called pleurodesis.

The new experimental stages of mesothelioma therapy:

1. Photodynamic Therapy. Photodynamic therapy or PDT uses laser light to kill cancer cells. the patient receives a photosensitizing agent that collects in the cancerous cells but not in healthy cells. A photosensitizer is a drug that makes the cancer cells vulnerable and sensitive to light of specific wavelength. After the cancer cells have been sensitized, fiber–optic cables are placed in the body (usually through open–chest surgery) in order to focus light of just the right frequency on the tumor. This causes the photosensitizer to react with oxygen to produce a toxic molecule that kills the cancer cell.
2. Immunotherapy. Immunotherapy (or biological therapy) attempts to build up your immune system to fight cancer cells. It includes :
   

• Gene Therapy. Gene therapy means inserting specific genes into cells to change or restore their functions. The procedure may be used to block abnormal genes in cancer cells, or to repair or replace the abnormal genes. Monoclonal antibodies are made in the laboratory; they derive from a single, cloned antibody–producing cell.
• Monoclonal Antibody Teraphy (Passive Immunotherapy). Antibodies are proteins made by B cells, which are types of lymphocytes or white blood cells that fight disease.
• Cytokine Proteins such as interferons (IFN) and interleukins (IL). Cytokines are proteins that occur naturally in the human body, and that are similar to hormones. They may act as messengers in the immune system, triggering the bone marrow to make more blood cells. Interleukin is capable of stimulating the growth of immune system cells called “T–cells. Interferons are other cytokine proteins that inhibit the growth of cancer cells, as well as enhance the immune system.