Mesothelioma Treatment Types
There are several treatment types available for people who suffer from malignant mesothelioma. The most common are:
- Surgery (the removal of the cancer);
- Chemotherapy (the use of drugs to fight the cancer); and
- Radiation Therapy (the use of high energy rays to remove cancer cells)
SURGERY
Surgery is recommended to alleviate the discomfort associated with the symptoms of the cancer or to slow down the progression of the same. Surgical procedures vary depending on the type of malignant mesothelioma one suffers from.
For patients afflicted with pleural mesothelioma (pleural refers to the membrane surrounding the lungs), a surgeon may perform a thoracentesis, pleurodesis or pleurectomy to ease discomfort and control pleural effusion (fluid build-up around the lungs causing chest pain and shortness of breath). Other surgeries may also be considered like the performance of pneumonectomy or an extrapleural pneumonectomy to slow down tumor progression.
For patients suffering from peritoneal mesothelioma (peritoneal refers to the membrane lining the abdomen), a surgeon may opt to perform paracentesis, a procedure that eases peritoneal effusion or the build-up of fluid in the abdomen. Another possible procedure is peritonectomy or the removal of the abdomen lining. Relative to cytoreductive surgery, this procedure requires the surgeon to open the abdomen and remove all visible signs of cancer cells left therein.
For patients dealing with pericardial mesothelioma (pericardial refers to the membrane surrounding the heart), a surgeon may decide to perform pericardiocentesis, a procedure that involves the fluid removal around the heart. Extrapleural pneumonectomy may be performed in some cases to remove the tumor and surrounding tissues.
1. Thoracentesis
This procedure involves removal of fluid that may have accumulated in the chest between the lung and the pleura. This is done by placing a tube in the chest to drain accumulated fluid therein. It is categorized under the palliative treatment as the main purpose of Thoracentesis is to alleviate discomfort without aggressively treating the disease.
2. Pleurodesis
This surgical procedure is aimed at controlling or restricting pleural effusion or the build-up of fluid between the lung and its lining. It is done by closing the pleural space (between the lung and its lining) to prevent accumulation of fluid. There are two approaches to the performance of this procedure:
1st ApproachTube insertion into the chest is done to remove excess fluid. Once fluid is removed, a schlerosing agent (a substance that makes tissue to scar or harden like a sterile talc powder) is injected into the chest tube so that it may enter the pleural space. The agent then distributes itself into the pleural space via patient movement. Once the agent is distributed, the suction process is applied to the chest tube to bring forth two pleural spaces together by jointly scarring them.
2nd Approach
This procedure utilizes thoracoscopy which involves the application of small incisions into the skin. A thorascope is placed in the incision to enable better visibility of the pleura. Once the pleura are seen, the schelerosing agent is applied to the area by inflicting scars on the affected tissues to cover or close them together.
3. Pleurectomy
This surgical procedure enables the removal of the pleura, an area where most of the tumor is located. Through this procedure, pleural effusion is restrained. Once fluid build-up is controlled, the pain inflicted by the tumor eases tremendously. This procedure is considered a palliative treatment as its principal objective is to relieve discomfort without aggressively treating the disease itself.
4. Pneumonectomy
This surgical procedure refers to the removal of the lung either in part or in its entirety. A cut will be performed on the side of the chest to make the lung visible to the eyes. Once visibility is achieved, the surgeon makes an assessment on the tumor and on that basis proceeds with the decision to either remove all or a part of it.
5. Extrapleural Pneumonectomy
This is an elaborate surgery that requires an expert surgeon to perform. It involves the removal of the pleura, pericardium, diaphragm and the entire lung on the side of the cancerous tumor. The surgeon, while operating, may also contemplate on keeping or removing some of the surrounding tissues as well.
6. Paracentesis
This is a palliative treatment designed to relieve the patient with the discomfort usually associated with peritoneal mesothelioma. With this type of cancer, peritoneal effusion or fluid build-up in the abdomen is more likely to happen. Once it occurs, the excess fluid in the abdomen is drained through a needle and tube inserted into the abdomen. At this point, paracentesis is performed to assist in the removal of the pressure that may be inflicted on the internal organs and likewise, to reduce the possibility of infection due to fluid accumulation.
7. Peritonectomy
This procedure involves the removal of the peritoneum or the abdomen lining where tumor usually and initially develops. It is performed when early detection of mesothelioma is discovered. The surgeon may opt to combine this procedure with intraperitoneal hypothermic perfusion, a heated chemotherapy where the chemotherapy drugs are delivered directly into the abdomen during and /or after the performance of the peritonectomy.
8. Cytoreductive Surgery
During this surgery, the abdominal cavity is opened to look for signs of cancer that may have been left behind after surgery so that these may also be removed. It is a procedure that requires time as the surgeon must search all possible locations in the abdominal area where residual cancer cells may still be present. This surgery may be performed together with intreperitoneal hypothermic perfusion where a heated chemotherapy is administered into the abdominal cavity to ensure the obliteration of the remaining cancer cells, if there any.
9. Pericardiocentesis
This procedure involves draining the fluid out of the affected area to ease the discomfort associated with pericardial mesothelioma. This is done by inserting a needle into the pericardium (the sac around the heart) to remove fluid surplus that may have accumulated therein. This way, the patient may be relieved of the discomfort associated with the circulatory problems that may have resulted there from. A piece of warning, however, must be noted when performing this procedure as the process of fluid removal involved herein may be accompanied by more serious complications later on.
References:
http://www.asbestos.com/treatment/
http://www.mesotheliomaweb.org/
http://www.maacenter.org/mesothelioma/treatment/
http://www.mesotheliomatreatmentcenters.org/
http://www.mesothelioma.net/mesothelioma-treatment.aspx
http://www.mesotheliomahelp.net/mesothelioma_treatments.asp
http://www.allaboutmalignantmesothelioma.com/mesothelioma-treatments.htm
http://www.mesotheliomanews.com/medical/treatment-for-mesothelioma/
http://www.cancer.gov/cancertopics/pdq/treatment/malignantmesothelioma/Patient