Mesothelioma Treatment

There is no truly effective treatment of mesothelioma, which gradually invades the chest wall and lungs. The efficacy of various treatment methods is reduced. The multimodal treatment of mesothelioma comprises:

   1. surgery - extra pleural pneumectomy (the surgical removal of the parietal pleura, of the pericardial, of the diaphragm and lungs, on the side of the tumor); this is relevant to the patients diagnosed in the incipient stage.
   2. chemotherapy - pre or postoperative
   3. radiotherapy

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Mesothelioma treatment depends on many factors such as: age, history of the patient's pathology (disease related), general condition and even body weight. Other factors are: the expansion stage of the tumor and its location.

The mesothelioma solution
In the case of this disease the solution adapted by almost every doctor is surgery. The surgery can remove a large proportion of the lung affected, even the entire lung if necessary, but also the surrounding structures that are attached to the tumor. Enlargement of the surgery will depend on the extension of the tumor. However, chemotherapy is also recommended. For this procedure are used drugs that kill the cancer cells. These medicines may be administered orally or intravenously. Through blood, the administered substances reach the cancer cells and destroy them.

Radiotherapy is also indicated. For this procedure X-ray are being used, which can be applied outside the body (by external radiation therapy) or inside the body (by internal radiation). Internal radiation therapy is performed using a plastic tube through which the doctor can also administer medication.

Practicing a radical intervention is associated with one survival of 48% at 5 years at some specified categories of patient (with histopathological epitelioid type and not sarcomatos, without metastases in the ganglia nodes). Some doctors do not believe that radical operations are the best option. It is required trial better achieved in order to provide grounds for establishing the optimal therapeutic guide. In this respect in Britain was initiated the MARS study (Mesothelioma and Radical Surgery) which till 2012 will offer an answer to this problem, in time for the following epidemic.

The way to treat mesothelioma
Adjuvant therapy is highly controversial, with experts who considered the peritoneal mesothelioma chemo-resistant. With good results at 22 months after administration proved to be the combination of Cisplatin, Etoposide and sodium thiosulphate, the only side effect being neutropenia. The administration of Cisplatin in combination with Ara-C intra peritoneal, in the case of small tumors, resulted in the fact of maintained remission at 54 months after administration.

Another chemotherapeutic with preoperative and postoperative intra peritoneal administration, with favorable results was Mito-xantrone, but which proved to cause severe intestinal fibrosis. Pemetrexedul is a compound that blocks the folic acid of the metabolism, affecting the cellular availability of the vitamins from group B. A phase III trial gave promising results, being obtained a decrease of the tumor diameter by 40%. A new cytostatic scheme is accepted for peritoneal mesothelioma, with Pemetrexed and Gemcitabine, the results were positive when applied to patients who haven't received preoperative or postoperative chemotherapy. Currently there are studies with Onconase and doxorubicin versus Doxorubicin in the administration of a chemotherapy course a week for 18 weeks, the results being encouraging.