Mesothelioma is a cancer of the mesothelium, the thin tissue that covers the lungs, heart, and other internal organs. Nearly all cases of this fatal disease are caused by exposure to asbestos. Often, the cancer takes decades to appear and, when it does, it has already reached Stage 3 or 4, making it especially difficult to treat.
Therefore, most victims of mesothelioma face a grim prognosis. Most typically survive 12 to 18 months from the time of diagnosis. Treatments, both conventional and experimental, may extend the life of mesothelioma patients, but there is no cure at this time.
The following are the most common treatment options for pleural mesothelioma, cancer of the lining of the lung:
• Extrapleural pneumonectomy (EPP) – The most aggressive type of mesothelioma surgery, EPP involves the removal of the lung along with its coverings and the associated coverings of the heart and diaphragm. It is followed by chemotherapy and radiation. It is reserved only for the healthiest of patients and involves much risk and a very long recovery period.
• Pleurectomy/decortication – This is surgery to remove the lining of the lung and, hence, the cancer cells found in the lining. In this type of procedure, the lung itself is preserved. Pleurectomy is usually followed by chemotherapy. This surgery is an option for patients whose limited heart and lung function prevent them from undergoing EPP.
• Chemotherapy/Radiation – Patients who are not candidates for any type of surgery may benefit from chemotherapy and radiation to shrink the tumor. These treatments are often used for “palliative” purposes as well, helping to lessen some of the very uncomfortable symptoms of the disease.
Surgery, chemotherapy, and radiation are also used to treat peritoneal (abdominal) mesothelioma, and pericardial (heart) mesothelioma.
During the late years of the 20th century, researchers and oncologists spent time and dollars researching the effects of Interferon Alpha on malignant mesothelioma tumors. Often, the Interferon was combined with cisplatin in the clinical trials made available to those with pleural mesothelioma. (Cisplatin is a common platinum-based chemo drug still used in the treatment of the disease, but now often combined with Alimta©, the only drug specifically approved by the FDA for the treatment of the disease.)
Author DeeDee Moore notes in her book, Dealing with Mesothelioma Cancer, that these interferon trials did indeed extend the lives of some meso patients.
“Treatment regimens involving immunotherapy have yielded variable results,” she explained. “Nonetheless, other trials involving interferon alpha have proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumor mass combined with minimal side effects.”
More recently, however, Interferon Alpha has taken on the role of a maintenance drug. At a conference for the Society of Thoracic Surgeons in 2006, Dr. Robert Cameron – a leading expert on the treatment of mesothelioma – presented proof that Interferon Alpha as “maintenance therapy” showed promise. Cameron noted that the median survival of patients receiving interferon alpha after undergoing pleurectomy with decortication followed by surgery was 37 months. Therefore, Cameron and his colleagues at UCLA concluded that interferon alpha, as a maintenance therapy, does indeed have a survival benefit.
Malignant mesothelioma remains one of the most frustrating forms of cancer for researchers and for oncologists who face victims of the disease each day. It is highly recognized that none of the current treatments will provide a cure for the disease but it is the hope of researchers that continued research and more clinical trials will be integral in the discovery of drugs or therapies that will prolong the lives of sufferers of asbestos-caused cancer. Only time will tell.