Pleural Mesothelioma
Pleural mesothelioma is a rare cancer often diagnosed in
people who have been exposed to high levels of asbestos. The malignancy affects
the pleura, a thin membrane of lubricating cells that lines the lungs and chest
wall. It sometimes takes ten years or more for changes to appear that are
indicative of pleural disease, and even longer for symptoms to manifest. These
differences can include a thickening or calcification of the pleural lining—a
condition commonly diagnosed as pleural plaques. Conditions like pleural
calcification or the development of pleural plaques often serve as precursors
to mesothelioma.
In most instances, pleural disease is not considered fatal
but it can cause diminished lung function and may confirm that a person has
sustained significant asbestos exposure. Patients diagnosed with pleural
conditions are generally considered to be at a higher risk for developing the
more severe pleural mesothelioma.
Pleural mesothelioma originates in the pleura but can
quickly spread to the outer chest wall, abdomen, and heart. Pleural
mesothelioma is typically fatal within one year of diagnosis. However,
understanding and recognizing key risk factors, like asbestos exposure, will
typically lead to early detection of the cancer. Those individuals who are
fortunate to receive an early diagnosis are likely to be more eligible for
life-sustaining treatments such as surgical resection of the cancer. This type
of treatment can extend a patient’s life years beyond that of a typical
mesothelioma patient.
While there is no cure for pleural mesothelioma, treatment
options do exist for this type of cancer. There are ways for patients to
control the disease through tumor management including traditional radiation
and chemotherapy methods. These methods can ease symptoms of the disease and
make a patient more comfortable. In patients where a diagnosis is made of early
stage disease, mesothelioma surgery can extend the survival rate far beyond
previous levels in untreated disease.
Treatment and Tumor Management
Nearly all patients diagnosed with pleural mesothelioma are
able to receive some form of treatment for their illness. While there is
currently no cure for mesothelioma, patients have been able to extend initial
prognosis through advanced mesothelioma treatment regimens currently being
developed at clinics and cancer centers across the United States.
Surgery
Surgical resection is difficult in pleural mesothelioma
patients when the disease is diagnosed in later stages because at that time the
tumor has typically metastasized to other areas of the body such as the
abdominal cavity and lymph nodes. However, in early-stage diagnoses, surgery
can absolutely be utilized to slow the advance of mesothelioma disease.
Common surgical procedures utilized in the management of
malignant mesothelioma are pneumonectomy and extrapleural pneumonectomy.
Pneumonectomy is a general procedure conducted not only in patients with
malignant mesothelioma, but in those battling lung cancers or related lung
conditions. Pleurectomy involves the removal of either a portion of the lung or
the entire affected lung in patients. Extrapleural pneumonectomy is a more
comprehensive procedure that is typically tailored to mesothelioma patients and
involves the removal of the entire affected lung, the pleura, the diaphragm,
and the pericardium, which is the mesothelial lining that surrounds the heart
cavity.
Chemotherapy
Chemotherapy is likely the most prevalent treatment utilized
by patients of malignant pleural mesothelioma. While several different
chemotherapy drugs have been utilized to varying degrees of effectiveness for
the management of malignant pleural mesothelioma, only one has been approved by
the Food and Drug Administration as a prescribed therapy for the treatment of
malignant pleural mesothelioma. A combination of Alimta(Pemetrexed) and
Cisplatin is currently the only drug combination in approved status. However,
several other clinical trials are currently active attempting to determine the
effectiveness of other drugs including Gemcitabine, Navelbine, and Onconase.
Radiation Therapy
Radiation therapy has been utilized in the treatment of many
types of cancer and pleural mesothelioma is no different. Often, radiation is
not able to manage cancer by itself so it is combined with either surgery,
chemotherapy, or both to augment the treatment plan as a whole. Radiation
therapy for pleural mesothelioma utilizes external beam radiation to mutate
tumor cells within the body and slow their growth and spread.
Alternative and Complementary Therapies
A growing school in cancer care involves integrative
approaches to the treatment of cancer. Integrative oncology utilizes not only
the conventional therapies discussed above, but also untraditional therapies
such as acupuncture, massage, and reflexology to assist the patient in managing
pain, anxiety, and restlessness. Patients battling pleural mesothelioma have
effectively utilized alternative therapies like these to increase the
effectiveness of their treatment program overall. Generally, patients who are
able to withstand the difficult side-effects of more potent chemotherapy and
radiation treatments will be best able to extend their prognosis. Patients of
pleural mesothelioma who have utilized alternative therapies have been able to
do just that. However, most of these therapies are preferential and will depend
on the health of the patient as to whether or not they will be able to engage
in them. As with any treatment, patients should seek the consultation of their
oncologist or cancer specialist before engaging in any alternative therapy
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