Malignant mesothelioma is difficult to treat for several
reasons. Like all cancers, it becomes more difficult to
treat after the disease progresses. And because
mesothelioma doesn't show its symptoms until decades after
the patient is exposed, it is often not found until it has
reached advanced stages. Unfortunately, mesothelioma is
also easily misdiagnosed, further delaying treatment. When
the disease is found, it frequently doesn't respond well to
conventional cancer treatments. The nature of mesothelioma
-- which affects tissues that line some of the major organs
of the body -- means that it cannot easily be removed with
surgery. And treatment can also be complicated by the
demographics of its victims -- generally, men over the age
of 50 -- whose health may not allow very radical treatments.
All of this means that even newly diagnosed mesothelioma
patients sometimes are given a very bad chance of recovery
by their doctors. Statistics are hard to come by, but
British scientists suggest that 10% of newly diagnosed
mesothelioma patients will live for at least three more
years; 5% will live five years or more. For patients in the
first stage, 50% live for at least two more years. But
doctors can be wrong, and a mesothelioma diagnosis is not
necessarily a death sentence. Famed scientist Stephen Jay
Gould lived with peritoneal mesothelioma for nearly 20
years. He eventually died from a different type of cancer.
There are four stages of malignant mesothelioma, which
measure how far the disease has progressed. How a patient's
mesothelioma is treated depends largely on which stage he
or she is in when the disease is found.
* Stage I: Localized mesothelioma that exists only in the
lungs, the diaphragm or the pericardial lining.
* Stage II: Advanced mesothelioma that has spread into the
lymph nodes of the chest.
* Stage III: Advanced mesotheioma that has spread into the
wall of the chest, the center of the chest, the lining of
the heart and the diaphragm. Stage III malignant
mesothelioma may or may not have spread to the lymph nodes.
* Stage IV: Advanced mesothelioma that has spread far from
the chest and abdomen into other organs.
Surgery
Patients with Stage I or milder Stage II mesothelioma are
generally offered one or more of the conventional cancer
treatments: surgery, radiation and chemotherapy. For
early-stage patients, surgery for mesothelioma aims to cure
the disease by literally cutting the cancer out of the
patient's body. The most common type of surgery for pleural
mesothelioma is a pleurectomy/decortication, which is where
doctors remove all or part of the tissues lining the lungs
and chest cavity. If doctors find that they can't remove
the cancer without removing the lung underneath those
tissues, they may remove one lung as well; this is called a
pneumonectomy. A more radical type of surgery for pleural
mesothelioma is called an extrapleural pneunonectomy (EPP).
In an EPP, doctors remove parts of the pleura, one lung,
the lining of the heart and the diaphragm. These are
difficult and dangerous surgeries that doctors won't
recommend lightly.
Patients with peritoneal mesothelioma -- the kind that
affects the abdomen -- may be offered cytoredutive surgery.
In this surgery, doctors are trying to remove all of the
cancerous tissue they can find in the abdomen and gut. They
may also choose to do a peritonectomy -- removal of the
entire lining of the abdomen. Again, this is not an easy
surgery and may not be possible for everyone, but it has
been successful in some patients. Patients with pericardial
mesothelioma are not generally offered surgery.
Radiation and Chemotherapy
In addition to or instead of surgery, doctors may offer an
early-stage mesothelioma patient chemotherapy, radiation or
both. Radiation and chemotherapy are designed to kill the
cancer cells without killing the patient. Unfortuantely, in
order to kill the cancerous cells, these treatments often
kill healthy cells as well. This is why cancer patients
often lose their hair, have trouble eating and feel
generally weak and sick during treatment. Doctors who
prescribe chemotherapy or radiation may also suggest
dietary supplements or other measures to control these
symptoms.
Chemotherapy gives patients a drug designed to attack the
cancer cells as they divide. The drug is swallowed or
injected into the bloodstream regularly over a period of
weeks or months, in cycles that give a patient some
recovery time in between treatments. Patients can live at
home and just go into a doctor's office for the treatment;
sometimes, they can even have the treatments at home. In
some cases, doctors may choose to apply chemotherapy drugs
directly to the cancerous tissue; this requires surgery, so
patients must check into a hospital. There are many
different kinds of chemotherapy drugs, and scientists are
trying to develop better ones every day.
Radiation therapy seeks to kill the cancer cells with
high-energy rays of radiation, such as x-rays, that stop
them from growing. In external-beam radiation, patients
endure directed beams of radiation aimed at the parts of
their bodies where the cancer lies. This treatment lasts
about 30 minutes a day and is given in the exact same way
each day over a period of weeks. In internal radiation
therapy (brachytherapy), doctors put a container of
radioactive material next to the cancerous tissue, using
surgery or an existing body cavity. Some will be left in
the body; others will be removed and replaced. Finally,
radiation is sometimes administered through radioactive
drugs (radiopharmaceuticals), which are injected, swallowed
or placed directly into a body cavity.
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