Treatment of Mesothelioma
Certain factors affect the prognosis of the disease (the overall chance of recovery) and these include:
Treatment Options
There are three types of standard treatment and these include:
Surgery: which includes the following procedures:
Even if the surgeon all visible signs of the cancer during the surgical procedure some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after surgery, to increase the chances of a cure, is called adjuvant therapy.
Radiation Therapy
Radiation therapy uses high-energy rays (x-rays or γ-rays) or particles (α- or β-particles) to kill cancer cells. Two main types of radiation therapy are used: external beam radiation and brachytherapy:
External Beam Radiation Therapy (EBRT):
n this technique, radiation is focused on the tumour from a source outside your body. It is much like getting a diagnostic x-ray but for a longer time. Before treatments start, imaging studies such as MRIs, CT scans, or plain x-rays of the chest are done to find the exact location of the prostate gland and marks are made on the skin to aid in the location of the tumour.
Intensity modulated radiation therapy (IMRT): is a form of three-dimensional radiation therapy that uses a machine which moves around the patient as it delivers radiation. In addition to aiming beams from several directions, the intensity (or strength) of the beams can be adjusted to minimize the dose of radiation reaching the most sensitive normal tissues while delivering a uniformly high dose to the cancer.
Conformal proton beam radiation therapy: This technique is focuses proton beams on the cancer. Protons are the positive particles at the heart of atoms which cause little damage to tissues they pass through but are effective in killing cells at the end of their path. This means that proton beam radiation may be able to deliver more radiation to the prostate while reducing side effects on nearby normal tissues. However, this technique, whilst promising, is in early stages of development.
Brachytherapy:
Brachytherapy (also called seed implantation or interstitial radiation therapy) is a form of radiation therapy that uses small radioactive pellets, or "seeds," each about the size of a grain of rice which are that are placed directly into the tumour. In general, this technique is used only employed for early stage tumours that are relatively slow growing. Imaging tests such as transrectal ultrasound, CT scans, or MRI help guide the placement of the radioactive pellets in or near the tumour so that radiation is delivered only to the prostate and not the surrounding (healthy) tissue. There are tow main kinds of Brachytherapy:
Permanent [Low Dose Rate (LDR) Brachytherapy: uses pellets of radioactive material (such as the isotopes 125I and 103Pd) which are placed in thin needles. These needles are inserted through the skin of the chest or abdomen and into the prostate. The pellets (seeds) are left in place as the needles are removed and give off low doses of radiation for weeks or months. Usually, anywhere from 40 to 100 seeds are placed. Because they are so small, their presence causes little discomfort, and they are simply left in place after their radioactive material is used up.
Temporary [High Dose Rate (HDR)] Brachytherapy: This is a relatively new technique where hollow needles are placed through the chest or abdomen and into the tumour itself. Radioactive 192Ir is then introduced into the needles and left for between five to fifteen minutes. Generally, about 3 brief treatments are given, and the iridium is removed each time. These treatments are usually combined with external beam radiation given at a lower dose than it normally would be if used by itself. The total dose of radiation is high enough to kill all the cancer cells. The advantage is that most of the radiation is concentrated in or near the tumour itself, sparing the urethra and the tissues around the tumour such as the liver and the lungs.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). Combination chemotherapy is the use of more than one anticancer drug. The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Biological Therapy (Immunotherapy)
Biological Therapy (also known as Immunotherapy) is one of the latest forms of treatment for cancer. It relies on the fact that most forms of cancer cells produce slightly unusual proteins on their surfaces (these are called epitopes). Laboratory manufacture of these proteins allows large doses to be given to a patient in the hope that the patient's own immune system will recognize these proteins as being foreign. If this happens then the immune system will begin attacking any cancer cells that produce these proteins. In effect the body is being conditioned to heal itself. Recent trials with interferon alpha have proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumour mass combined with minimal side effects.