A diagnosis of mesothelioma affects not only the person with the disease but those close to him or her as well, as a mesothelioma lawyer Washington DC trusts knows all too well. Immediately after receiving the diagnosis it can be very difficult to navigate the medical world, particularly if neither the patient nor a family member is a doctor or nurse. A second opinion is often recommended both to confirm the diagnosis and to explore treatment options.
Mesothelioma may be broadly divided into two types: a cancer of the lining of the lung or pleura known as pleural mesothelioma; and a tumor of the lining of the abdomen known as peritoneal mesothelioma. Beyond that there are many subtypes of mesothelioma. The type and subtype of mesothelioma will help your physician prescribe treatment options in your specific case.
Traditional treatments may include surgery, chemotherapy, radiation and/or immunotherapy. There are also novel treatments that are being developed and implemented in clinical trials offered at various institutions in different parts of the country. A newly diagnosed patient may wish to visit the National Cancer Institute’s website that identifies numerous clinical trials that are open for enrollment across the nation: https://www.cancer.gov/about-cancer/treatment/clinical-trials/disease/C4456/treatment.
Discuss this option with your oncologist to see if a clinical trial may be appropriate in your case.
In the case of pleural mesothelioma, if a patient is a candidate for surgery, it is common for the surgeon to attempt to remove as much of the tumor as is feasible. This process is known as debulking and may lead to improved results when followed by chemotherapy or radiation which are designed to kill off remaining tumor cells. One type of surgery for pleural mesothelioma is a pleurectomy/decortication which removes the lining of the affected lung and chest wall as well as any portions of visible tumor. A second and more aggressive surgery is an extrapleural pneumonectomy where the affected lung and the lining inside the chest, as well as the hemi-diaphragm and pericardium, are removed.
Different chemotherapy regimens and radiation therapy may be used in conjunction with surgery or independently depending on the patient’s circumstance. Combinations of various chemotherapeutic agents may be used and new combinations of chemotherapy drugs are being explored in clinical trials.
In the case of peritoneal mesothelioma, surgery to remove the abdominal tumor mass is frequently combined with heated intraoperative hyperthermic intraperitoneal chemotherapy. During the surgical procedure, after removal of all visible tumor, the abdomen is filled with heated chemotherapeutic agents which will remain there for 1 to 2 hours, after which time the fluid is drained. This procedure has shown improvement over traditional chemotherapy in some studies.
Immunotherapy is a treatment form that tries to harness and stimulate the body’s immune system to fight the cancer. Most immunotherapy treatments are being offered in the form of clinical trials. There have been some recent successes with immunotherapy that may clear the way for FDA approval of some new treatment options for mesothelioma patients.
It is important to discuss all treatment options with your oncologist.
Thanks to our friends and contributors from Brown | Gould | Kiely LLP for their insight into mesothelioma.