SPECIAL ARTICLE: TYPES OF CHEMOTHERAPY IN MESOTHELIOMA

Alimta

Alimta is the very first chemotherapy drug to be approved by the Food and Drug Administration (FDA) to treat patients suffering from malignant pleural mesothelioma cancer. Also known as Pemetrexed, Alimta is administered to mesothelioma patients who are unable to undergo surgical procedures to remove cancerous tissue.

Developed in 2000, Alimta has been hailed as a "huge breakthrough" in treating mesothelioma cancer patients. In clinical trials at Britain's Newcastle Freeman Hospital, Alimta was administered to 27 British mesothelioma sufferers, most of whom were former construction workers. The use of Alimta resulted in a rapid improvement of their symptoms. Trial leader Professor Hilary Calvert stated that half of the patients experienced a decrease in tumor size and that most of the patients had marked improvement in their symptoms. Professor Calvert called the trial's findings "the best results I've seen in my career."

Alimta is most generally administered along with Cisplatin, a chemotherapy drug. Together, these two drugs have been known to extend the life of mesothelioma cancer patients by several months, and are beneficial in controlling mesothelioma symptoms, such as discomfort and breathing difficulties.

Alimta treatment occurs over a 21-day period. On the first day of treatment, Alimta is administered intravenously, which takes about fifteen minutes. Cisplatin is infused following the first dose of Alimta, but is not administered again until the 22nd day of treatment. Side effects associated with Alimta include fatigue, anemia, fever, upset stomach, and mouth sores, but certain antibiotics can control these unpleasant effects of the chemotherapy treatment.

As with any mesothelioma treatment method, your doctor must determine whether or not you are a good candidate for Alimta treatment.

Cisplatin

Cisplatin is a chemotherapy drug that was approved by the Federal Drug Administration (FDA) in 1978 and is used to treat patients suffering from malignant pleural mesothelioma.
Cisplatin is administered when surgical procedures are not an option, and it is often used in combination with other chemotherapy drugs, including Alimta. Manufactured by Bristol Myers Squibb, Cisplatin is also used to treat ovarian and lung cancer and is a highly effective method of mesothelioma treatment that is often recommended by oncologists.

Cisplatin is administered intravenously and may be given along with other drugs, such as anti-nausea medication and antibiotics that prevent buildup of Cisplatin within the kidneys. Your doctor will determine how often you receive Cisplatin and for how long, but patients who receive Cisplatin in tandem with Alimta will follow a 21-day treatment cycle.

Because Cisplatin was developed three decades ago, the side effects associated with this drug are often much more severe. Side effects include damage to the kidneys, (which is often prevented by administering other drugs, such as a diuretic or sodium polystyrene sulfonate, during Cisplatin treatment) serious nausea, depleted levels of calcium, potassium and other nutrients, loss of appetite, tiredness, hair loss, and an increased risk of infection. Because cancer treatment in general has become so advanced since Cisplatin was first developed, doctors are generally able to control the unpleasant side effects associated with Cisplatin treatment in an effort to make the patient more comfortable.

Other drugs similar to Cisplatin include Carboplatin, generally used to treat cancer of the lung, head and neck, and Oxaliplatin, which is most often used to treat colorectal cancer.

As with any mesothelioma cancer drug, your doctor will decide whether or not Cisplatin is a beneficial option for treating your cancer.

MESOTHELIOMA TREATMENT

Conventional Therapies

Conventional mesothelioma therapies include surgery, radiation and chemotherapy. You should keep in mind that if you choose one course of action for mesothelioma treatment, you may preclude other courses. All of your options should be considered as soon as possible.
Surgery

Depending on the stage of a mesothelioma, surgery may be used to remove the cancer and some of the surrounding tissue. Often, however, an operation is not appropriate and the patient may have only minimally invasive procedures to relieve symptoms. A thoracentesis, where fluid in the chest is removed by placing a needle into the chest cavity, may be done to make a patient more comfortable. Sometimes talc or an antibiotic may be injected into the chest cavity to try to prevent the fluid from returning. These techniques are successful in controlling the fluid, at least temporarily, in as many as 90% of patients. Because pleural fluid can compress the lung and cause shortness of breath, these procedures can help patients breathe more easily, however, they do not cure the cancer. In the case of peritoneal mesothelioma, a needle may be inserted into the abdomen to drain the fluid. Similarly, a needle inserted into the pericardium (sac around the heart) can drain pericardial fluid and help relieve circulatory problems. However, draining this fluid may result in complications. Sometimes the cancer cells spread along the needle path, and a tumor nodule may form under the skin of that area.

Surgery for mesothelioma may be performed for one of two reasons: for palliation (to relieve pain and discomfort caused by the tumor), or to cure. Palliative surgery is typically done in cases where the tumor has already spread beyond the mesothelium and is difficult to completely remove, or in cases where the patient is too ill to tolerate a more extensive operation. Curative surgery is offered when the patient is in otherwise good health and the tumor is thought to be localized and can be completely removed. Unfortunately, microscopic spread of cancer cells into the chest wall and diaphragm are common even when such spread cannot be detected by routine tests. Therefore, given the extent of these operations and their very limited success, the exact role of surgery in treating mesothelioma is often debated.

There are two types of operations that may be offered to patients with pleural mesothelioma:
Pleurectomy/decortication and
Extrapleural pneumonectomy.

Pleurectomy/decortication is usually a palliative (relieves symptoms without curing the cancer) operation in cases where the entire tumor cannot be removed. It involves removal of the pleura, where the majority of the tumor is located. It is effective in controlling effusions (fluid accumulation) and decreasing the pain caused by the cancer.

Extrapleural pneumonectomy is a far more extensive operation and most often used in cases of localized mesothelioma. The operation is technically difficult and performed only by surgeons in large specialized medical centers. It involves removing the pleura, diaphragm, pericardium, and the whole lung on the side of the tumor. The patient must be in overall good health with no other serious illnesses in order to tolerate the large operation. This operation is intended to remove all or most of the cancer and some surrounding tissues as well.

Surgical treatment of peritoneal mesothelioma is often performed either to help relieve symptoms or to attempt to remove the tumor from the wall of the abdomen and other digestive organs. As with pleural mesothelioma, these tumors are often too extensive to remove completely. Similar operations can be performed to remove a mesothelioma from the pericardium (the sac around the heart).

Radiation Therapy

Radiation therapy uses high-energy x-rays to kill cancer cells. External beam radiation therapy uses radiation delivered from outside the body that is focused on the cancer. This type of radiation therapy is often used to treat mesothelioma. These treatments are much like getting a diagnostic x-ray except for a longer time. Brachytherapy involves radioactive material being placed directly into the chest or the abdomen at the site of the mesothelioma. Radiation therapy is sometimes used as the main treatment of mesothelioma in some patients, especially those whose general health is too poor to undergo surgery. Adjuvant radiation therapy can be used in addition to surgery to kill small deposits of cancer that cannot be seen and removed during surgery. Palliative radiation therapy can also be used to ease symptoms of mesothelioma such as shortness of breath, pain, bleeding, and difficulty swallowing.

Side effects of radiation therapy may include fatigue and mild skin changes that resemble a sunburn. Often these side effects are temporary. Radiation may also make the side effects of chemotherapy worse. Chest radiation therapy may cause lung damage and lead to difficulty breathing and shortness of breath. Abdominal radiation therapy may cause nausea, vomiting and diarrhea. If you are having any of these side effects of radiation therapy, talk with your doctor since there are ways to help control these symptoms.

Chemotherapy

Chemotherapy is the use of drugs for treating cancer. The drugs can be swallowed in pill form or they can be injected by a needle into a vein or muscle. Chemotherapy is systemic therapy. This means that the drug enters the bloodstream and circulates throughout the body (through the whole system) to reach and destroy the cancer cells.

In treating mesothelioma, these drugs may also be given intrapleurally (directly into the chest cavity), or intraperitoneally (into the abdominal cavity). Depending on the type and stage of mesothelioma, chemotherapy may be given as the primary (main) treatment or as an adjuvant (addition) to surgery.

Several anticancer drugs have been used to treat mesothelioma. The drug most effective when given alone is doxorubicin (Adriamycin). Other drugs that may be given alone include cisplatin and methotrexate. These anticancer drugs are often given in combination to try to increase their effectiveness. Combinations of drugs used in the treatment of mesothelioma include methotrexate and vincristine; cisplatin and alimta, vinblastine and mitomycin; cisplatin and doxorubicin; and doxorubicin, cyclophosphamide (or ifosfamide) and cisplatin. Other drugs such as paclitaxel and irinotecan are currently being studied to determine their effectiveness in treating mesothelioma.

Chemotherapy drugs kill cancer cells but also damage some normal cells. Therefore, careful attention must be given to avoiding or minimizing side effects, which depend on the specific drugs, the amount taken, and the length of treatment. Temporary side effects might include nausea and vomiting, loss of appetite, loss of hair, and mouth sores. Because chemotherapy can damage the blood-producing cells of the bone marrow, patients may have low blood cell counts. This can result in an increased risk of infection (due to a shortage of white blood cells), bleeding or bruising after minor cuts or injuries (due to a shortage of blood platelets), and fatigue or shortness of breath (due to low red blood cell counts).

Most side effects disappear once treatment is stopped. There are remedies for many of the temporary side effects of chemotherapy. For example, antiemetic drugs can be given to prevent or reduce nausea and vomiting.

If you experience any side effects, be sure to talk with your doctor.

I HOPE YOU HAVE ALL GAINED FROM THE LESSONS ON THE TYPES OF MESOTHELIOMA

We have finished the lesson on the types of mesothelioma and I hope you all enjoyed the topics.

If you want to know more about the topics and more elaborations, you can check this site for more information: www.mesothelioma.com

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MALIGNANT MESOTHELIOMA (ASBESTOS CANCER)

Malignant Mesothelioma is a rare form of cancer that affects the thin cell wall lining of the body's internal organs and structures. This lining is known as the mesothelium. Malignant mesothelioma has three known varieties. They are malignant pleural mesothelioma, malignant pericardial mesothelioma, and malignant peritoneal mesothelioma. Pleural mesothelioma occurs in the pleura, the lung's lining. Peritoneal mesothelioma occurs in the peritoneum, the abdominal cavity wall. And pericardial mesothelioma occurs in the lining of the hearth, known as the pericardium.

What Causes Malignant Mesothelioma?

Mesothelioma is known only to be caused by asbestos exposure. Asbestos is a nature, yet toxic mineral that was used commonly in heavy industry. Microscopic asbestos fibers enter the body through the lung or ingestion. Once inside, the durable fibers are unable to be broken down or expelled by the body, causing a harmful inflammation and scarring of the mesothelium. This scarring lays the groundwork mesothelioma and other respiratory conditions, such as asbestosis.

How is Malignant Mesothelioma Treated?

Malignant mesothelioma prognoses are poor, as often the disease will be diagnosed in its later stages after symptoms have appeared. However, there are several treatment options for the management of the cancer. Among these are chemotherapy, radiation therapy, and surgical resection. Chemotherapeutic and radiation therapy methods are more likely but surgery is often an option for those whose disease is diagnosed early enough.

How is Malignant Mesothelioma diagnosed?

Malignant Mesothelioma will typically be suspected if the patient complains of chest pain, difficulty breathing, shortness of breath, chronic cough, or difficulty swallowing. While any of these could indicate mesothelioma, they are also associated with many other respiratory conditions so further diagnostic procedures are typically warranted. These may include imaging scans, such as computer topography or magnetic resonance imaging. A diagnostic biopsy is also required for cancer specialist to examine the behavior of these cells before a diagnosis is determined.

PERITONEAL MESOTHELIOMA

Malignant peritoneal mesothelioma is a rare type of cancer that occurs in the thin cell walls which surround the abdominal cavity, known as the peritoneum. Other types of mesothelioma include malignant pleural mesothelioma, occurring in the cell wall surrounding the lungs, and malignant pericardial mesothelioma, which occurs in the pericardial lining of the hearth. Peritoneal mesothelioma is the second rarest form of the disease and accounts for approximately 20% of all mesothelioma cases each year.

What Causes Peritoneal Mesothelioma?

Peritoneal mesothelioma is known only to be caused by exposure to asbestos, a microscopic natural fiber that was used heavily in industry. Asbestos is said to reach the abdominal wall by one of two methods. The first is through ingested asbestos fibers which are processed through digestion and become lodged in peritoneum. These other method is through the lungs and lymph nodes, by inhaled asbestos fibers. Mesothelioma of the pleura is also known to metastasize directly into the abdominal cavity if its spread is not slowed.

How is Peritoneal Mesothelioma Treated?

Prognosis of mesothelioma patients is poor, and peritoneal mesothelioma patients are no exception. Most peritoneal treatment regimens for patients include palliative methods such as chemotherapy and radiation therapy. However, if the disease is diagnosed in its earlier stages, patients may be eligible for surgical resection of the disease, which could potentially add years to initial prognoses.

How is Peritoneal Mesothelioma Diagnosed?

Physicians may suspect peritoneal mesothelioma if the patient complains of stomach, chest, or abdominal pain. Suspicious hernias may actually be a pleural effusion caused by peritoneal tumor growth. Misdiagnosis is common and patients will likely undergo multiple imaging scans and a diagnostic biopsy before an official diagnosis is made.

What are a patient's options?

Patients of peritoneal mesothelioma may be eligible for financial compensation if they exposed to asbestos. Industrial exposures were common and those exposed have collected compensation to finance high treatment costs.

PERICARDIAL MESOTHELOMIA

Malignant pericardial mesothelioma is a type of cancer that originates in the mesothelium, a thin wall of cells that surround the body's organs and internal body structures. Pericardial mesothelioma originates in the lining of the heart. Other locales of the disease are malignant pleural mesothelioma, which occurs in the lining of the lungs and malignant peritoneal mesothelioma, which occurs in the abdomen wall. Pericardial mesothelioma is the rarest of these malignancies and accounts for only an estimated 10 percent of all mesothelioma incidences annually.

What Causes Pericardial Mesothelioma?

Pericardial mesothelioma is known only to be caused by exposure to asbestos, a naturally occurring but toxic mineral that was used in industrial capacities. While the precise route by which microscopic asbestos fibers reaches the pericardial lining is not known, physicians surmise that inhaled asbestos fibers are absorbed into the bloodstream and become entangled in the heart's lining as the blood processes through the heart. Mesothelioma occurring in other parts of the body, such as in the pleura or peritoneum, can also metastasize to the pericardial lining.

How is Pericardial Mesothelioma Treated?

Prognoses are poor in cases of pericardial mesothelioma, just as nearly all mesothelioma cases are. However, several treatment options exist to help patients manage the disease and maintain comfort. Chemotherapy and radiation therapy are the most likely treatment options for patients of this disease. Surgery is typically not an option because of the local of the disease and the risk of grave damage to the tumor area.

How is Pericardial Mesothelioma Diagnosed?

Physicians will often suspect pericardial mesothelioma if the patient has trouble breathing, shortness of breath, or chest pain. A comprehensive diagnostic and biopsy process will be undergone through use of multiple body imaging scans.

What a Patient's Options?

Patients of pericardial mesothelioma may be eligible for financial compensation if they were wrongly exposed to asbestos. Anyone who worked with asbestos products is potentially at-risk and should fill out the brief form on this page to receive additional treatment and legal information.

PLEURAL MESOTHELIOMA

Pleural disease is often seen in people who have been exposed to high levels of asbestos on the job. It sometimes takes 10 years or more for changes to appear that are indicative of pleural disease which affects the thin membrane layer in the chest. These differences can include a thickening or calcification of the pleural lining and is usually diagnosed as pleural plaques, pleural thickening and pleural calcification.

In most instances, pleural disease is not considered fatal but it does have the ability to impair lung function and it does confirm that a person has sustained significant asbestos exposure and could be at a higher risk for developing more severe asbestos cancer. If you have been diagnosed with pleural disease it is important to preserve your legal rights.

However, pleural plaques can lay the groundwork for mesothelioma, which is an extremely aggressive cancer known only to be caused by asbestos exposure. Pleural mesothelioma originates in the pleura but quickly spreads to the outer chest wall, abdomen, and heart. Mesothelioma is typically fatal within 1 year of diagnosis. However, early recognition of risk factors, like asbestos exposure will typically lead to early detection of the cancer. Those whose disease is discovered early enough will likely be much more eligible life-sustaining and bettering treatments. Mesothelioma patients who receive an early diagnosis may be eligible for surgical resection of the cancer, which can extend life years beyond that of typical mesothelioma patients.

Other treatments are available for mesothelioma, including traditional radiotherapy and chemotherapeutic methods which can ease symptoms of the disease and make the cancer much more manageable.

Don't Let Time Get in the Way!

Don't let time prevent you from taking legal action. Every state establishes set timeframes for filing lawsuits for an asbestos related injury. These timeframes are also known as the state statutes of limitation. The deadlines established in the statutes are fixed so it is important to consult with a legal professional soon after the onset of an asbestos related illness to determine what, if any action may be appropriate.