Mesothelioma, a cancer caused by exposure to asbestos, attacks a protective tissue that encases the body’s organs called the mesothelium. The mesothelium is found in several body cavities including the pleural or chest cavity, the peritoneum or abdominal cavity and the pericardium, the cavity in which the heart resides. Pleural mesothelioma is by far the most common form of the cancer, but it can also occur in the peritoneum or pericardium. Mesothelioma is a very aggressive cancer and it is considered fatal in all forms, no matter where the site of the tumor or tumors. Like all cancers, early detection could go a long way in improving the efficacy of treatments, but unfortunately it is not very common with mesothelioma. The reasons that mesothelioma is unlikely to be diagnosed in its early stages are somewhat obscure, but at least two factors stand out as considerable contributors. Mesothelioma is what’s considered a high latency disease, meaning that it develops a very long time after a patient is exposed to the the perpetrating agent, in this case, asbestos fibers. Symptoms of the disease are hardly useful in discerning it, either, as they generally resemble flu or common cold symptoms until the development of a detectable tumor. The fact that its symptoms are so hard to recognize coupled with its high latency often means that the disease is in its later stages when it is finally diagnosed. Mesothelioma has a notoriously poor prognosis; most patients who learn that they have the cancer can expect to live no more than six to eighteen months.
Much like other forms of cancer, the most frequently recommended conventional treatment methods for mesothelioma are radiation therapy, surgery, and chemotherapy. Studies continue to show that strategic combinations of these treatments depending on the patient’s particular circumstances tend to be more effective than any single treatment. A recent study confirms this trend, finding that trimodal therapy (chemotherapy, radiotherapy and surgery together) is particularly effective in patients who receive radical pleurectomy surgery.
Radical pleurectomy surgery is an operation for patients with pleural mesothelioma that removes tumors, malignant cells, and affected mesothelium from the patient without removing either of their lungs. The surgery is considered far less invasive than an extrapleural pneumonectomy, one of its alternatives wherein an entire lung is removed.
Pleural mesothelioma patients who receive radical pleurectomy surgery rather than an extrapleural pneumonectomy were the focus of the recently conducted study because they often recover more rapidly than patients that undergo a more invasive surgery. A rapid recovery from surgery makes a patient a good candidate for further treatments of chemotherapy and radiation therapy. The study followed the progress of 35 patients, all of whom underwent similar radical pleurectomy surgeries followed by four cycles of chemotherapy and four to six weeks of radiotherapy. The trimodal approach to therapy, the study says, was a success. The patients survival rates were improved an average of an entire year compared to normal mesothelioma patients. That claim may appear more positive than it actually is, considering that patients who are candidates for trimodal therapy may have a better prognosis to begin with. All in all, however, the study shows that combination therapies tend to be the best option when they are an option. The study stated that:
“[radical pleurectomy] as a surgical strategy allows patients to capitalize on all the aspects that a multimodality treatment approach has to offer without compromising the surgical oncological result and thus we believe RP [radical pleurectomy] is a cornerstone of the promising long-term results achieved in our pilot study. The observed and theoretical benefits of this trimodality treatment approach warrant confirmation in larger multi-center prospective controlled studies.”
Another study recently discussed in the European Journal of Surgical Oncology and one reported from Victoria, Australia confirm similar findings regarding combination treatments. In both cases two or more forms of treatment tended to be more effective in treating mesothelioma than any single mode of therapy. Studies in this vein are likely to continue as there is clearly merit in multiple therapy approaches.
