Best Surgery and Chemotherapy Options for Mesothelioma

The treatment of mesothelioma is highly personal and unique to each individual patient. Today, there is no set standard for care for the disease, as the therapeutic options remain controversial. Most doctors recommend a multi-modal treatment strategy, which combines traditional options such as surgery, chemotherapy, and radiation.

Mesothelioma lawyers at Pintas & Mullins Law Firm highlight two recent studies that compared these traditional modes of treatment to determine the best possible program to extend both survival time and quality of life for patients.

The first study was conducted by researchers at two respected university hospitals in Belgium. The researchers examined the differences between two surgical resection therapies: extrapleural pleuropneumonectomy (EPP) and pleurectomy/decortications (P/D).

P/D removes as much of the tumor as possible to enable re-expansion of the lung and provide relief from pleural effusions, discomfort, and pain caused by tumors. Operative mortality from P/D is less than 2%, while mortality from EPP ranges from 6 to 30%. EPP is a much more invasive surgical treatment, often conducted in the cancer’s more advanced stages.

EPP is the most aggressive surgical regimen, removing one entire lung, lining of the lung, diaphragm, and pericardium siding (sac around the heart) in one surgery. The diaphragm and pericardium are reconstructed after the surgery with artificial patching.

Mesothelioma is very different from most other cancer types because it manifests in a sheet of cancer cells covering nearly every organ and surface in the chest. Even with EPP, it is impossible to remove all the cancer cells without compromising the major organs.

Esteemed mesothelioma institutes such as the Pacific Meso Center perform P/D on nearly every patient, followed by radiation and a long-term therapy program usually involving immunotherapy and experimental treatments. Doctors prefer P/D because it spares the healthy lung while still removing most of the mesothelioma tumors.

In the Belgian study, doctors initiated combinations of surgery, chemotherapy, and radiation to determine the best strategy. They found that patients treated with P/D had an equal to better outcome than those with EPP, and those treated with EPP and chemotherapy fared better than EPP alone. These findings suggest that patients would have even better prognosis with P/D and chemotherapy.

In the second study, researchers at the Cairo University Faculty of Medicine evaluated the benefits of chemotherapy drug combination gemcitabine and cisplatin compared to pemetrexed and carboplatin in mesothelioma patients. There were about 20 patients in each chemotherapy group. The study found that response was better in the pemetrexed/carboplatin group, which had a 1.5 year survival rate of nearly 58%. The gemcitabine/cisplatin group had a 1.5 year rate of only 41%.

The findings of this study mirror those of another study performed by Italian researchers. They compared pemetrexed and cisplatin with pemetrexed and carbopltin in more than 50 patients, followed by curative operations and radiation. About 4% of patients given pemetrexed and carboplatin displayed complete response, while none of the compared patients showed total response. Additionally, the pemetrexed and cisplatin group had higher grade three anemia incidence, more cumulative asthenia incidence, and overall worsened performance status.

The preeminence of aggressive and radical surgeries has largely been abandoned in favor of a multi-modal therapeutic approach. P/D enables patients to reserve physiological strength for further treatment options, while still removing the majority of cancerous cells from the chest. Radiation and chemotherapy are administered after the surgery to kill any remaining cancer cells, which prevents reorganization and recurrence of mesothelioma tumors.

Unfortunately, neither surgery nor chemotherapy offers a complete cure for mesothelioma. These treatment options merely slow the progression of ht disease, meaning patients are able to live longer and enjoy better quality of life in the long run.

Mesothelioma lawyers at Pintas & Mullins Law Firm remind the public that the best way to treat mesothelioma is by catching it in its first stages. This cancer is caused by exposure to asbestos, which is most prevalent in the shipbuilding, automotive, and construction industries. If you or someone you love was diagnosed with mesothelioma or any other asbestos-related disease, you may be entitled to compensation, and should contact an experienced asbestos exposure attorney immediately for a free legal consultation.

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