Treatment by stages
Treatment depends on the location of the cancer, how the disease has spread, your age and overall health.
You could be considered a standard treatment based on their effectiveness in a number of patients in previous studies or may choose to take part in a clinical trial. Not all patients are cured with standard therapy and some standard treatments may have more side effects desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the latest information. Are ongoing clinical trials in various parts of the country for many patients with malignant mesothelioma. If you would like more information, call the Information Service on Cancer at 1-800-4-CANCER (1-800-422-6237), TTY 1-800-332-8615, in the United States.Malignant mesothelioma - LOCALIZED (phase I)
If cancer is found only in one part of the chest or abdomen, treatment will probably consist of surgery to remove part of the pleura and some tissue around it.
If cancer is found in a larger part of the pleura, you may receive one of the following treatments:
1. Surgery to remove the pleura and the tissue adjacent to relieve
symptoms, with or without radiation therapy after the operation.
2. Surgery to remove sections of the pleura, the lung, the diaphragm
and the coating of the heart.
3. External beam radiation therapy to relieve symptoms.
4. Clinical trial of chemotherapy followed by surgery within
abdomen.
5. Clinical trial of surgery, radiotherapy and / or chemotherapy.
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Malignant mesothelioma - ADVANCED (phases II, III and IV)
The treatment may be one of the following:
1. Drain liquid from the chest or abdomen (thoracentesis or paracentesis) to
reduce the discomfort. They could also administered drugs in the chest or abdomen to prevent further accumulation of fluid.
2. Surgery to relieve symptoms.
3. Radiation therapy to relieve symptoms.
4. Chemotherapy.
5. A clinical trial of surgery, radiotherapy and chemotherapy.
6. Chemotherapy administered in the abdomen or chest.
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Malignant mesothelioma - RECURRENT
The treatment will depend on several factors, including the location where it has reappeared and cancer treatment given previously. New treatments are being evaluated through clinical trials.
Treatment of malignant mesothelioma
There are treatments for all patients with malignant mesothelioma. Used three types of treatment:
surgery (removal of the cancer)
radiotherapy (using high doses of X-rays or other high-energy rays
to kill cancer cells)
chemotherapy (using drugs to fight cancer)
Surgery is a common treatment for malignant mesothelioma. The doctor can remove the coating of the chest or abdomen and part of the fabric that is around him. Depending on how far the cancer has spread, you can also remove a lung operation called a pneumonectomy. They also removed part of the muscle that lies below the lungs that helps breathing (diaphragm).
Radiation therapy is the use of high-energy X-rays to eliminate cancer cells and reduce tumors. The radiation may come from a machine outside the body (external radiation) or materials that produce radiation (radioisotopes) and which apply to the area where the cancer cells through thin plastic tubes (internal radiation).
If you have accumulated fluid in the chest or abdomen, the doctor can drain the body by inserting a needle into the chest or abdomen and pulling with a soft suction. If fluid is removed from the chest, the procedure is called thoracentesis, while the procedure is performed in the abdomen is called paracentesis. The doctor may also introduce drugs into the chest through a tube in order to prevent further accumulation of fluid.
Chemotherapy is the use of drugs to eliminate cancer cells. These can be taken orally or injected into a vein or muscle. Chemotherapy is considered a systemic treatment because the drug is introduced into the bloodstream, travels through the body and can eliminate cancer cells throughout the body. In the case of mesothelioma, the drugs can be administered directly into the chest (intrapleural chemotherapy).
Intraoperative photodynamic therapy is a new type of treatment that uses drugs and a special light to kill cancer cells during an operation. For this, is injected into a vein, a drug that makes cancer cells more sensitive to light several days before performing surgery. During the operation to remove as much cancer as possible, using a special light to illuminate the pleura. This treatment is being studied for the early stages of mesothelioma in the chest.
surgery (removal of the cancer)
radiotherapy (using high doses of X-rays or other high-energy rays
to kill cancer cells)
chemotherapy (using drugs to fight cancer)
Surgery is a common treatment for malignant mesothelioma. The doctor can remove the coating of the chest or abdomen and part of the fabric that is around him. Depending on how far the cancer has spread, you can also remove a lung operation called a pneumonectomy. They also removed part of the muscle that lies below the lungs that helps breathing (diaphragm).
Radiation therapy is the use of high-energy X-rays to eliminate cancer cells and reduce tumors. The radiation may come from a machine outside the body (external radiation) or materials that produce radiation (radioisotopes) and which apply to the area where the cancer cells through thin plastic tubes (internal radiation).
If you have accumulated fluid in the chest or abdomen, the doctor can drain the body by inserting a needle into the chest or abdomen and pulling with a soft suction. If fluid is removed from the chest, the procedure is called thoracentesis, while the procedure is performed in the abdomen is called paracentesis. The doctor may also introduce drugs into the chest through a tube in order to prevent further accumulation of fluid.
Chemotherapy is the use of drugs to eliminate cancer cells. These can be taken orally or injected into a vein or muscle. Chemotherapy is considered a systemic treatment because the drug is introduced into the bloodstream, travels through the body and can eliminate cancer cells throughout the body. In the case of mesothelioma, the drugs can be administered directly into the chest (intrapleural chemotherapy).
Intraoperative photodynamic therapy is a new type of treatment that uses drugs and a special light to kill cancer cells during an operation. For this, is injected into a vein, a drug that makes cancer cells more sensitive to light several days before performing surgery. During the operation to remove as much cancer as possible, using a special light to illuminate the pleura. This treatment is being studied for the early stages of mesothelioma in the chest.
Stages of malignant mesothelioma
Once detected the malignant mesothelioma, will be more tests to determine whether cancerous cells have spread to other parts of the body. This procedure is known as classification stages. The doctor needs to know the stage at which the cancer to plan treatment. For the classification of malignant mesothelioma are used the following stages.
Localized malignant mesothelioma
Stage I: Cancer is in the coating of the thoracic cavity near the lung or heart or lung or diaphragm.
Advanced malignant mesothelioma
Stage II: the cancer has spread outside the chest coating to the lymph nodes in the area.
Stage III: cancer has spread to the chest wall to the center of the chest, heart, through the diaphragm, abdominal or coating, and in some cases to the adjacent lymph nodes.
Stage IV: The cancer has spread to distant organs or tissues.
Recurrent malignant mesothelioma
Speaking of recurrent disease, we mean that the cancer had reappeared (used) after being treated. You can return to appear in the coating of the chest or abdomen, or elsewhere in the body.
Localized malignant mesothelioma
Stage I: Cancer is in the coating of the thoracic cavity near the lung or heart or lung or diaphragm.
Advanced malignant mesothelioma
Stage II: the cancer has spread outside the chest coating to the lymph nodes in the area.
Stage III: cancer has spread to the chest wall to the center of the chest, heart, through the diaphragm, abdominal or coating, and in some cases to the adjacent lymph nodes.
Stage IV: The cancer has spread to distant organs or tissues.
Recurrent malignant mesothelioma
Speaking of recurrent disease, we mean that the cancer had reappeared (used) after being treated. You can return to appear in the coating of the chest or abdomen, or elsewhere in the body.
What is malignant mesothelioma cancer?
Malignant mesothelioma,is a rare form of cancer and it this disease lung cells became cancerous (malignant). For some step amd process malignant tissues cover and surround the chest (the pleura) or in covering the abdomen (peritoneum). Most people with malignant mesothelioma have worked in places where they inhaled asbestos breathing.
You should see a doctor if you lack the breath, pain in the chest or pain or swelling in the abdomen. If you have symptoms, the doctor may send you to a chest X-ray or abdomen.
The doctor can examine the inside of the chest cavity with a special instrument called thoracoscopy. To do this, make a slit through the chest wall and install the thoracoscopy in the chest between two ribs. This test, called thoracoscopy, is usually performed in a hospital. Before the test, will be given a local anesthetic (a drug that causes loss of sensitivity for a short period of time). You may feel some pressure, but generally do not feel pain.
The doctor also can examine the inside of the abdomen (peritoneoscopia) with a special device called peritoneoscopio, which is inserted into an opening made in the abdomen. Usually, this test is also carried out in hospital. Will be given a local anesthetic before they carried out the test.
If abnormal tissue is found, the doctor will have to remove a small piece to be submitted for analysis under a microscope to determine the presence of cancer cells. This process is known as a biopsy. Biopsies are usually done during the thoracoscopy or peritoneoscopia.
His chances of recovery (prognosis) depends on the size of the cancer, its location, how far has spread, the appearance of cells under a microscope, how the cancer responds to treatment and patient age.
You should see a doctor if you lack the breath, pain in the chest or pain or swelling in the abdomen. If you have symptoms, the doctor may send you to a chest X-ray or abdomen.
The doctor can examine the inside of the chest cavity with a special instrument called thoracoscopy. To do this, make a slit through the chest wall and install the thoracoscopy in the chest between two ribs. This test, called thoracoscopy, is usually performed in a hospital. Before the test, will be given a local anesthetic (a drug that causes loss of sensitivity for a short period of time). You may feel some pressure, but generally do not feel pain.
The doctor also can examine the inside of the abdomen (peritoneoscopia) with a special device called peritoneoscopio, which is inserted into an opening made in the abdomen. Usually, this test is also carried out in hospital. Will be given a local anesthetic before they carried out the test.
If abnormal tissue is found, the doctor will have to remove a small piece to be submitted for analysis under a microscope to determine the presence of cancer cells. This process is known as a biopsy. Biopsies are usually done during the thoracoscopy or peritoneoscopia.
His chances of recovery (prognosis) depends on the size of the cancer, its location, how far has spread, the appearance of cells under a microscope, how the cancer responds to treatment and patient age.
Care, treatment and medicament of maliggn mesothelioma
The choice of best treatment for each individual depends on many factors, including age, overall health status, stage of disease, the type of cells (which determines the aggressiveness of the cancer) and, above all, by personal desires. For help in the evaluation of this country will find a 'interdisciplinary team (MDT) of doctors, who will discuss your case and I would suggest the strategy of care. Among the members of this team may be a surgeon cardiotorácica, an oncologist, a radioncologo, a specialist in pain control and a specialist in palliative care. Could be involved nurses and other health workers.
The conventional treatment of mesothelioma offers several options to be discussed in detail one by one with the MDT before taking a decision on the therapy to be taken. Be sure to be informed as to risk factors, the prognosis with treatment, the potential side effects and quality of life that each alternative offers.
Surgery
There are two surgical approaches to mesothelioma: pleurectomia / decortication (P / D) and pneumonectomia extrapleurica (EPP). This is very specialized surgery that are not performed at all facilities. Not all of the thoracic surgeons are experienced in this type of intervention. The ultimate aim of these procedures is the removal of the disease at the macroscopic level, with knowledge that residual disease at the microscopic level will remain. Adjuvant therapy, which used other forms of care with the primary therapy, typically aims to remove these residues. The most common forms of therapy are adjuvant chemotherapy and / or radiotherapy.
Of the two approaches pleurectomia / decortication is seen as less radical because it involves only the removal of the pleura (lining of the lung) without underlying lung resection. In some cases, you can remove the pericardium and diaphragm, depends on the proportions of the tumor. The advantages of this procedure recovery times are generally faster, and benefits for patients who could not tolerate more radical EPP. Among the disadvantages, there is a greater risk of recurrence of the disease due to an inability to remove all the cancerous tumor, and the impossibility of using high doses of radiation because of the potential damage to the underlying lung.
The pneumonectomia extrapleurica is a radical procedure that involves the removal of the lung, the pleura (lining of the lung) of the pericardium surrounding the heart and part of the diaphragm. During surgery, the pericardium and diaphragm are reconstructed with materials like gortex. Patients eligible for this intervention chirugico are only those that meet certain criteria and show the proper functioning lung and heart to be able to tolerate the procedure.
Chemotherapy
Chemotherapy involves the use of anticancer drugs that act by preventing the proliferation of cancer cells. In most cases, combinations of drugs used to increase the effectiveness of therapy. Chemotherapy can be used aggressively to reduce the tumor or in a palliative for symptoms such as pain or shortness breath. The administration of chemotherapy can be injected into a vein or muscle, such as oral medication or may sometimes be administered directly into the pleural or peritoneal cavity. Some of the drugs most commonly used are:
Pemetrexed (Alimta)
Cisplatin (Platinol)
Carboplatin (Paraplatin)
Gemcitabine (Gemza)
Doxorubicin (Adriamycin)
Mitomycin
Raltitrexed (Tomudex)
Vinorelbine (Navelbine)
The search for new drugs by the pharmaceutical companies continue constantly, so it is good to ask your doctor information about the latest drugs and promising. One of these drugs, the Alimta (pemetrexed), was approved in Europe in September 2005.
Radiotherapy
Radiotherapy involves the use of x-rays with high energy to kill cancer cells and reduce tumors. It can be used for aggressive with the surgery to help eliminate the metastatic spread a microscopic level that can cause relapse of the disease, or as a palliative to combat pain caused by tumors that press on the nerve ends or other organs. Radiation has also proved effective in preventing the spread of tumors in locations biopsy and chest tube drainage.
Clinical studies
The purpose of clinical trials is to involve patients in the discovery of better and innovative treatments for their disease. The various studies have different purposes that may include the testing of new drugs, the comparison between different ways of treating a disease or experimenting with different techniques for the prevention of cancer. Clinical studies are divided into three phases. Here are briefly summarized the goals of each stage of experimentation.
Phase I studies are the first phase of the clinical trial. At this point, the drugs were tested only in laboratory conditions, but have proved effective in destroying cancer cells. For these studies, available only in a limited number of institutions of oncology, is recruited only a limited number of participants. The purpose of Phase I studies is to find the maximum dose of the drug tolerated without serious side effects, to understand what are the most common side effects and whether the drug continue to have an anticancer when administered to humans. If the drug shows to have an effect on cancer at a safe dose is tested in Phase II of the trial.
Phase II studies continue to verify the safety of medications or procedures, but also beginning to look more closely at its efficacy in specific types of cancer. For these studies, available in most institutions, is recruiting a higher number of participants. These studies can be "randomized", or different groups of participants are chosen by a computer, rather than from a doctor.
The phase III studies comparing bring new drugs or new procedures promising with the current standard of care. For these studies is recruited a large number of participants from different areas, or who receive the new treatment or the standard. One of the main objectives of the Phase III study is to determine whether the cancer is reduced or slowed by the medication, since the conditions of patients remain stable without the disease progresses and what are the effects of treatment with drugs on the quality of life.
If you are interested in participating in a clinical trial for mesothelioma, your doctor should be able to supply all the information on your suitability and availability of the study in your region.
The conventional treatment of mesothelioma offers several options to be discussed in detail one by one with the MDT before taking a decision on the therapy to be taken. Be sure to be informed as to risk factors, the prognosis with treatment, the potential side effects and quality of life that each alternative offers.
Surgery
There are two surgical approaches to mesothelioma: pleurectomia / decortication (P / D) and pneumonectomia extrapleurica (EPP). This is very specialized surgery that are not performed at all facilities. Not all of the thoracic surgeons are experienced in this type of intervention. The ultimate aim of these procedures is the removal of the disease at the macroscopic level, with knowledge that residual disease at the microscopic level will remain. Adjuvant therapy, which used other forms of care with the primary therapy, typically aims to remove these residues. The most common forms of therapy are adjuvant chemotherapy and / or radiotherapy.
Of the two approaches pleurectomia / decortication is seen as less radical because it involves only the removal of the pleura (lining of the lung) without underlying lung resection. In some cases, you can remove the pericardium and diaphragm, depends on the proportions of the tumor. The advantages of this procedure recovery times are generally faster, and benefits for patients who could not tolerate more radical EPP. Among the disadvantages, there is a greater risk of recurrence of the disease due to an inability to remove all the cancerous tumor, and the impossibility of using high doses of radiation because of the potential damage to the underlying lung.
The pneumonectomia extrapleurica is a radical procedure that involves the removal of the lung, the pleura (lining of the lung) of the pericardium surrounding the heart and part of the diaphragm. During surgery, the pericardium and diaphragm are reconstructed with materials like gortex. Patients eligible for this intervention chirugico are only those that meet certain criteria and show the proper functioning lung and heart to be able to tolerate the procedure.
Chemotherapy
Chemotherapy involves the use of anticancer drugs that act by preventing the proliferation of cancer cells. In most cases, combinations of drugs used to increase the effectiveness of therapy. Chemotherapy can be used aggressively to reduce the tumor or in a palliative for symptoms such as pain or shortness breath. The administration of chemotherapy can be injected into a vein or muscle, such as oral medication or may sometimes be administered directly into the pleural or peritoneal cavity. Some of the drugs most commonly used are:
Pemetrexed (Alimta)
Cisplatin (Platinol)
Carboplatin (Paraplatin)
Gemcitabine (Gemza)
Doxorubicin (Adriamycin)
Mitomycin
Raltitrexed (Tomudex)
Vinorelbine (Navelbine)
The search for new drugs by the pharmaceutical companies continue constantly, so it is good to ask your doctor information about the latest drugs and promising. One of these drugs, the Alimta (pemetrexed), was approved in Europe in September 2005.
Radiotherapy
Radiotherapy involves the use of x-rays with high energy to kill cancer cells and reduce tumors. It can be used for aggressive with the surgery to help eliminate the metastatic spread a microscopic level that can cause relapse of the disease, or as a palliative to combat pain caused by tumors that press on the nerve ends or other organs. Radiation has also proved effective in preventing the spread of tumors in locations biopsy and chest tube drainage.
Clinical studies
The purpose of clinical trials is to involve patients in the discovery of better and innovative treatments for their disease. The various studies have different purposes that may include the testing of new drugs, the comparison between different ways of treating a disease or experimenting with different techniques for the prevention of cancer. Clinical studies are divided into three phases. Here are briefly summarized the goals of each stage of experimentation.
Phase I studies are the first phase of the clinical trial. At this point, the drugs were tested only in laboratory conditions, but have proved effective in destroying cancer cells. For these studies, available only in a limited number of institutions of oncology, is recruited only a limited number of participants. The purpose of Phase I studies is to find the maximum dose of the drug tolerated without serious side effects, to understand what are the most common side effects and whether the drug continue to have an anticancer when administered to humans. If the drug shows to have an effect on cancer at a safe dose is tested in Phase II of the trial.
Phase II studies continue to verify the safety of medications or procedures, but also beginning to look more closely at its efficacy in specific types of cancer. For these studies, available in most institutions, is recruiting a higher number of participants. These studies can be "randomized", or different groups of participants are chosen by a computer, rather than from a doctor.
The phase III studies comparing bring new drugs or new procedures promising with the current standard of care. For these studies is recruited a large number of participants from different areas, or who receive the new treatment or the standard. One of the main objectives of the Phase III study is to determine whether the cancer is reduced or slowed by the medication, since the conditions of patients remain stable without the disease progresses and what are the effects of treatment with drugs on the quality of life.
If you are interested in participating in a clinical trial for mesothelioma, your doctor should be able to supply all the information on your suitability and availability of the study in your region.
Who is at risk for developing mesothelioma?
Those who have worked in direct contact with asbestos or its products carry the greatest risk for developing mesothelioma, however, mesothelioma has been reported in some individuals whose exposure was minimal.
Among the activities at high risk for developing mesothelioma include:
Metal plate workers (including the construction of ships)
Manufacturers of vehicles (including rail vehicles)
Plumbers
Installers of gas
Joiners
Electricians
Workers in the construction industry
Plasterer
Builders
Workmen handyman
Steel erectors
Painters
Workers of sheets
Welders
What types of products usually contain asbestos?
These products generally contain asbestos in different concentrations. This list is not complete and is designed only as a general reference.
Pre-shaped or coatings used for thermal insulation of pipes and boilers
Asbestos in spray used as fire protection in the pipeline, in the margins fender, the panels in the walls, in the axis of the loft, the panels of the ceiling and around steel structures
Assi insulation used for fire protection, thermal insulation, the walls and the pipes
The coverings of asbestos used in the margins fender and spaces of the ceiling
Double-pressed cardboard, paper and paper products used for insulation of electrical equipment, paper asbestos can also be used as a fire retardant coating on the panels of wood fiber
The products of the cement asbestos sheeting and corrugated plates that are used for roofing or wall cladding; cement products were also used in gutters, the rain and water tanks
Structured coatings (such as Artex)
Covering material made of bitumen
Vinyl tiles or thermoplastic
Among the activities at high risk for developing mesothelioma include:
Metal plate workers (including the construction of ships)
Manufacturers of vehicles (including rail vehicles)
Plumbers
Installers of gas
Joiners
Electricians
Workers in the construction industry
Plasterer
Builders
Workmen handyman
Steel erectors
Painters
Workers of sheets
Welders
What types of products usually contain asbestos?
These products generally contain asbestos in different concentrations. This list is not complete and is designed only as a general reference.
Pre-shaped or coatings used for thermal insulation of pipes and boilers
Asbestos in spray used as fire protection in the pipeline, in the margins fender, the panels in the walls, in the axis of the loft, the panels of the ceiling and around steel structures
Assi insulation used for fire protection, thermal insulation, the walls and the pipes
The coverings of asbestos used in the margins fender and spaces of the ceiling
Double-pressed cardboard, paper and paper products used for insulation of electrical equipment, paper asbestos can also be used as a fire retardant coating on the panels of wood fiber
The products of the cement asbestos sheeting and corrugated plates that are used for roofing or wall cladding; cement products were also used in gutters, the rain and water tanks
Structured coatings (such as Artex)
Covering material made of bitumen
Vinyl tiles or thermoplastic
How common is mesothelioma?
Country cases per million cases per year per year statistics for europe.
Finland 75 (2002) 18
France 870 (2000) 18
Germany 1094 (2001) 16
Great Britain 1862 (2002) 39
Italy 1050 (2000) 21
Netherlands 389 (2000) 30
Norway 57 (2000) 16
Sweden 149 (2003) 20
Finland 75 (2002) 18
France 870 (2000) 18
Germany 1094 (2001) 16
Great Britain 1862 (2002) 39
Italy 1050 (2000) 21
Netherlands 389 (2000) 30
Norway 57 (2000) 16
Sweden 149 (2003) 20
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