Mesothelioma is generally radiation and chemotherapy. In the long-term survival and cure are exceedingly rare. Mesothelioma cancer in earlier stages has a better prognosis. Conduct clinical cancer affected by many factors, including surface mesothelial continued pleural cavity which favors the spread of local cells exfoliated invade underlying tissue and other organs in the cavity membrane. Lung and very long latency period between asbestos exposure and development.Of disease Subtype tissue and the patient's age and health status also help predict prognosis epithelioid histology better to respond to treatment and survival advantage over Microbiology sarcomatoid.
surgery
The surgery itself has proved disappointing. In the series, a big one with a survival average with surgery (including extrapleural pneumonectomy) was only 11.7 months. However, research shows that success differently when used in combination with radiation and chemicals. Therapy (Duke, 2008), or one of the pleurectomy / decortication. Surgery is the most common, in which the lining of the chest is removed. Less common are pneumonectomy extrapleural (EPP), in which the lung, lining of the chest, the hemi- diaphragm and the pericardium are removed. [citation needed] in local tissue disease. pericardectomy can solve; When the tumor has spread, pericardectomy. Palliative care is an option. Not all tumors usually can be removed.
ray
For patients with localized disease, and who can tolerate a radical surgery, radiation will receive post-surgical treatment. consolidative The half - breasts treated with radiation, often given together with chemotherapy. Delivering radiation and chemotherapy after radical surgery has led to extended life expectancy in selected patient populations. It can also cause serious side effects including serious lung infection. As part of the remedy is. Mesothelioma, radiation therapy is used widely to sites of chest drain inserted in order to prevent the growth of tumor along the track in the chest wall.
Although the disease can be resistant to treatment with radiotherapy alone, palliative treatment is sometimes used to relieve symptoms caused by tumor growth, such as obstruction of a major blood vessel. Radiation therapy alone, when treated with the intent has never been shown to improve survival from the disease. The dose needed to treat a disease that has not been surgically removed would be very toxic. [Citation needed] Radiation therapy is the use of some of the diseased tissue.
Chemotherapy
Chemotherapy is the treatment for the disease has been proven to improve survival in randomized and controlled. A landmark study published in 2003 by Vogelzang and colleagues compared cisplatin chemotherapy alone with a combination of cisplatin and pemetrexed (brand name Alimta) chemotherapy in patients who did not receive. chemotherapy for pleural disease, cancer [44] earlier and candidates for more aggressive "curative" surgery.
This trial was the first to report a survival advantage from chemotherapy in malignant pleural mesothelioma, showing a. statistically significant improvement in median survival from 10 months in the patients treated with cisplatin alone to 13.3 months in the group of patients treated with cisplatin in the combination with pemetrexed and who also received supplementation with folate and vitamin B 12. vitamins to patients. Most of the trials and pemetrexed, the side effects associated significantly less than in receiving pemetrexed patients when they receive folate 500mcg in daily oral and intramuscular vitamin B-12 1000mcg every nine weeks.
When compared to the group receiving pemetrexed without vitamin supplements. The objective response rate increased from 20% in the cisplatin group to 46% in the combination pemetrexed group some side effects such as nausea, vomiting, diarrhea and mouth were more common in the combination pemetrexed. But affected only a minority of patients and overall the combination of pemetrexed cisplatin and has been well tolerated when patients received vitamin supplementation; Both quality of life and tests of lung function improved in the combination pemetrexed group in February 2004, the US Food and Drug Administration approved pemetrexed for treatment of malignant pleural Mesothelioma but there are still unanswered questions. not about the best use of chemotherapy, including when to start treatment and the appropriate number of cycles to give. [Citation needed] cisplatin and pemetrexed shared patients survived on average 12.1 months.
cisplatin in combination with raltitrexed has shown an improvement in survival with pemetrexed in combination with cisplatin, but raltitrexed the report will not be commercially available for this indication. For patients unable to tolerate pemetrexed, cisplatin in combination with Gemcitabine, or vinorelbine is an alternative, or vinorelbine on its own, although a survival benefit has not been shown for these drugs. For patients with cisplatin can not be used, carboplatin can be substituted but non-randomized showed lower response rates and high rates of toxicity blood for including carboplatin followed despite the survival. similar to patients receiving cisplatin.
In January 2009, the US FDA approved using conventional therapies, such as with surgery, radiation and or chemotherapy on stage I or II Mesothelioma after research conducted by educators across the country. Duke University concluded an almost 50 point increase in remission rate. [Citation needed]
In the diseased tissue chemotherapy - often Adriamycin and / or cisplatin - used primarily to reduce the size of the tumor and not the solution.
immunity
The treatment of immune-related variable results. For example, intrapleural inoculation of Bacillus Calmette-Guérin (BCG) in an attempt to increase the responsiveness of the immune system were found to be beneficial to patients without. (While it may be beneficial to patients with bladder cancer) Mesothelioma cells proved susceptible to in vitro dissolution of LAK cells following activation by interleukin-2 (IL-. 2) However, patients who experience side effects that are particularly important. Indeed, this trial was suspended in view of the executive are not toxic IL-2 and severity of side effects such as fever and cachexia However, other trials involving alpha interferon has proved encouraging. more with 20% of patients with greater than 50% reduction in tumor mass combined with minimal side effects. [Citation needed]
During abdominal surgery, chemotherapy warm.
This technique is used in combination with surgery [47] as well as in patients with malignant pleural disease. [48] The surgeon removes as much of the tumor as possible under the direct administration of the chemotherapy agent, heated to between 40 and 48 ° C in the peritoneal fluid is perfused 60 to 120 minutes and then drained. High concentrations of drugs that are administered at a surface abdomen and pelvis. Heating the chemotherapy treatment increases the permeability of the drug into the tissues. The heat itself damage the cancer cells than normal cells.
Multimodality therapy
All of the standard method for the treatment of solid tumors, radiation, chemotherapy and surgery have been validated in patients with pleural Mesothelioma Although surgery itself is not very effective with surgery, treatment with chemicals. adjuvant chemotherapy and radiation. (Therapy trimodality) has produced a significantly extended survival (3-14 years) in patients with poor prognostic factors. [49] However, other large series of monitoring the treatment of multimodality. Have shown only modest improvement in survival (median survival 14.5 months and only 29.6% survived two years.) Reduction of the tumor with surgery. cytoreductive Is the key to extend survival. Two surgeries have been developed: extrapleural pneumonectomy and pleurectomy / decortication. For a measure of operating performance, these are unique. The choice of action is based on tumor size of patients. This is considered important because the tumor has been identified as prognostic factors in disease. pleurectomy / decortication Parts lung basis and will be conducted in patients with early stage disease, when the intention is to remove all visible tumor initially. (Macroscopic complete resection), not just one. Relief extrapleural pneumonectomy. The operation is more widely associated with surgery and parietal pleurae. Internal organs lung basis ipsilateral (same side), diaphragm, and ipsilateral pericardium. This action is indicated for the subset of patients with advanced melanoma is resistant to pneumonectomy.
Clinical trials
Clinical trials are research studies that test new ways to prevent, detect, diagnose, or treat disease. People who participate in clinical trials for cancer is likely to lead to scientific knowledge about cancer and to assist in the development of better cancer treatments. For advanced cancers and aggressive like. Mesothelioma, a clinical trial may be one of the best options for treatment for Mesothelioma only has about 78 open studies on www.clinicaltrials.gov.
Prognosis
Mesothelioma prognosis is not good. The average survival time for Pleural Mesothelioma is 12 months from diagnosis. Women, young people who have cancer, minimum, and those with cancer, epithelioid have prognoses better. [3] prognostic factors negatively, including microbiology, sarcomatoid or biphasic platelet count is high (over 400,000), age over 50 years. the number of white blood cells Above 15.5, glucose levels in lung fluid levels of albumin and low levels of fibrinogen high marks are under investigation as prognostic factors including nuclear grade and serum C-reactive protein survival. Long-term is difficult.
Pulp disease had a median survival of 10 months. In celiac disease, high expression of WT-1 protein indicates that disease.
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