Guía de tratamiento del mesotelioma

Mesotelioma treatment is usually a combination of two or more therapies, including chemotherapy, surgery, and radiation therapy. Palliative treatments are also important, as are novel therapies currently under investigation in clinical trials. Alternative medicine can be used to treat síntomas.

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About Mesothelioma

Mesothelioma is a rare, aggressive cancer that develops in the mesothelium, a layer of tissue that lines organs and cavities in the body. Mesotelioma pleural is the most common form and occurs in pleural tissue around the lungs. Mesotelioma peritoneal is less common and develops in the abdomen.

Asbestos is the only known cause of mesothelioma. Most people diagnosed with mesothelioma were exposed to asbestos in the workplace. Not everyone exposed to asbestos will develop mesothelioma.

Warning signs and symptoms of mesothelioma may include:

• Dificultad para respirar
• Tos
• Dolores en el pecho
• Bultos debajo de la piel del pecho
• Abdominal pain and swelling
• Diarrea o estreñimiento
• Pérdida de peso
• Fatiga

Doctors often diagnose mesothelioma by first ruling out more common illnesses. They do this with a physical exam, chest X-rays, and imaging scans, like CT or MRI.

If imaging scans show abnormalities, doctors perform a biopsy to remove a tissue sample. A pathologist examines the tissue to look for cancer cells and to identify their type.

If mesothelioma is diagnosed, doctors will then stage it, assigning a stage of 1, 2, 3, or 4 depending on how far the cancer has spread.

Staging and other information help a patient’s medical team determine the best treatment plan. If you have been diagnosed with mesothelioma, starting treatment as soon as possible is best. Earlier, more aggressive treatment will give you a better outcome.

Mesothelioma Treatment Basics

There are many treatment options for cancer. For mesothelioma, in general, chemotherapy is the primary treatment.

However, there is no single accepted treatment plan for everyone with mesothelioma. Treatment depends on individual factors.

The patient’s information is the starting point for mesothelioma treatment, including age, medical history, previous occupations, weight, síntomas del mesotelioma, and more. Next, the patient’s diagnosis will determine what type of treatment will work best.

For most patients with mesothelioma, chemotherapy is the first-line treatment. This is most often followed by other treatments for a multimodal approach.

How Does Mesothelioma Treatment Affect Life Expectancy?

Life expectancy after a mesothelioma diagnosis is better with treatment. Patients who forgo treatment have a life expectancy of less than a year. With treatment, life expectancy averages between 12 and 21 months.

Can Mesothelioma Be Cured?

There is no cure for mesothelioma. Rarely, do patients go into remission with treatment. A handful of people even live many years after remission. For most patients, remission is unlikely or leads to recurrence later.

It’s important to view mesothelioma treatment as something that can extend your life. Mesothelioma is like a chronic illness that will never truly resolve, but treatment helps.

Is There a Standard Treatment for Mesothelioma?

Treatment for mesothelioma is on a caso-by-case basis. However, there are standards that guide mesothelioma treatment plans:

• First-line chemotherapy drugs are pemetrexed with cisplatin or carboplatin.
• Some patients benefit from adding bevacizumab to chemotherapy treatment.
• Patients in the early stages may benefit from extensive surgery.
• Surgery should not be used alone. It should be preceded by or followed by radiation, chemotherapy, or both.
• Stage 4 mesothelioma patients should not undergo curative surgery.

The guidelines are set by the National Comprehensive Cancer Network and contributing specialists. They serve as a guide to help doctors develop the best individualized treatment plan for each patient.

Mesothelioma Surgery

Patients diagnosed before the disease has spread too far are often candidates for cirugía. Patients in more advanced stages might not be eligible for surgery.

Resectable Mesothelioma

When surgery is a good option, the cancer is considered resectable. The goal of surgery is usually to remove as much of the cancerous tissue as possible.

Surgery is usually followed or preceded by chemotherapy, radiation, or both. If the disease has spread too far, it will be at the physician’s discretion as to whether surgery is a viable option.

Some of the surgical options for mesothelioma include:

• Wide Local Excision. If the tumors are highly localized, the surgeon may remove them and some of the healthy tissue around them.
• Pleurectomy/Decortication. P/D is a more extensive procedure that removes the pleural tissue and some of the lung tissue.
• Extrapleural Pneumonectomy. The most aggressive surgery for mesothelioma is an EPP. It includes the removal of an entire lung on the side of the chest where the mesothelioma developed.

Non-Resectable Mesothelioma

Although there are always exceptions to the rule, most victims in the later stages of enfermedades relacionadas con el amianto are not healthy enough to withstand surgery. These are cases of non-resectable cancer. Tumors have spread throughout the body at this point and are difficult to remove.

Sarcomatoid mesothelioma is a rare but very aggressive cell type of mesothelioma. Because it tends to spread so rapidly, it is usually considered non-resectable.

Palliative Surgery

Surgical procedures for mesothelioma can be palliative. The goal is not to treat the cancer. It is to make the patient more comfortable. An example is pleurodesis. This is a procedure that seals the two layers of the pleural to prevent fluid buildup that can be painful.

Quimioterapia

Quimioterapia is the least intrusive form of treatment and also the most practical way of increasing a patient’s life expectancy rate.

Chemotherapy usually includes a combination of chemotherapy drugs for an increased chance of success. The goal of chemotherapy is to reduce tumors and eliminate cancer cells.

Keep in mind that the type of chemotherapy and how long it will take will depend on the patient’s disease and how advanced it is. Options include systemic chemotherapy or direct chemotherapy into the infected areas.

If a patient undergoes systemic chemotherapy, medicine is typically either swallowed or injected. The most widely used chemotherapy drugs are:

• Navelbine
• Onconase
• Carboplatin
• Alimta
• Gemcitabine
• Cisplatin

Chemotherapy causes various side effects, including hair loss, fever, fatigue, rashes, anemia, body aches, and more. Undergoing chemotherapy is a viable option to extend life expectancy for qualifying patients.

Patients with peritoneal mesothelioma may have the option to benefit from one of the most effective mesothelioma treatments: cytoreductive surgery and HIPEC.

Cytoreductive surgery removes as much of the cancerous tissue as possible from the abdomen. It is followed by HIPEC, the circulation of heated chemotherapy drugs in the abdomen.

Radioterapia

Radioterapia is a type of therapy in which direct radiation is applied to the cancer cells in the body. Doctors rarely use radiation alone for mesothelioma.

Radiation therapy is typically used in combination with other forms of treatment and has been proven to help patients in all stages of cancer.

Patients who qualify for radiation therapy can usually expect the pain and the severity of the disease to lessen. However, not all patients will be eligible for combination treatments.

There are different types of radiation therapy for mesothelioma patients. Depending upon the severity of the disease, patients may receive the following forms of treatment:

• Brachytherapy: Brachytherapy is used less than all other forms of radiation therapy as it is still being researched. It involves tiny, radioactive seeds being inserted into the affected area. The seeds then send out doses of radiation to the cancerous cells.
• Intensity-Modulated Radiation Therapy (IMRT): IMRT is a form of radiation therapy that uses beams of radiation to target cancerous cells. The radiation beams are monitored and controlled so that healthy tissue is not affected.  The more severe the cancer is the higher beams of radiation.
• Three-Dimensional Radiation Treatment (3D-CRT): 3D-CRT is similar to the other forms of radiation therapy in that it sends beams of radiation to cancerous cells. However, what sets this form of radiation therapy apart is that the tumors can be seen in 3D, making it easier for physicians to target.

Radiation side effects include fatigue, nausea, cardiac damage, and skin redness.

Multimodal Treatment for Mesothelioma

Multimodal therapy combines two or more kinds of treatment together so that patients can extend their life expectancy.

Before starting multimodal therapy, physicians will factor in the patient’s history along with any risk factors.

There are no guarantees of success with multimodal therapy. However, multimodal therapy usually provides the best prognosis for mesothelioma.

Multimodal therapy began when scientists discovered that combining therapy can help prolong the survival rate compared to single forms of therapy alone.

After studying a group of patients in the 1980s, scientists and researchers determined that qualified patients stand a much better chance of an extended life expectancy when the top forms of treatment are combined.

When determining candidacies for multimodal therapy, physicians look at:

• La etapa del cáncer
• The cell type of the cancerous tumor
• Patient medical history
• Complications that may arise
• The lung health of the patient

Emerging Treatments

Researchers continue to seek out and test new treatments for mesothelioma. Some of the most promising include:

Inmunoterapia

Immunotherapy drugs are already on the market, with at least two approved for mesothelioma. These drugs harness the patient’s immune system to attack cancer cells.

The FDA approved a combination of Obdivo and Yervoy in 2020, the first new treatment approved for mesothelioma in years. Researchers continue to investigate other immunotherapy drugs in clinical trials.

Tumor Treating Fields

Also newly approved is a therapy called tumor treating fields, or TTFields. It uses electric fields externally to kill cancer cells. Studies show it can extend life expectancy for mesothelioma patients.

Targeted Therapies

Researchers continue investigating medications, including chemotherapy drugs, immunotherapy, and gene therapies, targeting cancer cells. Targeted therapies are more specific than standard chemotherapy drugs. They may provide better results and limit side effects.

Vaccine Therapy

The CRS-210 vaccine is another new treatment option in its clinical trial stages. Physicians injected a weakened form of Listeria monocytogenes into the mesothelioma patient’s system to have the immune system attack the disease and prevent cells from producing mesothelin.

In clinical studies, the vaccine is usually used with traditional treatment medications, such as cisplatin and pemetrexed.

Can I Benefit From Mesothelioma Clinical Trials?

Another treatment option for some mesothelioma patients is participation in a clinical trial. Clinical trials are tests of novel treatments and therapies using human subjects.

You might want to participate in a trial to get access to a treatment your doctors would otherwise be unable to provide.

New treatments undergo a lot of testing to get to the clinical trial stage and are considered generally safe. Still, there are always risks associated with new therapies. Your doctors can help you determine if you qualify for any trials and if the potential benefits outweigh the risks.

Complementary and Alternative Medicine

Complementary and alternative medicine (CAM), also known as complementary and integrative medicine, is a non-traditional approach to medical care. CAM treatments do not target cancer or treat it directly.

CAM can be good for relieving symptoms and side effects of treatment. It can improve your quality of life and help you better tolerate traditional treatments and get the most out of them. Some common CAM therapies generally considered safe for cancer patients include:

• Acupressure
• Acupuncture
• Aromatherapy
• Biofeedback
• Massage therapy
• Meditation
• Nutrition therapy
• Tai chi
• Yoga

Talk to your medical team before trying any alternative therapies. They can recommend qualified practitioners. They can also tell you if any of these therapies are not appropriate for you.

Palliative Treatment

Palliative therapies aim to improve a patient’s quality of life. They are not designed to treat cancer and are not curative or life-extending. Like CAM, palliative treatments address your symptoms, including physical symptoms and mental health.

Your medical team can discuss palliative options that are best for you. They might include traditional treatments, like radiation therapy to shrink a painful tumor. They could also include alternative therapies, counseling, medications, medical cannabis, and more.

Where Should I Get Treatment for Mesothelioma?

Your doctor can help you find the right specialists for your treatment. Mesothelioma is both rare and complicated. Effective treatment requires a team of specialists in oncology, radiation therapy, surgery, and more.

For the best results, the specialists you work with should have experience treating mesothelioma. Major cancer centers typically have specialists on staff, but you might have to travel to benefit from their care.

The Costs of Mesothelioma Treatment

The expense of treatments plays a significant factor in deciding which form of treatment will be used and how. The patient’s location, the ability to consistently travel for treatment if needed, and financial stability all play prominent roles in mesothelioma treatment.

Remember that aside from surgery, therapy, and other forms of treatment, the cost of equipment, special foods, and other options should be factored in. Assistance may be available through federal government programs and other forms of financial assistance for those who qualify.

If you received a mesothelioma diagnosis, you might qualify for a asentamiento or asbestos trust fund payout. Contact an asbestos abogado to learn about your rights and options.

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