Chemotherapy and Radiotherapy for Mesothelioma Treatment

Chemotherapy and radiotherapy for pleural mesothelioma treatment should be considered if the cancer is in late stage, where surgical intervention is likely to be of any use due to spread (metastasis) of pleural mesothelioma to other parts of the body such as abdomen and other body parts.

Chemotherapy for treatment of malignant pleural mesothelioma:

This is the most common form of treatment in pleural mesothelioma, as most of the patients with pleural mesothelioma are treated withchemotherapy, even if surgery and/or radiotherapy is used for management of pleural mesothelioma. Chemotherapy must be used in late stages of the disease, when surgery will have little or no effect in treatment of pleural mesothelioma due to spread of the disease in distant parts of the body. There are several chemotherapeutic agents which are useful in treatment of malignant pleural mesothelioma, but at present USFDA (United States Food and Drug Administration) approve only use of Cisplatin along with Alimta for treatment of pleural mesothelioma. Other chemotherapeutic agents are not approved by USFDA for treatment of pleural mesothelioma. There are several chemotherapeutic agents undergoing clinical trial to determine effectiveness of these chemotherapeutic agents, such as Gemcitabine, Navelbinein treatment of pleural mesothelioma.

Radiotherapy for treatment of malignant pleural mesothelioma:

Radiotherapy or radiation therapy is also commonly used modality in treatment of pleural mesothelioma, especially in the late stages, as is used in treatment of other forms of cancer. Generally radiotherapy is used in combination with surgery or chemotherapy or with both for best results in pleural mesothelioma. External beam radiation is used to cause mutation of tumor cells within the body and slow their growth and spread.

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Positron Emission Tomography (PET) Chillers

 

Positron emission tomography (PET) produces highly detailed images of the biological functions of the body. Also referred to as a PET scan or PET imaging, positron emission tomography is being used more frequently in the diagnosing of various malignant diseases.

PET scans revolve around the emission of positrons (tiny particles that are emitted from radioactive substances) for the purpose of radiation detection.

Positron Emission Tomography – Patient Preparation

Patients undergoing positron emission tomography will be advised by their physician to complete a series of preparatory steps that include:

• Avoid eating food for at least four hours prior to the exam.
• Drink plenty of water.
• Inform the physician of any medications being taken.
• Inform the physician if diabetic.
• Bring any previous imaging scans (CT, MRI, etc.) relevant to the malignancy in question.
• Wear comfortable clothing (Procedure can take from two to four hours).

Anywhere from 30 to 90 minutes prior to undergoing a PET scan, patients receive an intravenous injection of a radioactive substance (e.g. radioactive fluorine) that has been produced in a machine designed to accelerate clusters of charged particles (cyclotron). This radioactive substance is attached to certain types of natural body compounds; glucose is the most commonly used compound, though water or ammonia can also serve the same purpose. After injection, the radioactive substance travels throughout the body, soaking into the tissue being evaluated.

The PET scan itself can take anywhere from 30 to 45 minutes, during which patients lay motionless inside a large, doughnut shaped machine housing a series of detectors. The machine is designed to record the emissions produced by the radioactive substance that has been injected into the body.

There is no pain associated with the radioactive substance that is injected into the patient's body and no pain associated with the scanning portion of the procedure. Following completion, patients are advised to drink plenty of water to help flush the radioactive substance from the body (most radiation is eliminated from the body within 18 hours following the PET scan).

The results of the PET scan are interpreted by a radiologist. It can take anywhere from one to three days for the results to be reported to the patient's attending physician.

Positron Emission Tomography – Pros and Cons

A PET scan differs from other types of imaging technology (MRI, CT scan, and x-ray) in that it displays the chemical function of a particular organ or section of tissue. PET scans are able to detect biochemical and metabolic changes suggesting disease before they are detected by standard imaging devices. Another benefit associated with PET scanning is that the radiation dosage is relatively low, equivalent to about half that of a CT scan.

One of the problems associated with positron emission tomography is the diagnostic tool's sensitivity. If a patient's chemical balances are not normal (diabetic patients or those who ate something prior to the test) then PET scans can produce false results.

Positron Emission Tomography and Mesothelioma

Medical professionals believe that PET scans hold a great deal of promise in regards to the diagnosing and staging of malignant mesothelioma. Various studies have shown PET scans to be more successful in diagnosing the presence of malignant mesothelioma when compared to standard mesothelioma diagnostic procedures (e.g. thoracoscopy or surgical biopsy). Such studies suggest that although standard imaging tests like CT scans and MRIs should continue to play a role, PET scans are becoming increasingly important in the diagnosis of mesothelioma.

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Traditional Mesothelioma Treatment Options

Traditional Mesothelioma Treatment Options

• Surgery (physical removal of the cancer)
  Surgery involves the physical removal or other operative treatment of the cancer. There are several different surgeries available for mesothelioma patients, some of which are used palliatively to treat symptoms and some of which are considered radical surgery, such as removal of one of the lungs, and used with curative intent. The physician will decide upon the nature and type of surgery to be performed based on his or her overall treatment strategy and the information determined during the patients workup.
• Chemotherapy (using drugs to fight the cancer)
  Chemotherapy uses drugs and other chemical agents to kill cancer cells. It is referred to as systemic treatment because the drug is introduced into the patient’s bloodstream and travels throughout the body killing cancer cells. The introduction of pemetrexed-based chemotherapy has improved the efficacy of chemotherapy treatment for mesothelioma patients.
• Radiation Therapy (using radiation to kill cancer cells)
  Radiation therapy uses ionizing radiation to destroy cancer cells and shrink tumors. For mesothelioma treatments, radiation can be used as part of a multimodal treatment protocol or it can be used in a palliative manner to reduce the pain associated with the disease.

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