ma it will cause shortness of breath and lack of physical stamina. For all of these forms of malignant mesothelioma, fatigue, sweating, weight loss and difficulty sleeping may also become physical difficulties.
Malignant Mesothelioma Treatment
The nature of the treatment received by mesothelioma patients is directed by the degree to which the disease has advanced. That question is analyzed by medical personnel through the process of staging, a formal protocol that provides a series of benchmarks for the malignancy, the degree to which it has spread, its location(s) within the body and the types of malignant cells that make up the tumor development.
The key question for mesothelioma treatment is whether or not there is a surgical option to remove some or all of the malignant tissue. If the staging diagnosis determines that surgery is feasible, a resection procedure will remove the malignant portion of the mesothelium, or as much as can be removed, and often adjacent tissue that is diseased or threatened as well. With pleural mesothelioma, for example surgical intervention often involves a partial pneumonectomy, which means removing a portion of the lung next to the malignant mesothelium tissue. Surgery to remove portions of the peritoneum in the case of peritoneal mesothelioma may also involve removing portions of the stomach.
In cases where surgical intervention is warranted and performed, a program of chemotherapy combined with radiotherapy usually follows. Depending on the location of the malignancy and whether or not malignant tissue remains in the body, the chemotherapy may be administered via the standard intravenous method or may be applied directly to the targeted tissue during surgery. The two drugs that the FDA has approved for the treatment of mesothelioma are pemetrexed and cisplatin, usually used in combination because they attack different weaknesses in cancer cells.
Techniques have been developed to minimize the damage that radiation therapy does to healthy cells near the malignant areas being targeted, but limiting healthy cell damage remains an issue for both chemotherapy treatment and radiation. Sometimes radiotherapy is used during the course of surgery so that physicians can target precisely the diseased tissue remaining in the body while it is still exposed on the operating table.
Photodynamic therapy has been developed to allow for the targeting of radiological cancer treatment as well. Still in experimental stages, photodynamic therapy essentially uses photosensitive medications that are injected into the patient and activated by light when they reach the appropriate area to be treated. This promising technique is under study in several clinical trials, as is immunotherapy – another method of attacking cancer cells with specific molecules.
There are three or more sets of guidelines for the staging of malignant mesothelioma cases. The most common is the TNM system, an acronym that references tumors, nodes and metastases. TNM is used to stage lung cancer, ovarian cancer and other types of the disease, and has been approved as a standard by the American Joint Committee on Cancer, an organization that counts the National Cancer Institute among its founding members.
Currently pleural mesothelioma is the only form of the disease that has a formal staging structure. It is the most common form of a relatively rare disease; accordingly physicians assess the spread of cancer in peritoneal mesothelioma or pericardial mesothelioma based on less form analyses of the presence of malignancy.
Briefly, the four TNM stages are as follows:
Stage I: Mesothelioma is present in the pleura covering either the right or left lung. It may have spread to the pericardium or the diaphragm or lung on the same side of the body. There is no evidence of cancer in the lymph nodes.
Stage II: Mesothelioma meets all of the conditions of stage I with the additional spread to lymph nodes near the malignant tissue in the pleura and on the same side of the body.
Stage III: Mesothelioma has advanced into the chest wall, the heart, the esoph