|Treatment Options for Peritoneal Mesothelioma|
Treatment for this type of mesothelioma includes surgery, chemotherapy and experimental therapies such as immunotherapy. Doctors believe combining traditional treatments often works better than any single treatment. A combination of one or more treatments is called multimodal therapy. Research shows that a multimodal treatment approach usually offers the best improvement in terms of survival.
The most promising peritoneal mesothelioma treatment is heated intraperitoneal chemotherapy (HIPEC), a treatment that combines surgery and heated chemotherapy. While doctors only perform HIPEC on a case-by-case basis, it has extended survival and improved quality of life. In studies on small groups of patients treated with HIPEC, around half lived five years or longer.
To qualify for HIPEC, a patient’s cancer must be limited enough for doctors to completely remove with surgery and not have spread beyond the abdomen.
In addition, qualifying patients must spend more than half of their waking hours up and about and be capable of self-care, which includes basic health maintenance, personal hygiene and the ability to follow doctor recommendations.
Surgery is the most promising traditional treatment option for peritoneal mesothelioma in the abdomen, but it is only effective for early-stage cancer. Because doctors most commonly diagnose asbestos-related diseases after the cancer has spread, most surgeries only attempt to remove sections of the tumor.
Surgery can be curative or palliative. Curative surgery aims to remove as much of the tumor as possible in hopes of curing the cancer. Otherwise, doctors may perform palliative surgery, which aims to remove parts of the tumor to relieve symptoms, extend survival and improve quality of life. Palliative therapies do not stop the cancer.
Tumor spread is usually too vast once they reach beyond the abdomen for surgery to completely remove the cancer. Surgery with a curative intent is not recommended after the cancer has spread. However, a surgery to remove the majority of tumors may be performed to alleviate pain and improve symptoms such as abdominal distention and pain.
Doctors can provide chemotherapy drugs that shrink peritoneal mesothelioma tumors and slow the growth and spread of cancer. It can be given before, during or after surgery. In some cases, doctors offer chemotherapy as the only treatment option. Chemotherapy drugs considered effective in treatment include pemetrexed, cisplatin, carboplatin and gemcitabine.
Doctors are now seeing extraordinary results with HIPEC. Once an experimental treatment, HIPEC starts with surgery to remove all visible tumors from the patient’s peritoneum. Next, doctors introduce a heated salt-water solution that contains chemotherapy drugs.
A machine pumps the medicine throughout the patient’s abdomen, helping destroy any cancer cells left behind after surgery. Nearly half of peritoneal mesothelioma cancer patients who receive HIPEC can live at least five years after diagnosis.
Although some studies show radiation therapy can improve peritoneal mesothelioma survival slightly when combined with surgery and chemotherapy, doctors tend not to recommend radiation for these patients.
Even though targeted radiation can shrink tumors and slow cancer growth, the procedure is risky because of the location of these tumors. The peritoneum wraps around the stomach, liver and intestines. Aiming radiation at nearby tumors could harm these organs and cause damage.
Alternative treatments and emerging therapies are available, but these treatments have less predictable outcomes. Immunotherapy boosts the body’s immune system to help fight cancer. However, research on this emerging therapy mainly focuses on the treatment of pleural mesothelioma, which develops in the lining of the lungs.
Many patients find hope in clinical trials, which are medical studies that test new and experimental treatments. Research from clinical trials helps improve treatment outcomes and may bring us the standard treatments of tomorrow.
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