Tag Archive for The Mesothelioma Center

The 4 Stages of Mesothelioma & Their Treatment Options

doctors Meet GUEST BLOGGER Michelle Whitmer.  Michelle has been a medical writer and editor for The Mesothelioma Center since 2008. Focused on the benefits of natural and holistic medicine for cancer patients, Michelle is a certified yoga instructor and earned her B.A. in Environmental Studies from Rollins College in Florida.

Accurately diagnosing a mesothelioma patient’s stage of cancer development is essential to getting appropriate treatment. The stages of mesothelioma are determined by the degree of tumor growth and spread. Stage I represents minimal tumor growth and stage IV indicates extensive tumor growth and spread.

Diagnosing the correct mesothelioma stage is challenging, but crucial to providing effective treatment recommendations. Unless your first opinion came from a mesothelioma expert, most people diagnosed with mesothelioma should seek a second opinion from one of the nation’s specialists. Because the cancer is relatively rare, few oncologists have experience diagnosing and treating mesothelioma. Seeking the opinion of a mesothelioma specialist could lead to better treatment.

For example, pleural mesothelioma specialist Dr. David Sugarbaker pioneered one of the most effective surgeries for the cancer, the extrapleural pneumonectomy. Patients with early-stage mesothelioma often qualify for his aggressive treatment approach that may significantly extend survival.

The same goes for people with peritoneal mesothelioma, which develops in the lining of the abdominal cavity. Specialist Dr. Paul Sugarbaker pioneered the most effective treatment for peritoneal mesothelioma, which is cytoreductive surgery with heated chemotherapy that is circulated throughout the abdominal cavity rather than systemically throughout the whole body. The treatment approach significantly improved survival rates for the cancer.

Diagnosing Mesothelioma

Mesothelioma is a challenging cancer to diagnose. There’s no officially adopted standard protocol for diagnosing mesothelioma, so patients will have different experiences. However, certain diagnostic tools are universally used to reach a mesothelioma diagnosis, such as imaging scans and biopsies.

In many cases, the first imaging scan patients receive is an X-ray, which is followed with more scans if anything unusual is seen in the X-ray. More detailed imaging scans like CT, PET and MRI come next. These scans help provide a clearer indication of how far the cancer may have spread.

To confirm a mesothelioma diagnosis, a biopsy is necessary. A thoracoscopy is a common biopsy for pleural mesothelioma that involves the use of a camera-tipped tube to collect a tumor sample. A mediastinoscopy might also be used to determine if the cancer has spread to the mediastinal lymph nodes, which are located between the lungs in the center of the chest. Spread to the lymph nodes is an indication of stage III cancer.

Treatment for Mesothelioma by Stage

Treatment recommendations are made based upon a patient’s stage. Early-stage tumors respond best to surgery, while stage IV mesothelioma has spread too far for surgery to be effective. Chemotherapy and radiation therapy may be used at any stage, except when a person’s general health is too poor to withstand the side effects.

Most people with mesothelioma receive multimodal therapy, which is the combination of two or more cancer treatments. The most effective combination for mesothelioma to date is surgery, chemotherapy and radiation therapy. This approach is most effective for stage I patients, but stage II and III patients often qualify for the aggressive approach with life-extending results. Stage IV patients may receive a combination of chemotherapy and radiation therapy to relieve symptoms and extend survival.

Stage I Treatment

Because tumor growth is minimal at stage I, surgery is highly recommended to remove as much cancerous tissue as possible. There are two surgeries patients may qualify for, a pleurectomy/decortication (P/D) and an extrapleural pneumonectomy (EPP). An EPP removes one lung while a P/D keeps the lung intact and only removes the lining of the lung.

Chemotherapy with the drugs cisplatin and Alimta is commonly administered after surgery in stage I patients. Radiation therapy is used after surgery to prevent local recurrence, though some centers are having improved success administering radiation prior to surgery to shrink tumors.

Stage II Treatment

Stage II surgery for pleural mesothelioma is usually an EPP. A P/D surgery wouldn’t be as effective since the cancer has spread to the lung in stage II. Following recovery from surgery, chemotherapy is recommended to kill remaining cancer cells the surgery couldn’t remove. Radiation therapy is then used to prevent recurrence, especially along surgery incisions (which is a common place for the cancer to recur).

Stage III Treatment

Certain patients in good health with stage III mesothelioma can qualify for an EPP. The surgery is extensive, so the person must be in adequate physical health to undergo the surgery. Chemotherapy and radiation therapy are given to destroy lingering cancer cells. If the cancer returns, second-line chemotherapy with other drugs, such as gemcitabine and vinorelbine, are recommended.

Stage IV Treatment

Stage IV tumors have grown too much and have spread too far for an EPP surgery to remove all the cancer. However, less aggressive surgeries might be recommended to otherwise healthy patients to reduce tumor size, which can help to relieve pain and improve breathing.

Chemotherapy and radiation therapy can be used to shrink tumors, which can help to relieve pain and improve breathing as well. They might also help to prolong life expectancy by several months.

Other therapies are given to alleviate symptoms, such as medication for pain, pulmonary rehabilitation to improve breathing and occupational therapy to reduce discomfort.

Because the cancer rarely causes symptoms in the early stages, the majority of mesothelioma patients are diagnosed in stage III or IV. Aggressive treatment is most effective at early stages, which stresses the importance of annual physical checkups for anyone who may have been exposed to asbestos in the past.

Sources:

Guidelines for the diagnosis and treatment of malignant pleural mesothelioma. 

Malignant mesothelioma: Review.

Malignant pleural mesothelioma: Update on treatment options with a focus on novel therapies. 

 

Navigating A Diagnosis of Mesothelioma

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This post was written by guest blogger Tim Povtak.  Tim is a former newspaper reporter  who has been writing for The Mesothelioma Center since 2011.  The Mesothelioma Center provides incredible support and resources for people and families who need help understanding and coping with this disease.

Knowledge is key when it comes to battling malignant mesothelioma cancer. The more you know, the better you will feel about the fight. Not only is it tough to pronounce, it’s even tougher to understand all the intricacies involved.

Getting skilled help is crucial. It’s just not easy to do.

To help someone first diagnosed with mesothelioma, it’s vital to find the right resources – doctors and other medical professionals who see it regularly —  and a support group that is traveling the same route.

There is no replacement for experience.

Mesothelioma is a rare cancer – only 3,000 cases are diagnosed annually in the United States — caused almost exclusively by an exposure to asbestos, the naturally occurring mineral that was used extensively through much of the 20th century.

Reliable information can be difficult to find. Although there is no cure, recent curative advancements have been made. Novel therapies are being developed today. Alternative, supplemental remedies can help, too.

Selecting the right specialist might be the most important decision a patient will face. That’s where help, and support, is needed.

A typical diagnosis of mesothelioma may sound like a death sentence – six to 18 months was the norm not long ago – but many patients are surviving longer, and some even thriving, with the right help.

Rule No. 1: Don’t Do It Alone

As a caregiver, or just good friend, it’s important to learn about the disease. There is an easy-to-read encyclopedia of resources available at Asbestos.com.

The Mesothelioma Center helps patients and caregivers find the best doctors and the most appropriate cancer centers with the latest and greatest, most technologically advanced equipment. This is not the time to take short cuts.

At Asbestos.com, there are Patient Advocates who can advise patients and caregivers on where to turn, what to do next and how to connect with medical professionals. There is a registered nurse on staff to answer questions. There is a Veterans Department with counselors to answer questions that might be exclusive to veterans, helping navigate through the often-frustrating VA Health Care System.

Rule No. 2: Find a Support Group

There is a support group at Asbestos.com that meets the second Wednesday of each month at 8 p.m. EST. You can join in online or by phone. It’s moderated by a licensed mental health counselor and open to mesothelioma patients, families and caregivers who can ask questions, discuss concerns and chat on various topics.

There also is a Mesothelioma Facebook page, where ideas are exchanged and support is received. Also, check out the Wall of Hope, a section on mesothelioma survivors who have beaten the odds because they refused to concede to this terrible cancer.

Rule No. 3: Stay Positive

There is hope, so don’t believe all the gloom and doom. Explore the world of clinical trials. Mesothelioma treatment is changing. Gene therapy, immunotherapy, photodynamic therapy are the future, but they aren’t yet part of the traditional approach. They are available, though, through various clinical trials. Go to the National Cancer Institute website to see what is being offered.

Something could work. There is no universal therapy that works for everyone, but people respond differently to different treatments. Finding the right one sometimes takes the help of a friend.

Where to Turn for Treatment Help if You Have Mesothelioma

MEET GUEST BLOGGER Faith Franz.  Faith is a writer for the Mesothelioma Center. She combines her interests in whole-body health and medical research to educate the mesothelioma community about the newest developments in cancer care.  So without further ado, Faith’s article on “Where to Turn for Treatment Help if You Have Mesothelioma”.

 

When mesothelioma patients are first diagnosed with their cancer, they often confer with their general practitioner about what types of treatment to pursue. However, general practitioners are not usually familiar with treating diseases that relates to asbestos, so they will most commonly provide patients with information or referrals to mesothelioma specialists.

The first doctor that a mesothelioma patient should reach out to for assistance is their primary oncologist. The oncologist often serves as the head of the patient’s treatment team, and they are best able to coordinate the various branches of treatment.

An oncologist can provide referrals to other specialists who can discuss additional treatment options with the patient. These doctors may include:

  • Surgeons
  • Medical oncologists
  • Radiation therapists

Patients may also reach out to holistic medical practitioners for treatment. These doctors can practice a number of therapies, including homeopathy, acupuncture or massage.

Mesothelioma patients may also turn to a nutritionist for help constructing a diet that provides them with extra energy and vitamins during treatment.

Picking a Physician

Although there are a number of doctors who mesothelioma patients can turn to for treatment, not all doctors are equally equipped to handle the rare cancer. Across the United States, several doctors have emerged as leading mesothelioma specialists. David Sugarbaker, M.D., Robert Cameron, M.D., and Harvey Pass, M.D., are among the nation’s leading mesothelioma experts.

Several hospitals have also emerged as national leaders for mesothelioma treatment. These include Brigham and Women’s Hospital, Memorial Sloan-Kettering and the University of Chicago.

Because of the overwhelming nature of choosing a treatment plan, mesothelioma patients may be unsure of where to start in their search for health care. The Mesothelioma Center offers a free educational packet discussing the various types of treatment, and their Doctor Match Service can also connect patients with a leading doctor in their area.

Mesothelioma patients may also consider turning to support groups to help each other through treatment. Although information shared within a support group should never be regarded as medical advice, patients can benefit from hearing other patients’ testimonials. Support groups allow patients to help each other understand the experience that comes with a certain form of treatment and share recommendations for how to cope.