Standard
Treatment
Surgery, radiation therapy, and
chemotherapy are the standard
ways to treat cancer, and mesothelioma
is no exception. Treatment of
cancer by some combination of
these methods is called multimodality
therapy.
Surgery is exactly what it sounds
like: Surgical removal of tumors
and cancerous cells. In theory,
cancer can be completely cured
by removing every cancerous cell
from the body, but unless the
cancer is highly localized, it
is impossible to accomplish this
through surgical means alone.
Surgery can be risky. For example,
one operation that is sometimes
performed on early-stage sufferers
of mesothelioma, called extrapleural
pneumonectomy, increases chances
of disease-free survival, but
kills six to thirty percent of
patients. This makes the operation’s
overall efficacy difficult to
gauge. Surgery is nonetheless
usually the first step in cancer
treatment, and can be followed
by radiation, chemotherapy, or
nonstandard treatments (discussed
in the next section.)
Radiation therapy refers to any
attempt to kill cancer cells with
ionizing radiation. Since radiation
is harmful to the body, the tumor
is specifically targeted with
a focused beam of radiation. The
procedure is not painful. Radiation
damages the DNA of cells, impeding
their ability to reproduce. Radiation
therapy can be used even when
there is no hope of a cure, because
it can help slow the spread of
the disease and provide symptomatic
relief. Unfortunately, there are
numerous side effects, including
soreness over the affected area,
nausea, vomiting, and, ironically,
a chance of introducing secondary
cancers.
Chemotherapy refers to the use
of chemical substances to treat
cancer. Most chemotherapy drugs
work by impeding mitosis, or cell
division, which affects cancer
more than other cells because
cancerous cells divide rapidly.
In some cases, other drugs can
be taken to help shield healthy
cells from the effects of chemotherapy.
Unfortunately, despite such precautions,
chemotherapy tends to affect other
rapidly-dividing cells as well,
such as hair cells. This is why
many patients of chemotherapy
suffer hair loss. Other side effects
can include nausea, diarrhea,
and suppression of the immune
system.
On the standard treatment front
of the battle against mesothelioma,
there is good news and bad news.
The bad news is that mesothelioma
is unusually resistant to standard
treatment. Post-surgical radiation
and chemotherapy have not improved
chances of survival. Radiation
therapy is particularly ineffective.
The good news is that that may
be changing. There is a new chemotherapy
drug on the market, which is specifically
designed for mesothelioma. This
drug is called pemetrexed, and
it is being marketed under the
brand name Alimta™.
In 2002, researchers announced
that patients on a chemotherapy
regimen that included pemetrexed
experienced twenty-five to thirty
percent improved survival over
those taking the then-standard
chemotherapy regimen. Tumors shrank
in forty-one percent of pemetrexed
users, compared with only seventeen
percent in the control group,
and the pemetrexed users lived
an average of three months longer.
In 2004, the FDA approved the
drug for the treatment of mesothelioma.
It is important to be cautious
and informed before taking any
chemotherapy drug. Pemetrexed
may cause sterility and birth
defects. It may interact harmfully
with other drugs and foods. Side
effects may include sores around
the mouth, nausea, vomiting, decreased
red and white blood cell count,
diarrhea, constipation, loss of
appetite, difficulty breathing,
and in rare cases, severe allergic
reaction. There may also be side
effects that the patient is unable
to detect, such as changes to
the blood cells. These “invisible”
side effects must be monitored
by a physician.
Most people do not experience
many of these side effects, and
side effects can be reduced with
daily doses of folic acid and
vitamin B12, with occasional steroid
tablets. It is also essential
to begin taking folic acid several
days before treatment begins.
Abstract on
radiation treatment
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