Mesothelioma Medical Terminology: Understanding Key Terms and Definitions
Mesothelioma is a rare and aggressive form of cancer that primarily affects the lining of the lungs, abdomen, and heart. It is mainly caused by exposure to asbestos, a naturally occurring mineral that has been widely used in construction, insulation, and other industries.
This comprehensive guide will provide an overview of the various treatment options for mesothelioma, along with insights into the latest research and clinical trials. The treatment of mesothelioma is complex and depends on various factors, such as the stage of the disease, the patient’s overall health, and the specific type of mesothelioma.
Diagnosis of Mesothelioma
Biopsy
To diagnose mesothelioma, a biopsy is the only way. The doctor removes a small portion of tissue for laboratory examination. The doctor selects the right biopsy procedure for the patient depending on the affected area of the body. The options include:
- Inserting a needle through the skin: The doctor removes fluid or a piece of tissue with a thin needle inserted through the skin on the chest or abdomen.
- Collecting a sample of tissue during surgery: A fluid or tissue sample might be collected during an operation. The surgeon might make a small incision and insert a tube with a video camera to see inside the chest or abdomen. Special tools can be passed through the tube to collect a tissue sample.
Determining the extent of the cancer
Once mesothelioma is confirmed, additional tests may be recommended by the doctor to determine whether the cancer has spread to the lymph nodes or to other areas of the body. Tests may include CT scans of the chest and abdomen, magnetic resonance imaging (MRI), and positron emission tomography (PET). The information from these tests is used by the doctor to assign the cancer a stage. The stages of pleural mesothelioma are indicated using Roman numerals ranging from I to IV. A lower numeral means the cancer is more likely to be localised to the area around the lungs, and the highest numeral means the cancer has spread to other areas of the body.
Treatment options for mesothelioma
Surgery
Surgery is one of the main treatment options for early-stage mesothelioma. In some cases, it can cure the cancer. However, most of the time, it is not possible to remove all of the cancer. Surgery may help reduce the signs and symptoms caused by mesothelioma spreading in the body. There are different surgical options available for mesothelioma, including:
- Surgery to decrease fluid buildup: Pleural mesothelioma may cause fluid to build up in the chest, making it difficult to breathe. Surgeons insert a tube or catheter into the chest to drain the fluid. Doctors may also inject medicine into the chest to prevent fluid from returning (pleurodesis).
- Surgery to remove the tissue around the lungs: Surgeons may remove the tissue lining the ribs and lungs (pleurectomy). This procedure may relieve the signs and symptoms caused by mesothelioma, but it won’t cure the disease.
- Surgery to remove a lung and the surrounding tissue: Removing the affected lung and the tissue that surrounds it may relieve the signs and symptoms of pleural mesothelioma. If radiation therapy is planned for the chest after surgery, this procedure also allows doctors to use higher doses since they won’t need to worry about protecting the lung from damaging radiation.
- Surgery for peritoneal mesothelioma: Peritoneal mesothelioma is sometimes treated with surgery to remove as much of the cancer as possible. Chemotherapy may be used before or after surgery.
Chemotherapy
Chemotherapy uses drugs to kill cancer cells. Systemic chemotherapy travels throughout the body and may shrink or slow the growth of mesothelioma that cannot be removed using surgery. Chemotherapy may also be used before surgery (neoadjuvant chemotherapy) to make an operation easier or after surgery (adjuvant chemotherapy) to reduce the chance that cancer will return. In the case of peritoneal mesothelioma, chemotherapy drugs may also be heated and administered directly into the abdominal cavity (intraperitoneal chemotherapy).
Radiation Therapy
Radiation therapy uses high-energy beams focused on a specific spot or spots on the body. Radiation may be used after surgery to kill any remaining cancer cells. It may also help reduce the signs and symptoms of advanced cancer in situations where surgery is not an option.
Targeted Therapy
Targeted therapy uses drugs that attack specific vulnerabilities in cancer cells. These drugs are not commonly used for treating mesothelioma, but doctors might recommend targeted therapy based on the results of tumor DNA testing.
Immunotherapy
Immunotherapy uses the body’s immune system to fight cancer. Cancer cells produce proteins that blind the immune system cells, preventing them from attacking the cancer. Immunotherapy works by interfering with that process. This treatment might be an option if other treatments are not working.
Clinical Trials
Clinical trials are studies of new mesothelioma treatment methods. People with mesothelioma may opt for a clinical trial for a chance to try new types of treatment. However, a cure is not guaranteed. Carefully consider treatment options and talk to a doctor about what clinical trials are open. Participation in a clinical trial may help doctors better understand how to treat mesothelioma in the future. Currently, clinical trials are investigating a number of new approaches to mesothelioma treatment, including new targeted therapy drugs and new approaches to immunotherapy.
Treatment for Other Types of Mesothelioma
Pericardial mesothelioma and mesothelioma of the tunica vaginalis are very rare. Early-stage cancer may be removed through surgery. Doctors have yet to determine the best way to treat later-stage cancers, though. Doctors may recommend other treatments to improve the quality of life.
Preparing for Treatment and Life Afterwards (Prehabilitation)
Before treatment, it’s important to take steps to maintain physical and mental wellbeing. Preparing for treatment, also known as prehabilitation or prehab, can help individuals feel more in control of their health.
Treatment Options for Pleural Mesothelioma
Treatment options for pleural mesothelioma include chemotherapy, radiotherapy, and surgery. The type of treatment recommended will depend on the stage of the cancer.
Treatment Options for Peritoneal Mesothelioma
Chemotherapy is a common treatment option for peritoneal mesothelioma. Surgery may also be considered in some cases.
Follow-Up and Survivorship Care
The Dana-Farber Cancer Institute’s Adult Survivorship Programme is a member of the LIVESTRONG Survivorship Centre of Excellence Network. The program provides clinical care and services for adult-onset cancer survivors. It also conducts research that focuses on finding solutions to key problems adult survivors may face after cancer treatment.
Conclusion
The treatment of mesothelioma requires a personalised approach that takes into account multiple factors. Patients with mesothelioma can achieve better outcomes and a better quality of life with the right care and support. It is essential to work closely with healthcare teams to develop a treatment plan that meets the patient’s needs and preferences.