Mesothelioma is an uncommon form of cancer almost always linked with exposure to asbestos. It is sometimes referred to as asbestos cancer or shortened to "meso."
Asbestos is a carcinogenic fibrous substance that is naturally resists heat, fire and erosion. Because of its thermal properties, affordability, and availability, asbestos was added to thousands of construction and industrial products. Over the past century, millions of people worldwide have been exposed to asbestos either on the job, in the environment, or second hand.
Mesothelioma begins when asbestos becomes airborne and is inhaled or ingested into the body. Toxic fibers then become lodged in the lining of the heart, chest or abdominal cavities. Decades later, tumors form in the body's mesothelium (cancerous cells develop). Due to the long latency period and difficulty recognizing symptoms, the disease is usually not diagnosed until it has reached advanced stages. Median survival time is 16 months for patients with pleural mesothelioma and only 5 months for those with extensive disease.
Currently there is no known cure for mesothelioma and treatment options are limited for those with advanced disease. Because of this, interventions are generally not curative but focus on extending survival times and increasing quality of life. Front line therapy refers to the first kinds of medical interventions tried and are usually considered the standard clinical practice. Front line therapies for mesothelioma are surgical resection, chemotherapy and radiation therapy. An even more common practice is to combine two or more of these methods.
Surgery can include pleurectomy and decortications. Radiation therapy and chemotherapy often follow surgical intervention. Common chemotherapy agents used to treat mesothelioma are pemetrexed, cisplatin, carboplatin, doxorubicin, epirubicin, mitomysicn, cyclophosophamide and ifosfamide. Phase II clinical trials have shown success combining cisplatin and pemetrexed in chemotherapy-naive patients and this combination is now recognized as the preferred first line treatment for mesothelioma patients.
Surgery, chemotherapy and radiation treatments are generally palliative but do not result in extended survival times.
After initial front line treatments have been used, second line therapies can be tried. Clinical trials investigate second line treatments in hopes of finding more effective ways to fight or even cure mesothelioma. Second line treatments can take the form of new therapeutic drugs, new methods of surgery or radiation, or new combinations or continuations of previous front line approaches. Controlling symptoms or the disease by diet, exercise or alternative healing techniques are considered to be supplementary not front line or secondary methods of treatment.
Not all mesothelioma patients will be eligible for clinical trials researching new therapeutic interventions since they each have their own requirements. After completing standard treatments, patients who wish to participate in a clinical trial involving the use of second line treatments will need to see if they are eligible. Some eligibility requirements are whether the tumors are resectable, whether or to what extent patients have been pretreated with pemetrexed or other chemotherapy agents, and what type or stage of disease the patient currently has.
Second line treatments involving new chemotherapy drugs for mesothelioma are constantly being researched. As diagnostic methods improve and mesothelioma is being identified in earlier stages, second line therapies are increasingly being used for those patients who are still healthy at the time of diagnosis. New drugs, anti-angiogenic compounds, molecular antibodies and other alternatives are being tested worldwide. For best results, first and second line treatments should begin right away to achieve the most effective results.
If you or a loved one has been diagnosed with any type of mesothelioma or asbestos related disease, consult with your oncologist to see about any clinical trials you may be eligible to participate in. The National Cancer Institute website lists all past and current studies and is a great resource as well.
Sally Clapper is the public relations manager for the law firm of Clapper, Patti, Schweizer & Mason, mesothelioma lawyers that have given legal representation to people with mesothelioma for over a quarter of a century. The firm has several expert asbestos attorneys and is recognized as one of the leading plaintiffs' mesothelioma law firms in the nation.
