Abdominal Mesothelioma Treatment
Researchers and doctors are trying to improve the treatment for mesothelioma. Most commonly, treatment includes radiation therapy, surgery and chemotherapy.
Doctors can diagnose peritoneal mesothelioma by an examination of the body and a tissue sample. A surgeon inserts a needle into the skin of the chest or abdomen and collects fluid or tissue for testing.
Cytoreduction
For patients who have been diagnosed with peritoneal cancer who are able to undergo surgery for cytoreduction, it is the most effective treatment. During this procedure, surgeons remove the abdominal cavity's lining, as well as any visible tumors or cancerous tissue. The procedure is performed by an incision in the belly button or through small incisions around the abdomen. The surgery can take up to 12 hours. It is often paired with HIPEC, which involves heated chemotherapy drugs being circulated in the abdominal cavity after surgery.
HIPEC is a mesothelioma treatment only available in special centers. It can improve the prognosis of a patient dramatically. However, it's not a suitable option for all mesothelioma patients, especially for patients with advanced stage cancer.
Specialists treating mesothelioma will use medical exams to determine whether a patient is able to. They will make use of the results of a CT scan and biopsy results to see how far the mesothelioma spread throughout the body. They will then determine whether the patient is an ideal candidate for cytoreduction treatment using HIPEC.
Doctors may also include chemotherapy for systemic use to the surgical plan. This is typically done prior to chemotherapy or cytoreductive procedures, or within the first few weeks after the surgery. Patients are not allowed to return to work for a minimum of six weeks after this type of mesothelioma treatment.
During cytoreduction, doctors may have to combine up to five surgical procedures in order to completely eliminate mesothelioma cancer cells. They'll also have to remove any dead mesothelioma tumor and the fluid. In order to reach the peritoneal space doctors will have to perform laparotomy or a open abdominal surgery. It is also possible to use another procedure, like a colectomy, or bowel removal.
A study recently published in the Journal of Gastrointestinal Surgery found that a delay in mesothelioma cytoreductive surgery and HIPEC results in lower long-term survival rates. Researchers suggest that patients suffering from Adenocarcinoma of the peritoneal region be immediately referred to a center offering this treatment. In addition, the authors recommend that health insurance companies offer coverage for this procedure for mesothelioma patients. Veterans may be able to benefit from this procedure through VA benefits.
Hyperthermic intraperitoneal chemotherapy (HIPEC).
As a part of cytoreduction surgery, HIPEC involves bathing the abdomen with heated chemotherapy to kill any cancerous cells that are left after surgery. During this procedure surgeons insert catheters into the abdomen and connect them to a perfusion pump that circulates the solution of chemotherapy to and from the body of the patient. This process lasts anywhere between 30 minutes and 120 minutes. During the treatment, doctors will move the patient's body from side to side to ensure that the medication is absorbed into all areas of the abdominal cavity. When the chemotherapy is completed the doctors will remove the body of the fluid and stitch the surgical wound, and then transport patients to intensive care.
Doctors usually use a mix of chemotherapy drugs during HIPEC which includes carboplatin, cisplatin and doxorubicin. They may also employ different types of chemotherapy drugs, depending on the stage and type of the mesothelioma. They can also adjust the dosages to increase their effectiveness. When performing HIPEC the surgical team will keep track of the patient's temperature and blood pressure to ensure that these vital body functions aren't impaired.
During HIPEC, the surgeons will also employ cooling systems to maintain the patient's internal temperature constant. This is essential because high levels of heat can increase the toxicity of certain chemotherapy drugs.
HIPEC as part of a multimodal treatment approach has produced promising results in mesothelioma. It could boost the chance of survival by a significant amount for younger patients and those with smaller tumors. It is also used to treat malignant ascites which is a fluid buildup in the abdominal cavity caused by certain types of mesothelioma. It is however an extremely invasive procedure that should only be performed in university centers with mesothelioma specialists who are experienced. Patients should be aware that this kind of treatment could take months to complete. In this period, patients should ensure they have plenty of sleep and follow the guidelines of their medical teams to aid in healing and avoid complications. Patients should also remain active within their limits, and eat a healthy diet to help their body recover.
Therapy with a specific goal
Mesothelioma, a tumor that is cancerous is formed in a thin layer of tissue that covers the majority of your internal organs. It affects the tissue lining your chest and abdomen (peritoneum). Mesothelioma is typically located in the pleura that surrounds your lungs, however it can also manifest in the peritoneum around your testicles or the heart. Exposure to asbestos fibers can cause mesothelioma decades before symptoms develop.
The symptoms include abdominal pain, swelling and weight loss, accumulation of fluid in the abdomen (ascites), and fatigue. Most patients have these symptoms for several months before their doctor diagnoses mesothelioma.
There are many treatments for peritoneal mesothelioma, however targeted therapy is the most promising. This type of treatment works by targeting the genetic mutations that cause mesothelioma. These drugs eliminate cancerous cells without harming healthy cells.
Your doctor will determine if are eligible for targeted therapy by performing an examination of the biopsy or by examining the results of other tests. They will then determine whether your tumor has the molecular targets that the medication is designed to target. This can be determined using blood tests as well as a tumor sample computed tomography scans.
If doctors discover a target they will match that with one of the many targeted treatments. These drugs can stop cancer cells from growing or telling them to self destruct. These drugs can be taken in the form of pills or delivered via an intravenous drip.
Targeted therapy is usually used in combination with other treatments such as surgery and radiation. In some cases it is possible to use it in combination with immunotherapy agents such as Yervoy, Opdivo or Tecentriq. These drugs can activate your immune system to help fight cancer.
Your doctor will schedule regular appointments to observe the progress of your treatment. They will conduct blood tests and X-rays to check your condition and assess how the targeted therapy is effective. They will also ask how you are handling any adverse effects of the medication. The doctors will decide if you need to continue with targeted therapy or switch to a different medication.
Therapy with radiation
Mesothelioma may begin in the tissue that covers the lungs (pleura) or less frequently in the tissues that line the abdomen (peritoneum). The symptoms appear when the cancer begins to spread and grow. The disease is most common for those who were exposed to asbestos during their work.
Mesothelioma usually manifests in later stages and is diagnosed when patients experience persistent symptoms, which could be caused by other illnesses or conditions. Mesothelioma treatments aim to reduce the tumor and keep symptoms under control.
Doctors use a system called the peritoneal cancer index to determine how advanced a patient's mesothelioma. The system divides the abdomen into 13 sections and assigns a number (0-3) based on the amount of tumor growth. Doctors then add the numbers to determine the mesothelioma stage. Stage 1 is the least advanced mesothelioma stage. Stage 4 is the most advanced.
Doctors also take into consideration the size and size of the primary tumor when determining if peritoneal msothelioma is present. They also consider whether the cancer has spread to lymph nodes or to other organs. This is called metastasis.
In general the worse the prognosis, the more severe mesothelioma. However, there are many treatment options available to help improve the patient's quality of life.
Finding a reputable mesothelioma specialist is the first step in achieving a positive prognosis. This specialist can determine the most effective treatment based on the type of cancer a patient has and stage.
Another treatment option is targeted therapy, which employs drugs to kill cancer cells or stop them from growing and spreading. These drugs are administered via an intravenously administered pill or a tablet. The targeted therapy can be utilized as a stand-alone treatment or in conjunction with other treatments.
At UPMC doctors also offer a cutting-edge surgical technique called HIPEC. This procedure involves a doctor removing visible mesothelioma tumours within the abdominal cavity and surrounding areas. Then the chemotherapy is heated and pumped into the abdomen. The purpose of HIPEC is to eliminate any microscopic traces of mesothelioma that remain.
Mesothelioma treatment is most effective when it begins as soon as it is possible. Patients suffering from peritoneal mesothelioma should seek out an experienced mesothelioma surgeon to set up a consultation.