Abdominal Mesothelioma Treatment
Researchers and doctors are working together to improve the treatment of mesothelioma. The most commonly used treatment options comprise radiation, surgery, and chemotherapy.
Doctors diagnose peritoneal mesothelioma with an examination of the body and a tissue sample. A surgeon inserts a needle under the skin of the chest or abdomen and collects tissue or fluid to be tested.
Cytoreduction
Cytoreduction is the most effective treatment for patients with peritoneal msothelioma. During this procedure, surgeons remove the lining of the abdominal cavity, as well as any visible tumors or cancerous tissue. Doctors perform this surgery through an incision made in the belly button or by making small incisions on the abdomen. The surgery can take up to 12 hours. It is often performed with HIPEC which is a process that involves heated chemotherapy drugs being circulated in the abdominal cavity after surgery.
HIPEC is a specialized mesothelioma therapy that is only available at specialized centers. It can improve the patient's outlook dramatically. However, it's not a good fit for every mesothelioma patient, particularly patients with advanced stage cancer.
Mesothelioma specialists employ a medical test to determine if a patient is eligible for this treatment. They will make use of the CT scan and biopsy results to determine how far the cancer has spread inside the body. They will then determine if the patient is a candidate for cytoreduction with HIPEC.
Doctors may also include chemotherapy systemic to the surgical plan. This is typically done before cytoreductive surgery, or within the first month after the procedure. After this type of treatment for mesothelioma patients are not allowed to return to their jobs for at least six weeks.
Doctors may need to combine five surgical procedures in the process of cytoreduction to completely eliminate mesothelioma cancer cells. They will also need to remove any dead mesothelioma tumor and the fluid. To access the peritoneal area, doctors will perform laparotomy or a open abdominal surgery. They may also have to undergo a different procedure, such as a colectomy or bowel resection.
A study published in the Journal of Gastrointestinal Surgery revealed the delay in mesothelioma surgeries and HIPEC could cause a decrease in the long-term survival rate. The researchers recommend that patients who have peritoneal mesothelioma be given immediate referral to a center which offers this procedure. The authors also suggest that health insurance companies offer coverage for this procedure for mesothelioma patients. In some instances, veterans are able to get this treatment through VA benefits.
Hyperthermic intraperitoneal chemotherapy (HIPEC).
HIPEC is a cytoreduction surgery that involves heating chemotherapy to eliminate cancerous cells left after surgery. During this procedure surgeons insert catheters into the abdomen and connect them to an infusion pump that circulates the drug solution into and from the patient's body. The procedure can last between 30 minutes and 120 minutes. During treatment, the doctors rock back and forth the abdomen of the patient to ensure the medicine reaches every inch of the cavity. When the chemotherapy is completed the doctors will remove the body of the fluid and then stitch the wound and transport patients to a hospital for intensive care.
Doctors utilize a combination chemotherapy drug during HIPEC. This includes carboplatin, doxorubicin and cisplatin. They can also utilize different types of chemotherapy drugs, based on the stage and type of the mesothelioma. Additionally, they may alter the dosages of these drugs to improve their effectiveness. During the HIPEC treatment, the surgical team will carefully examine the patient's blood pressure and temperature to ensure that these crucial body functions don't suffer.
In HIPEC the surgeons also use mesothelioma treatments a cooling device to keep the patient's temperature. This is vital, as high temperatures can cause adverse effects and toxicity of certain chemotherapy drugs.
As part of a multimodal approach HIPEC has demonstrated promising results for mesothelioma patients. It can increase survival rates by a significant amount, especially for younger patients with less invasive tumors. It can also help treat malignant ascites, the build-up of fluid within the abdominal cavity which can be caused by some types of mesothelioma. It is a very invasive procedure and should only be performed by mesothelioma specialists in university centers. Patients should be aware that this kind of treatment can take months to be completed. During this period patients must get plenty of sleep and follow the recommendations of their treatment team to help promote healing and avoid any complications. They should also exercise within their limits, and eat a healthy diet to aid their body in recovering.
Therapy with a specific goal
Mesothelioma is a cancer that is found in the thin layer of tissue that covers the majority of your organs. It affects the tissue lining your abdomen and chest (peritoneum). Mesothelioma typically occurs in the pleura, which covers your lungs. However, it may also develop in the peritoneum that surrounds the testicles or your heart. Exposure to asbestos fibers can cause mesothelioma decades before symptoms develop.
The symptoms include abdominal pain swelling, weight loss, the accumulation of fluid in the abdomen (ascites), and fatigue. The majority of sufferers experience these symptoms for a few months before their doctor determines that they have mesothelioma.
There are a variety of treatments for peritoneal sarcoidosis, but targeted therapy seems to be the most promising. This kind of treatment is aimed at the genetic mutations responsible for mesothelioma. These drugs can destroy cancerous cells, without harming healthy cells.
Your doctor will determine if you are eligible for targeted treatment through biopsies or analyzing the results of other tests. They will then check whether your tumor is a carrier of the molecular targets that the medication is intended to target. This can be accomplished with blood tests as well as a tumor sample computed tomography scans.
If doctors find a target, they will match that with one of a variety of targeted therapies. These drugs destroy cancerous cells, stop them from growing, or tell them to self-destruct. They can be taken in pill form or delivered through an intravenous drip.
Targeted therapy is often utilized in conjunction with other treatments such as surgery and radiation. In some instances it is possible to use it in combination with immunotherapy agents like Yervoy, Opdivo or Tecentriq. These medicines can stimulate your immune system, and help it fight the cancer.
Your doctor will set up regular appointments to check the progression of your treatment. They will run blood and X-rays to assess your condition and assess how well the targeted treatment is effective. They'll also inquire about how you're managing any adverse effects from the medication. The doctors will decide whether you should continue with targeted therapy or change to a different medication.
Therapy with radiation
The tissue that covers the lungs, the pleura, or the abdomen, peritoneum, is the most frequently encountered place where mesothelioma begins. The cancer starts to grow and spread once symptoms begin to show. The disease is more common for those who were exposed to asbestos during their work.
Mesothelioma is typically diagnosed in its later stages, after the patient has persistent symptoms that could be caused by another disease or condition. Mesothelioma treatment is designed to reduce the tumor while ensuring that symptoms are under control.
Doctors use a system called the peritoneal cancer index, to determine how advanced the patient's mesothelioma. The system divides an abdomen into 13 sections, and assigns a numerical value (0-3) depending on the size of the tumor. The doctors then add the numbers in order to determine the mesothelioma stage. Stage 1 indicates the least advanced mesothelioma. Stage 4 is the most advanced.
Doctors also look at the size and extent of the primary tumor when determining whether there is a peritoneal msothelioma. They also consider whether the cancer has gotten to the lymph nodes or other organs, also known as metastasis.
In general the greater the size of mesothelioma that a person has is, the worse their chances of survival. There are a variety of treatment options that can help improve the quality of life for patients.
Finding a mesothelioma expert with experience is the first step to making sure that you have a positive outlook. The specialist can determine the most appropriate treatment for a patient's stage and mesothelioma-cell type.
Another treatment option is targeted therapy, which uses drugs to kill cancer cells or stop them from growing and spreading. These medications can be taken in pill form or administered intravenously. The targeted therapy can be utilized alone or in combination with other treatments.
At UPMC, doctors also offer an innovative surgical procedure called HIPEC. This procedure involves a surgeon taking out visible mesothelioma tumors in and around the abdominal cavity. Then, they inject a mixture of heated chemotherapy into the abdomen. The aim of HIPEC is to eradicate any mesothelioma traces that remain.
Mesothelioma treatment is most effective when it starts immediately. People with peritoneal mesothelioma should seek out an experienced mesothelioma surgeon to set up a consultation.