Progress And Challenges With Treating Mesothelioma
Nowadays, asbestos is a well-known carcinogen thanks to years of effort from environmental health experts and concerned union leaders. However, there was a time when people were unaware of the dangers of asbestos.
History of Mesothelioma Treatment:
Pleural mesothelioma is a rare form of cancer. Therefore, doctors were unable to diagnose it in the beginning. Doctors initially believed that pleural cancer is secondary to primary cancer in the body. Fortunately, by the 1900s, the medical community agreed that cancer originates in the pleura. In the 1960s, doctors began to research the connection of asbestos with mesothelioma.
The fundamental issue with pleural mesothelioma is that patients experience symptoms after several years of working near asbestos. Therefore, most patients suffer from end-stage mesothelioma when they think about consulting a doctor. By then, it is too late.
What are the symptoms of mesothelioma?
Mesothelioma is a type of cancer that develops in the lining of an organ. It may affect the lungs, the lining of the tummy, or the heart.
There are several types of mesothelioma, including peritoneal mesothelioma and pleural mesothelioma. The symptoms of mesothelioma are unique for each category.
For example, symptoms of malignant peritoneal mesothelioma include digestive problems and bloating. Patients suffering from pleural mesothelioma complain of difficulty breathing.
Surgery:
In the 1940s, doctors began treating mesothelioma with surgical intervention. Initially, doctors used pneumonectomy and pleurectomy. However, in the 1960s, doctors developed a new method. The process is the decortication procedure, which is still in use.
Later in the 1970s, doctors experimented with extrapleural pneumonectomy. However, the mortality rate was 31 percent. With time, the mortality rate dropped to 4 percent.
Chemotherapy:
Doctors introduced chemotherapy drugs to treat mesothelioma in the 1990s. In the beginning, doctors offered doxorubicin and cisplatin. However, by 2003 41.3 percent of trials of cisplatin and pemetrexed were successful. Nowadays, patients use a combination of doxorubicin, cisplatin, and pemetrexed.
Radiation therapy:
Since the 1950s, doctors are experimenting with radiation therapy. They use the intrapleural instillation of colloidal gold for mesothelioma. By 2001, phase II clinical trials of radiation therapy after EPP surgery had promising results.
Current treatment and challenges:
Currently, doctors use an established treatment method for mesothelioma called trimodal. Treatment options include surgery, radiation, and chemotherapy. Sugarbaker introduced this intervention method in the 1990s. Scientists have not been able to improve the treatment method in the past two decades.
The treatment method has several complications. Pleural mesothelioma affects the lining of the lungs. Within a few years, the tumor spreads to the other parts of the body. The disease is challenging to diagnose, aggressive, and sometimes impossible to treat with surgery.
Most patients with mesothelioma cannot opt for surgical intervention. Therefore, doctors recommend a chemotherapy combination of cisplatin and pemetrexed.
Managing mesothelioma is a challenging task for doctors. The long latency period between when a patient gets in contact with asbestos and the development of symptoms is decades-long. So, the primary challenge is that the diagnosis occurs when the situation is dire.
Secondly, mesothelioma is a rare disease with innocuous symptoms. Therefore, patients often get a misdiagnosis of pneumonia. And even when oncologists recognize mesothelioma as cancer, they may misdiagnose it as lung cancer. Issues in the diagnostic process waste precious time of the patients.
Lastly, mesothelioma is an aggressive disease. It spreads quickly and complicates treatment plans. Most patients develop multiple small tumors which are inoperable. Later symptoms include chest pain and difficulties in breathing. However, patients have to manage these issues along with slowing cancer growth. Juggling both these tasks is a complicated maneuver.
These challenges reduce life expectancy outcomes for mesothelioma patients. But, new treatments and procedures are giving people hope for a better tomorrow.
Prospective treatments:
Technology is helping doctors improve cancer research. Robotics, AI, and Gene therapy have revolutionized cancer research.
Gene therapies:
With gene therapy, researchers can add new genes to cancerous cells and make them easier to destroy. Researchers use viruses to deliver new components. For example, gene therapy can help stimulate the immune system of the patient to kill cancerous cells.
Suicide gene therapy is another type of targeted chemotherapy. However, unlike chemotherapy, suicide gene therapy only targets cancer cells. The cells produce an enzyme that makes chemotherapy drugs toxic to cancerous cells.
Immunotherapy:
A recent treatment, immunotherapy, is helpful for cancer intervention. Oncologists boost the immune system to destroy cancer cells. They also inject components to target tumors.
Clinicians are currently testing atezolizumab on patients with pleural mesothelioma. It blocks the receptor protein and prevents cancerous cells from affecting the immune system. The treatment aggressively uses immunotherapy, along with the trifecta of chemo, surgery, and radiation.
Personalizing treatment:
Scientists in the University of Leicester, United Kingdom, are introducing a personalized approach towards cancer treatment. They examine patient’s DNA and match therapies according to individual needs since the one-size-fits-all approach is not working.
Conclusion:
There is hope that we are at the brink of a cure for mesothelioma. Medical research has improved over the past few years. Many researchers are still working on the issue and introducing better therapies to target cancerous growth. Nowadays, doctors understand mesothelioma better and are looking for palliative care. Oncologists are also recommending psychosocial care for mesothelioma patients.
