Abdominal Mesothelioma Treatment
Researchers and doctors are working together to improve treatment of mesothelioma. The most commonly used treatment is radiation therapy, surgery and chemotherapy.
Doctors can diagnose peritoneal mesothelioma by a physical exam and a tissue sample. A surgeon inserts an needle into the chest's skin or abdomen to collect tissue or fluid.
Cytoreduction
Cytoreduction is the most efficient treatment for patients with peritoneal mesothelioma. In this procedure, doctors remove the abdominal lining cavity as well as any visible cancerous tissue or tumors. Doctors perform this surgery through an incision in the belly button, or through small incisions on the abdomen. The procedure can last up to 12 hours. The procedure is usually performed with HIPEC which is a process that involves chemotherapy drugs heated and circulated within the abdominal cavity following surgery.
Cytoreduction using HIPEC is a mesothelioma treatment only available through mesothelioma centres. It can dramatically improve the patient's prognosis. It is not suitable for all mesothelioma patients particularly those with advanced cancer.
Mesothelioma specialists use a medical test to determine whether an individual is suitable for this treatment. They will make use of the CT scan and biopsy results in order to determine how far the cancer has spread throughout the body. They will then determine if the patient is suitable for cytoreduction using HIPEC.
Doctors may also include systemic chemotherapy to the surgical plan. This is typically performed prior to chemotherapy or cytoreductive procedures, or within the first few weeks following the procedure. Following this type of treatment for mesothelioma patients are not allowed to return to work for at least six weeks.
In the course of cytoreduction, doctors might need 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. To reach the peritoneal area doctors will have to perform a laparotomy or open abdominal surgery. They may need to resort to a different procedure, such a bowel resection or colocectomy.
A study published in the Journal of Gastrointestinal Surgery revealed that delaying mesothelioma surgery and HIPEC can result in a lower long-term survival rate. Researchers recommend that patients with Adenocarcinoma of the peritoneal region be immediately referred to a center offering this treatment. The authors also suggest that health insurance providers cover this surgery for patients suffering from mesothelioma. Veterans may be able to benefit from this procedure through VA benefits.
Hyperthermic intraperitoneal chemotherapy (HIPEC)
As a part of surgical cytoreduction, HIPEC involves bathing the abdominal cavity with a heated chemotherapy to destroy any cancerous cells that remain after surgery. In this procedure surgeons insert catheters in the abdomen and connect them to a perfusion pump that circulates the drug solution to and out of the patient's body. The process can last anywhere between 30 and 120 minutes. During treatment, doctors will move back and forth on the patient's abdomen to ensure that the medicine is absorbed into every part of the cavity. When the chemotherapy is completed and the patient is cured, doctors will drain the body of fluid, stitch the surgical wound and transport patients to a hospital for intensive care.
Doctors use a combination chemotherapy drug in HIPEC. This includes carboplatin, doxorubicin and cisplatin. Depending on the type of drug and stage, they might also employ a different type of chemotherapy drug. In addition, they can adjust the dosages of these drugs to improve their effectiveness. During the HIPEC treatment the surgical team will check the patient's blood pressure and temperature to ensure that these crucial body functions are not affected.
In HIPEC, the surgeons will also utilize cooling systems to ensure that the patient's temperature remains constant. This is important, as high temperatures can increase the toxic effects and side effects of chemotherapy drugs.
HIPEC as part of a multimodal treatment approach has produced promising results in mesothelioma. It can increase survival rates by a significant amount, especially in younger people with smaller tumors. It can also be used to treat malignant ascites - a fluid buildup in the abdominal cavity that is caused by mesothelioma of various types. However, it is an extremely invasive procedure that should only be performed in a university center with experienced mesothelioma specialists. Patients should also be aware that this type of treatment could take months to be completed. In this time patients must take their time sleeping and follow the recommendations of their medical team to aid in healing and to avoid complications. They should also stay active within their limits, and eat nutritious food to help their body recover.
Therapy with a specific goal
Mesothelioma is a cancer that develops in the thin layer of tissue that covers most of your organs. It affects the tissues of your abdomen and chest (peritoneum). Mesothelioma is typically located in the pleura that surrounds your lungs, but it can also be found in the peritoneum that surrounds your testicles or the heart. Exposure to asbestos fibers can cause mesothelioma decades before symptoms develop.
The symptoms of peritoneal cancer include abdominal pain, swelling in the abdomen and weight loss, the accumulation of fluid in the abdomen (ascites) and fatigue. Most patients experience these symptoms for several months before their doctor determines that mesothelioma is the cause.
There are a variety of treatments for the peritoneal sarcoidosis. However, targeted therapy appears to be the most promising. This kind of treatment targets genetic mutations that cause mesothelioma. These medications can kill cancerous cells without harming healthy cells.
Your doctor will determine whether you qualify for targeted treatment through biopsies, or by reviewing the results of other tests. They will also determine whether your tumor is a carrier of the molecular targets that the treatment is intended to target. This can be accomplished with blood tests as well as a tumor sample computed tomography scans.
If treatment mesothelioma discover an area of interest, they'll match it with one of several targeted therapies. These treatments can prevent cancerous cells from growing, or instruct them to self destruct. These drugs can be taken in the form of pills or delivered via an intravenous drip.
Targeted therapy can be used on its own or with other types of treatment, including surgery and radiation. In some cases it can be combined with immunotherapy drugs like Yervoy Opdivo and Tecentriq. These medications can activate your immune system and aid it fight the cancer.
Your doctor will set up regular appointments to check on your development. They will run blood and X-rays to check your condition and see how well the targeted therapy is working. They will also ask you what you are doing to manage any adverse effects of the medication. The doctors will determine whether you should keep taking targeted therapy or switch to a different medication.
Therapy with radiation
Mesothelioma can start in the tissue that covers the lung (pleura) or, less often, in the tissues in the abdomen (peritoneum). The cancer starts to grow and spread when symptoms appear. The disease is more common for those who were exposed to asbestos during their work.
Mesothelioma is usually diagnosed in the advanced stages, when the patient experiences persistent symptoms that can be caused by a different disease or condition. Mesothelioma treatments aim to manage the tumor and keep symptoms under control.
Doctors employ a method known as the peritoneal cancer index, to determine how advanced a person's mesothelioma has become. The system divides an abdomen into 13 sections, and assigns a numerical value (0-3) in accordance with the extent of the tumor growth. The doctors then add up the numbers in order to determine the mesothelioma stages. Stage 1 is the smallest advanced mesothelioma stage. Stage 4 is the most advanced stage.
For peritoneal mesothelioma, doctors also consider the size of the primary tumor as well as how much it has spread. 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 extensive the mesothelioma. There are many treatments that can improve the quality of life of patients.
The first step in obtaining an optimistic mesothelioma outlook is to locate a mesothelioma expert specialist. The specialist can determine the best treatment for a patient's cancer stage and mesothelioma cell type.
Another option for treatment is targeted therapy, which uses drugs to kill cancerous cells or stop them from growing and spreading. These medications can be taken in pill form or intravenously. The targeted therapy can be utilized on its own or in conjunction with other treatments.
At UPMC doctors also provide the most cutting-edge surgical procedure known as HIPEC. This procedure involves a surgeon removing visible mesothelioma tumors in and around the abdominal cavity. Then the chemotherapy is heated and pumped into the abdomen. The aim of HIPEC is to eliminate any microscopic traces of mesothelioma that remain.
The best way to treat mesothelioma is to begin immediately. People with peritoneal mesothelioma should seek out an experienced mesothelioma surgeon to set up a consultation.