The Latest Health News Extracts

We Show The Way, You Find All Info Easily!

Malignant Pleural Mesothelioma

The Latest Health Extracts From The World Of Research Via The Web

Patients with stage IV malignant pleural mesothelioma have cancer that is considered inoperable and has spread to the opposite side of the chest or to distant sites. Patients with recurrent or refractory malignant pleural mesothelioma have cancer that has failed primary treatment or recurred after an initial response. 45

The incidence of malignant pleural mesothelioma is increasing and is expected to peak in many developed countries in the next two decades. In 80% of the patients with malignant pleural mesothelioma there is a clear history of occupational or domestic exposure to asbestos. Very few patients are suitable for any potentially curative treatment and the effectiveness of radical therapy with surgery, radiotherapy and/or chemotherapy in curing patients or prolonging survival is uncertain. The role of radiotherapy is controversial. It has been used as a component of multimodal therapy (plus chemotherapy and/or surgery). To date the reviewers have not found any reports of randomised controlled trials (RCTs) that show that radiotherapy is an effective option for malignant pleural mesothelioma. There is a need for multicentre experimental studies assessing the role of radiotherapy in this disease. 2

The following is a general overview of treatment for stage IV or recurrent malignant pleural mesothelioma. Treatment may consist of surgery, radiation, chemotherapy, or a combination of these treatment techniques. In some cases, participation in a clinical trial utilizing new, innovative therapies may provide the most promising treatment. Circumstances unique to each patient?s situation may influence how these general treatment principles are applied and whether the patient decides to receive treatment. The potential benefits of multi-modality care, participation in a clinical trial, or standard treatment must be carefully balanced with the potential risks. The information on this website is intended to help educate patients about their treatment options and to facilitate a mutual or shared decision-making process with their treating cancer physician. 45

Radiation therapy is delivered to the site of mesothelioma from a machine outside the body, a technique that is called external beam radiation therapy (EBRT). Treatments are typically given daily over a 5-6 week period and additional concentrated radiation treatment, called a boost, may be given directly to a smaller area where the cancer was found. 32

Thirty-seven patients with biopsy-proven malignant pleural mesothelioma who underwent pleurectomy were identified from the files of the Division of Thoracic Surgery and the Department of Pathology at the University of California, San Francisco. In each case, the diagnosis was confirmed by a combination of clinical, histopathologic, and immunophenotypic methods. Cases were accepted as malignant mesothelioma if the clinical presentation and the tumor histopathology appeared consistent with the diagnosis and the tumor could be shown to express calretinin, but lack expression of CEA, LeuM1, and B72.3. In equivocal cases, electron microscopy was used to confirm the diagnosis. 37

Doctors classify pleural mesothelioma into 3 distinct categories: epithelioid, sarcomatoid, and mixed-type. Epithelioid is the most common, occurring in 60-70% of patients. However, it may be confused with another type of lung cancer called adenocarcinoma; therefore, special tests are necessary to confirm a diagnosis. The sarcomatoid type (10-20%) is the least common and most aggressive. Mixed-type (20-30%) shows features of both epithelioid and sarcomatoid.� Before considering treatment options, patients must have a confirmed diagnosis of mesothelioma and accurate staging of the disease performed. 33

The majority of patients with malignant pleural mesothelioma experience shortness of breath and a third of patients experience chest pain. Patients may also experience weight loss, cough, weakness, fever, and loss of appetite. A pleural effusion (fluid between the lungs and chest wall) is also present in the majority of patients.[2]� �Most patients have a significant history of asbestos exposure, which occurred 30-40 years prior to exhibiting signs of the disease. Men are three times more likely to have the disease than women because of work related exposure in high-risk occupations, such as mining, manufacturing, and ship construction. 33

Malignant pleural mesothelioma is a relatively uncommon disease, but the incidence is increasing and is expected to peak in many developed countries in the next two decades. The management of patients with malignant mesothelioma is controversial. Very few patients are suitable for any potentially curative treatment and the effectiveness of radical therapy with surgery, radiotherapy and/or chemotherapy in curing patients or prolonging survival is uncertain. The role of radiotherapy is controversial although it has been used as part of multimodal therapy. The present review will try to clarify these uncertainties. 2

The discomfort caused by the above symptoms can also result in loss of appetite and weight loss. Once mesothelioma is diagnosed, it’s important for patients to maintain good eating habits in order to better combat the disease. 11

One of the problems with radiation therapy for malignant pleural mesothelioma is that the cancer is usually widespread, requiring a large area to be radiated. The high doses of radiation necessary for eradication of disease may cause sunburn like changes to the skin, fatigue, and damage normal structures in the chest. 32

The development of more effective cancer treatments requires that new and innovative therapies be evaluated with cancer patients. Clinical trials are studies that evaluate the effectiveness of new drugs or treatment strategies. Future progress in the treatment of malignant pleural mesothelioma will result from the continued evaluation of new treatments in clinical trials. Participation in a clinical trial may offer patients access to better treatments and advance the existing knowledge about treatment of this cancer. Patients who are interested in participating in a clinical trial should discuss the risks and benefits of clinical trials with their physician. 32

All randomised controlled clinical trials using radiotherapy for malignant pleural mesothelioma in any stage, alone or combined with other therapies in patients of either sex and any age, were included. Studies without a control group were excluded. 2

The development of more effective cancer treatments requires that new and innovative therapies be evaluated with cancer patients. Clinical trials are studies that evaluate the effectiveness of new drugs or treatment strategies. Future progress in the treatment of stage IV malignant pleural mesothelioma will result from the continued evaluation of new treatments in clinical trials. Participation in a clinical trial may offer patients access to better treatments and advance the existing knowledge about treatment of this cancer. Patients who are interested in participating in a clinical trial should discuss the risks and benefits of clinical trials with their physician. 45

As radiotherapy has never been compared to chemotherapy or surgery or to best supportive care (as part of combination therapy) in a prospective, randomised trial, no data exist supporting one or the other treatment as a better option for patients with malignant pleural mesothelioma. There is a need for multicentre controlled randomised trials assessing the role of radiotherapy in the radical treatment of malignant pleural mesothelioma. The studies should be limited to patients with malignant pleural mesothelioma, classified by stage, cytology and type of radiotherapy. The type of radiotherapy should be defined in advance and variables of radiotherapy dose definition and delivery should be carefully controlled. 2

The Panacea offers these health-extracts to help people investigate health-related subjects in greater depth using the references given in each paragraph. Kindly note that these are current extracts from the web, meant for research, and that these are not meant to be medical advise. For all your health-related needs you must consult trained and licensed personnel.

Important posts in Cancer Related

comments

Leave a Reply