Radiation, Immunotherapy, Chemotherapy & Surgery:-
though surgery can be done in order to treat mesothelioma, but surgery results always turn out to be a bit disappointing. For patients with localized disease, and who can tolerate a radical surgery, radiation can be given after an operation or as a consolidative treatment. The entire hemi-thorax is treated with radiation therapy, often together along with chemotherapy. Even the treatment regimens involving immunotherapy have yielded variable results.
Lung Cancer Treatment for Mesothelioma
Chemotherapy is the only treatment for mesothelioma that has been proven to improve survival of the patients suffering mesothelioma in randomized and controlled trials.
Heated Intraoperative Intraperitoneal Chemotherapy:-
This technique is used in a conjugate manner along with surgery, both in patients with malignant & pleural forms.
The surgeon removes as much of the tumor as he can remove followed by the direct administration of a chemotherapy agent, heated to between 40 and 48°c, in the abdomen.
Then the fluid is perfused for 60 to 120 minutes and then drained in a vessel. Higher amounts of selected drugs are then allowed being administrated into the abdominal and pelvic parts. Heating the chemotherapy treatment increases the involvement of the drugs into tissues. Also, heating itself ruptures the malignant cells more than the normal cells.
All of the ways to treat solid tumors, radiation, chemotherapy, and surgery ,have been tried on in patients with malignant pleural mesothelioma. Surgery, is not very effective in this disease. Surgery along with adjuvant chemotherapy and radiation has produced significant survival extension which is about 3–14 years among the patients of mesothelioma with favorable prognosis ways. However, other large series of examining multimodality treatment have only demonstrate its modest improvement in survival ,median survival 14.5 months and only 29.6% surviving 2 years. The instructions ton perform these operations are unique. The size of the developed tumor determines the choice of operation.
Tumor volume has been known as a prognostic factor in mesothelioma. Pleurectomy decortication spares the underlying lung and is performed in patients with early stage disease when the intention is to remove all gross visible tumor, not simply palliation.
Extrapleural pneumonectomy is a more outer operation that includes resection of the parietal and visceral pleurae, underlying lung, ipsilateral diaphragm, and ipsilateral pericardium. This operation indicates for a subset of patients with more advanced tumors, who can tolerate a pneumonectomy.
Reducing the bulk of the tumor with cytoreductive surgery is key to extending survival. Two surgeries have been developed: extrapleural pneumonectomy and pleurectomy/decortication.