With no cure in sight for mesothelioma, hope for patients rests in improving treatment.
“Is there a cure? No,” says Neil Schachter, MD, medical director of respiratory care and a professor of pulmonary medicine at the Mount Sinai Medical Center in New York City. “There are some promising avenues of research going on now, but mesothelioma is a terrible disease with a poor prognosis, though there are some brighter areas in the field.”
Bartolome R. Celli, MD, chief of pulmonary care at St. Elizabeth’s Medical Center in Boston, adds that early detection coupled with surgical intervention can extend patients’ lives. “Unfortunately, there is no real cure,” says Dr. Celli. “Some mesothelioma cases caught early can have extensive resection [surgical removal] of pleura [lung and chest lining] and lung with some survival benefit.”
Mesothelioma: The Types
There are different types of mesothelioma, but they are all treated the same way. Statistics differ, but in general, more than 2,000 people in the United States develop mesothelioma each year.
Malignant pleural mesothelioma is the most common type of mesothelioma. People with this disease generally do not survive a long time; five years after diagnosis, only about 10 percent are still alive.
Mesothelioma: Standard Treatments
Mesothelioma remains a challenging disease to treat. Standard mesothelioma treatment options depending on a patient’s age and health condition and include:
- Surgical removal of some of the chest or abdomen lining, and even a lung and part of the diaphragm
- Radiation targeting specific problem areas
- A combination of the three
Mesothelioma: Bright Spots
But there are some bright spots on the treatments landscape.
- Direct chemotherapy delivery. Researchers are investigating chemotherapy treatments that are delivered right into the malignant site. Typically, chemotherapy is given intravenously.
- New uses for older drugs. Newer mesothelioma treatments also include combinations of older drugs. “People are working on available treatments to see if they can be refined,” says Dr. Schachter.
- Neoadjuvant therapy. With this therapy, chemotherapy used to shrink a tumor is given before surgical treatment instead of afterward, which has been the norm.
- Anti-growth factors. These treatments are also designed to cause tumors to shrink, says Schachter. These are being tested in animal models and preliminarily in people to see how toxic they are, “but I don’t think we’re anywhere near being able to use [this treatment method] therapeutically.”
Biologic therapy or immunotherapy. Another type of treatment being tested is biologic therapy, which can refer to the introduction of a bacterial, viral, or blood product for the treatment of a disease. In mesothelioma, biologics are being used to stimulate a patient’s immune system to fight cancer. Other types of biologic treatment attempt to decrease blood flow to the tumor, starving the cancer of what it needs to grow larger and spread.
Mesothelioma: Theories and Reality
“There are also some theoretical things out there,” Schachter says. “For example, there’s a virus implicated in the disease. It doesn’t necessarily cause the disease, but if you could treat it in at-risk workers, then you might be able to prevent some of these tumors — that’s the theory.”
But at the moment, Schachter says, the only treatment plan that increases life expectancy is surgery first, with chemotherapy and radiation. However, this only applies to a small proportion of the patients diagnosed with mesothelioma, Schachter says. “You have to be strong to undergo that, and then you’re left with only one lung.”