Abdominal Mesothelioma Treatment
Doctors and researchers are working together to improve the treatment of mesothelioma. The most commonly used treatment is surgery, radiation therapy and chemotherapy.
Doctors diagnose peritoneal mesothelioma using an examination and tissue sample. A surgeon inserts an needle into the chest's skin or abdomen to collect fluid or tissue.
Cytoreduction
For patients with peritoneal cancer who are eligible for surgery, cytoreduction is the best treatment. In this procedure, doctors remove the lining from the abdominal cavity, as well as any visible tumors or cancerous tissue. Doctors perform this procedure through an incision in the belly button, or through small incisions on the abdomen. The surgery can last up to 12 hours. It is often performed with HIPEC which involves heating chemotherapy drugs being circulated through the abdominal cavity following surgery.
Cytoreduction in conjunction with HIPEC is a complex mesothelioma treatment that is only available through mesothelioma centres. It can improve the prognosis of a patient enormously. However, it's not the best choice for all mesothelioma patients, particularly for those who have advanced stage cancer.
Mesothelioma specialists employ a medical test to determine whether the patient is a candidate 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. Then, they will determine whether the patient is eligible for HIPEC cytoreduction.
Doctors can also add systemic chemotherapy into the surgical plan. This is usually performed prior to cytoreductive surgery, or within the first month after the operation. Patients should not return to work for at least six weeks following this type of mesothelioma treatment.
Doctors may need to combine five surgical procedures during cytoreduction to completely remove mesothelioma cancer cells. They will also need to remove any mesothelioma cells and any fluid. To access the peritoneal area, doctors will perform a laparotomy or an open abdominal surgery. It is also possible to perform a different procedure for example, a colectomy or bowel resection.
A study recently published in the Journal of Gastrointestinal Surgery found that mesothelioma patients who delay cytoreductive surgery and HIPEC results in reduced long-term survival rates. The researchers suggest that patients with peritoneal mesothelioma receive immediate referral to a center which offers this procedure. The authors also recommend that health insurance companies cover this surgery for patients suffering from mesothelioma. In some instances veterans can get this treatment through VA benefits.
Hyperthermic intraperitoneal chemotherapy (HIPEC)
As part of surgical cytoreduction, HIPEC involves bathing the abdomen with heated chemotherapy to kill any cancerous cells that remain after surgery. In this procedure surgeons insert catheters into the abdomen and connect them to an infusion pump that circulates the drug solution into and from the body of the patient. The procedure typically lasts between 30 and 60 minutes. During treatment, doctors rock back and forth the abdomen of the patient to ensure that the medicine is absorbed into every inch of the cavity. After the chemotherapy is finished the doctors will remove the body of the fluid and then stitch the wound and transport patients to intensive care.
Doctors utilize chemotherapy drugs in combination during HIPEC. This includes carboplatin, doxorubicin and cisplatin. Depending on the type of drug and stage, they may also utilize a different kind of chemotherapy drug. They may also adjust dosages to improve their effectiveness. During HIPEC, the surgical team will monitor the patient's temperature and blood pressure to ensure these vital body functions aren't impaired.
During HIPEC, the surgeons will also utilize cooling equipment to keep the patient's internal temperature steady. This is important because the high levels of heat increase the toxicity of certain chemotherapy drugs.
As part of a multimodal approach, HIPEC has produced promising results for patients with mesothelioma. It can improve survival rates by a significant amount in younger patients and those with smaller tumors. It can also be used to treat malignant ascites - an accumulation of fluid within the abdominal cavity caused by certain mesothelioma types. It is however an extremely invasive procedure that should only be performed in a university center with mesothelioma specialists who are experienced. Patients should be aware that treatment could take a few months. During this time patients must get plenty of sleep and follow the recommendations of their treatment team to help promote healing and avoid any complications. Patients should also remain active within their limits and eat an appropriate diet to aid their body in recovering.
Targeted therapy
Mesothelioma, a cancerous tumor that develops in an extremely thin layer of tissues covering most of your internal organs. It affects the lining around the abdomen and chest. Mesothelioma is most often found in the pleura surrounding your lungs, however it can also manifest in the peritoneum that surrounds your testicles or the heart. Exposure to asbestos fibers can cause mesothelioma decades before symptoms develop.
Symptoms of peritoneal mesothelioma include abdominal pain, swelling in the abdomen and weight loss, a buildup of fluid in the abdomen (ascites) and fatigue. The majority of patients experience these symptoms for several months before their doctor diagnoses mesothelioma.
There are a number of treatment options for peritoneal mesothelioma however targeted therapy is the most promising. This type of treatment is aimed at the genetic mutations responsible for mesothelioma. These drugs can destroy cancerous cells, without harming healthy cells.
Your doctor will determine whether you are eligible for targeted treatment through a biopsies or checking the results from other tests. They will then determine whether your tumor is a carrier of the molecular targets the drug is specifically designed to target. This can be accomplished with blood tests or a sample of your tumor, or computed (CT) scans.
If doctors identify a target they'll match it with one of the many targeted treatments. These treatments can prevent cancerous cells from growing, or instruct them to self-destruct. They can be taken as pills or delivered through an mesothelioma life expectancy with treatment intravenous drip.
Targeted therapy may be used on its own or with other forms of treatment including radiation and surgery. In some cases it can be paired with immunotherapy agents like Yervoy Opdivo and Tecentriq. These medications can activate your immune system and aid in fighting cancer.
Your doctor will set up regular appointments to monitor your progress. They will evaluate your condition by conducting blood tests and X-rays and determine the effectiveness of the targeted treatment has been. They will also ask how you're handling any side effects from the medication. The doctors will decide whether you should keep taking targeted therapy or switch to a different drug.
Radiation therapy
The tissue that protects the lungs, the pleura, or the abdomen, peritoneum, is the most frequent site where mesothelioma develops. The cancer begins to develop and spread when symptoms appear. The disease is more common for those who were exposed to asbestos while at work.
Mesothelioma is typically diagnosed in the advanced stages, when the patient experiences persistent symptoms that could be caused by a different illness or condition. Mesothelioma treatments aim to control the tumor and keep symptoms under control.
Doctors utilize the peritoneal Cancer Index to determine the size of mesothelioma in a patient. The system divides an abdomen into 13 sections and assigns a numerical number (0-3) according to the size of the tumor. The doctors then add the numbers in order to determine the stages of mesothelioma. Stage 1 indicates the least advanced mesothelioma. Stage 4 is the most advanced.
Doctors also take into consideration the size and size of the primary tumor when determining whether peritoneal msothelioma is present. They also take into consideration whether the cancer has reached the lymph nodes and other organs, which is known as metastasis.
In general the greater the size of a person's mesothelioma is, the more difficult their outlook. There are a variety of options for treatment that can improve the quality of life of patients.
The first step towards an optimistic mesothelioma outlook is finding an experienced mesothelioma specialist. The specialist can determine the most effective treatment for a patient's cancer stage and mesothelioma-cell type.
Another treatment option is targeted therapy, which employs drugs to kill cancerous cells or stop them from spreading. The medications can be taken as pills, or administered intravenously. It can be used alone or with other treatments.
At UPMC, doctors also offer a cutting-edge surgical technique called HIPEC. The procedure involves a surgeon eliminating visible mesothelioma cancers in the abdominal cavity as well as the surrounding areas. Then, they inject a mixture of chemotherapy heated into the abdomen. The purpose of HIPEC is to eradicate any mesothelioma-like traces that remain.
Mesothelioma treatment is most effective when it begins as soon as it is possible. Patients with peritoneal mesothelioma must consult an experienced mesothelioma cancer oncologist to set up a consultation.