Tri-Modality Therapy
Doctors specializing in mesothelioma treatments frequently adopt a tri-modality approach in managing their patient's cancer. In cancer the term modality refers to major treatment catagories like surgery, chemotherapy or radiotherapy. The use of tri-modality therapy is due to the lack of effectiveness of single modality treatments in extending patient survival time. Tri-modality therapy for mesothelioma provides a combination of treatments that holds more promise of survival for mesothelioma patients. Studies are ongoing to determine if in fact tri-modality therapy is more effective.
Tri-Modality therapy involves a combination of chemotherapy, radiation therapy and surgical mesothelioma treatment. In some studies the average survival time for patients undergoing tri-modality therapy is up to 22 months.
Chemotherapy
Chemotherapy uses drugs to kill or prevent cancer cells from multiplying throughout the body. Researchers are also studying the effectiveness of delivering chemotherapy directly into the chest (intrapleural chemotherapy) or abdomen (intraperitoneal chemotherapy). Historically, doxorubicin has been the most widely used chemotherapy drug by oncologists.
Radiation Therapy
Radiation therapy uses energy to kill mesothelioma cancer cells. Similar to chemotherapy, the radiation not only attacks cancer cells but also attacks healthy cells inside the body. However, the healthy cells are better able to repair themselves and so far more cancer cells die than healthy cells. Radiation therapy on its own has not been effective in enhancing the survival time in mesothelioma patients, but radiation therapy has caused the cancerous tumors to reduce in size.
Surgery
Mesothelioma surgical procedures are used either to remove a cancerous tumor or to alleviate pain and suffering from the cancer. If the cancer is relatively contained, surgery can be used to remove part of the lining of the chest or abdomen. The main objective of the surgery is to remove the largest amount of cancer cells from the body; this is called debulking. Two types of mesothelioma surgeries are extrapleural pneumonectomy and pleurectomy.
Extrapleural pneumonectomy is the surgical removal of a lung, a portion of the pericardium (the sac covering the heart), the diaphragm and the pleura (the lining of the lungs). This operation is the best option when a tumor is located in the middle of the lung and also involves a portion of the pulmonary artery or veins. However, this surgery is risky, as the patient's breathing capacity will be diminished. Extrapleural pneumonectomy is a procedure that surgeons consider as a last option for the patient. Most surgeons first consider performing a pleurectomy as a form of treatment.
Pleurectomy is a more complicated surgical procedure, involving the removal of the pleura while preserving the lungs. Complete surgical removal of the cancerous tumor is unlikely when this procedure is performed. A pleurectomy will reduce the pain caused by the tumor mass and prevent the recurrence of pleural effusion. This surgery is generally considered to be palliative, that is, a pleurectomy decreases the discomfort but is not a cure of the disease.
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