Mesothelioma and General Health

The incidence of malignant pleural mesothelioma is increasing and is expected to increase in many developed countries over the next two decades. In 80% of patients with malignant pleural mesothelioma, no clear history of occupational or domestic exposure to asbestos. Very few patients are suitable for any potentially curative treatment is uncertain and the effectiveness of treatment with radical surgery, radiotherapy or chemotherapy in curing patients or prolonging survival. The role of radiotherapy is controversial. It has been used as a component of combination therapy (with chemotherapy or surgery). To date, the reviewers have not found any reports of randomized controlled trials (RCTs) that show that radiotherapy is an effective option for the treatment of malignant pleural mesothelioma. Experimental studies are needed to assess the role multicentre radiotherapy in this disease.

Background

Malignant pleural mesothelioma is a relatively uncommon disease, but its incidence is increasing and is expected to increase in many developed countries over the next two decades. Treatment of patients with malignant mesothelioma is controversial. Very few patients are suitable for any potentially curative treatment is uncertain and the effectiveness of treatment with radical surgery, radiotherapy or chemotherapy in curing patients or prolonging survival. Although radiation therapy has been used as part of combination therapy, its role is controversial. This review will try to clarify these uncertainties.

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According to experts, the best treatment for mesothelioma is one that combines surgery with intraperitoneal quimiohipertermia. While this scheme is very aggressive treatment, the results of experiments show that the 4 yrs of being audited and subjected to therapy, patients have a survival of 67%. And what is more surprising, 61% of them have no traces of the disease. These results are well above the expectation of survival and cure the old strategies that had the tumor.

The surgery can take between 14 and 16 hours, and is of significant complexity. According to the specialist Marcello Deraco, Tumor Institute of Milan (Italy), the drawing can be done entirely peritonectomy the tumor or at least leaving a residue that can be attacked after the intraperitoneal quimiohipertermia. The latter objective is to eliminate any free tumor cells in the abdomen. This special type of chemotherapy offers the possibility of using the dual effect of high temperature. On the one hand, the heat itself is active against neoplastic cells, and promotes entry into the cells of certain drugs and their anticancer activity. On the other, allows to use the cancer drugs in doses well above those supplied by the intravenous route, and minimizing adverse effects.

The pleura is a membrane lining inside the chest and all the organs found inside. It consists of two layers, the parietal pleura in contact with the rib cage and visceral pleura in contact with the organs of the chest.

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• Most patients tire easily after their first radiotherapy treatment. This gradually increases fatigue and may be severe and limit the ability to do normal daily activities. Fatigue typically yields one or two months after completing radiotherapy. If you feel fatigue is important to rest enough, but perhaps your doctor tells you to do as much activity as possible.

• Some patients lose their hair on the chest wall area included in the radiation field. This effect may be temporary or permanent, depending on the amount of radiation received.

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Stage 1 :

Standard :

1. Solitary mesothelioma:

En bloc surgical resection including adjacent structures to ensure comprehensive disease-free margins. Sessile polypoid lesions should be treated with surgical resection to ensure maximum healing potential.

2. Mesothelioma intracavitary :

A. Palliative surgery (pleurectomy and decortication) with or without postoperative radiotherapy.

B. Extrapleural pneumonectomy.

C. Palliative Radiotherapy.

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