Mesothelioma is a rare form of cancer caused by exposure to asbestos. Because of this association it is sometimes referred to as asbestos cancer and sometimes the name is shortened to "meso."
Asbestos is a carcinogenic fibrous substance that is naturally resists heat, fire and erosion. Because of its thermal properties, affordability, and availability, asbestos was added to thousands of construction and industrial products. Over the past century, millions of people worldwide have been exposed to asbestos either on the job, in the environment, or second hand.
Mesothelioma is caused when airborne asbestos fibers are inhaled or ingested into the body. Once asbestos has entered the body, fibers become lodged in the linings of the lungs, heart or abdomen. Anywhere from 10 to 40 years later, cancerous cells develop in the protective sac linings, or mesothelium. Due to the delay between exposure and diagnosis and difficulty identifying symptoms, mesothelioma is often not diagnosed until it has reached later stages. By this time, prognosis is usually poor, with a median survival time of less than a year.
Treatment options for advanced mesothelioma are limited, and currently there is no known cure. Treatments are intended to extend survival times and increase quality of life, but not to cure. Front line therapy is the standard types of treatments usually tried first. Standard treatments used for mesothelioma patients generally include surgery, chemotherapy and radiation. Most often, two or more methods are combined.
Surgery can include pleurectomy and decortications. Radiation therapy and chemotherapy often follow surgical intervention. Common chemotherapy agents used to treat mesothelioma are pemetrexed, cisplatin, carboplatin, doxorubicin, epirubicin, mitomysicn, cyclophosophamide and ifosfamide. Phase II clinical trials have shown success combining cisplatin and pemetrexed in chemotherapy-naive patients and this combination is now recognized as the preferred first line treatment for mesothelioma patients.
The focus of all front line therapies and combinations thereof is not necessarily to extend survival times or cure mesothelioma, but to alleviate pain and tumor burden.
Second line treatments are used after front line approaches have been attempted. Second line treatments are usually the focus of clinical trials being performed to find more effective approaches to fighting or curing cancer. Second line treatments often involve new anti-cancer drugs, new approaches to surgery or radiation, and/or new combinations or methods. Although helpful, diet, exercise, and alternative healing modalities are generally referred to as supplementary but not second line treatments.
Whether patients qualify for second line treatments depends on certain conditions that differ depending on the clinical trial being performed. Mesothelioma patients looking for therapies after they have tried standard treatments will need to look at the requirements to see if they are eligible. Examples of conditions to qualify are whether surgery can be performed, whether patients have been pre-treated with pemetrexed, and what type or stage of mesothelioma the patient has.
Second line treatments involving new chemotherapy drugs for mesothelioma are constantly being researched. As diagnostic methods improve and mesothelioma is being identified in earlier stages, second line therapies are increasingly being used for those patients who are still healthy at the time of diagnosis. New drugs, anti-angiogenic compounds, molecular antibodies and other alternatives are being tested worldwide. For best results, first and second line treatments should begin right away to achieve the most effective results.
To find out more about current clinical trials investigating both front and second line treatments, consult with your oncologist or mesothelioma specialist to see if you qualify to participate. The National Cancer Institute website is also a good resource and lists all past and current studies of second line mesothelioma treatments.
Sally Clapper is the publicist the law firm of Clapper, Patti, Schweizer & Mason, mesothelioma attorneys that have given legal representation to people with mesothelioma for over a quarter of a century. The firm has several expert asbestos lawyers and is recognized as one of the leading plaintiffs' mesothelioma law firms in the nation.
