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There are several types of treatment available for patients with mesothelioma, some recommended more frequently than others. The most commonly-used treatments are surgery, chemotherapy, and radiation therapy. In addition, some experimental treatments are becoming more widely used, or are showing some encouraging results in clinical trials. These treatments include photodynamic therapy, gene therapy, and immunotherapy. Most of these treatments are not used in isolation. In many cases, treatment may consist of a combination of therapies. For example, surgery to remove as much of the cancer as possible may be followed by radiotherapy or chemotherapy to remove residual cancer cells. This is one of the most common treatment options for mesothelioma among those who are candidates for surgery. Surgery Surgical treatments for mesothelioma are of three main types - diagnostic surgery, curative surgery, and palliative surgery. Some types of surgery fall into more than one category. For example, thoracentesis may be used as a diagnostic procedure, and as a palliative treatment to provide symptomatic relief. Only curative surgery can potentially remove all cancer from a patient with mesothelioma. However, for curative surgery to be effective, it is particularly important that mesothelioma be diagnosed as early as possible. Unfortunately, mesothelioma is usually not diagnosed until it reaches Stage III or IV and surgery is not an option. Chemotherapy Most forms of chemotherapy involve the intravenous administration of drugs such as Alimta and Cisplatin. Chemotherapeutic drugs are targeted to kill cells that are rapidly dividing by interfering with processes that occur during cell division. However, while cancer cells themselves divide rapidly, so do some types of healthy cells, causing some of the unpleasant side effects that are often associated with this form of treatment. Though chemo drugs of old seemed to do little to fight mesothelioma, newer chemotherapy drugs are showing much promise. A relatively new form of chemotherapy called heated chemotherapy is an option for patients with peritoneal mesothelioma. This treatment is carried out following surgery, and involves the perfusion of heated chemotherapeutic drugs into the peritoneum. Radiation Radiation therapy, or "ionizing radiation", is used to kill cancer cells and to limit the spread of cancer. For patients with mesothelioma, radiation therapy is most often used in conjunction with surgery. However, in some cases radiation may be used as a stand-alone treatment to relieve pain and other symptoms associated with mesothelioma. In either case, however, it is rare for radiation therapy to provide more than short-term symptomatic relief. Mesothelioma patients may receive one of two types of radiation therapy, depending on whether or not they are suitable candidates for either procedure. External beam radiation therapy is the traditional type of radiation therapy, where tumors are bombarded with beams of radiation to kill cancer cells. Brachytherapy is a newer type of radiation treatment. It involves tiny radioactive rods which are implanted within a tumor to provide a strong, concentrated dose of radiation to tumors while doing very little damage to surrounding healthy tissue. Photodynamic Therapy Photodynamic therapy is a highly specialized and specific form of treatment that is most often used to treat skin cancers, and some types of lung cancer, including pleural mesothelioma. However, this treatment is usually unsuitable for patients with metastasized cancer; it is most effective in patients who have localized disease. This type of therapy involves the use of light energy to kill cancer cells. In a photodynamic therapy treatment, the patient is given an intravenous solution of a drug that makes cancer cells highly sensitive to a particular kind of light. One to three days after this treatment, the patient is exposed to the light, and cancer cells that have absorbed the drug are killed. Gene Therapy Gene therapy involves using genetic material to specifically target cancer cells and make them more vulnerable to chemotherapy treatment. The main type of gene therapy being developed for use in mesothelioma patients is called "suicide gene therapy", because it forces cancer cells to produce substances that kill them. When undergoing this type of gene therapy, the patient is treated with a non-infectious virus that has been altered with genetic material that makes them produce a particular protein. Following this procedure, the patient is then treated with a chemotherapeutic drug that is specially formulated so that it is toxic only to cancer cells. This type of therapy has produced some promising results for mesothelioma patients, but it is still only available through clinical trials. Immunotherapy is a type of treatment in which the patient's own immune system is 'tricked' into killing cancer cells. A healthy, normally-functioning immune system does not kill cancer cells, because even though these are diseased cells, the immune system is unable to recognize them as being harmful. There are two main types of immunotherapy - active, and passive. In active immunotherapy, mesothelioma cancer cells are removed from a patient and then treated in a laboratory to turn them into a vaccine. Following this laboratory treatment, the patient is injected with the vaccine and if the treatment is successful, the patient's immune system recognizes the vaccine as a harmful substance, thus recognizing the cancer as being harmful as well. Passive immunotherapy is somewhat different in that it does not attempt to activate the patient's immune system. Instead, it uses substances such as cytokines - molecules that direct and regulate the immune system - and other agents to help boost the patient's immune response to their cancer. |