Treatment - Surgery

In some cases, surgery may be indicated to alleviate symptoms or slow the progression of mesothelioma. Surgery may be performed in tandem with other treatments such as chemotherapy and radiation, also known as “multi-modal therapy.”

Whether a surgery is recommended in your case will depend on factors unique to your situation, including the type and location of the cancer, the “stage” of the cancer, and your overall health. Of course, whether your doctor recommends surgery in your case will depend on factors individual to your case.

Pleural Mesothelioma Surgeries

Thoracentesis

This procedure involves the draining of fluid that may build up (called a “pleural effusion”) in the chest between the lung and the pleura. A tube is placed in the chest in order to drain out the fluid. Thoracentesis is a “palliative” treatment, meaning that its purpose is to help relieve discomfort.

Pleurodesis

Pleurodesis is a surgical procedure to help control pleural effusion, which is the buildup of fluid between the lungs and the lung lining. Pleurodesis closes the space between the lung and the lung lining, reducing the chance for fluid to accumulate.
There are two approaches to performing a pleurodesis. In the first, a tube that is inserted into the chest drains the excess fluid. After this fluid is drained, a schlerosing agent (a substance that causes tissue to scar or harden), such as sterile talc powder, is injected through the chest tube and into the pleural space. The schlerosing agent is allowed to distribute itself through the pleural space, with the patient being asked to move about in order to facilitate the distribution. Once the agent is distributed, suction is applied to the tube in the chest. Similar to collapsing a plastic bag, the suction brings the two pleural surfaces together, allowing them to “scar” together.

The second method of pleurodesis uses thoracoscopy, whereby a small incision, or a series of small incisions, are made in the skin. A thoracoscope is passed through the incision in order to get a better look at the pleura. The schlerosing agent is then applied to the area.

Pleurectomy/Decortication

Pleurectomy/decortication involves removing the pleura, where most of the tumor is located. This procedure may help control pleural effusions (fluid build-up) and help to decrease the pain caused by the tumor. It is a palliative treatment, meaning that its goal is to help to lessen the discomfort caused by mesothelioma.

Pneumonectomy

A pneumonectomy is the removal of all or part of the lung. Your surgeon will make an incision in the side of the chest. When the lung is revealed, the surgeon visually assesses the tumor and decides how much tissue should be removed.

Extrapleural pneumonectomy

This extensive surgery usually involves the removal of the pleura, pericardium, diaphragm, and the whole lung on the side of the cancerous tumor. Your surgeon may decide to remove some of the surrounding tissues, as well.

Peritoneal Mesothelioma Surgeries

Paracentesis

Peritoneal mesothelioma can cause fluid to build up in the abdomen in a process called peritoneal effusion. This excess fluid is drained through a needle and tube inserted into the abdomen. Paracentesis (sometimes called an “ascitic tap”) can help take the pressure off the internal organs, and also helps reduce the risk of infection that may be caused by the fluid buildup. This is a “palliative” procedure, meaning that the goal of paracentesis is to help to relieve the discomfort associated with peritoneal mesothelioma.

Peritonectomy

A “peritonectomy” involves removing the peritoneum, the lining of the abdomen where the mesothelioma first develops. This form of surgery is most often used when the cancer is detected in the very early stages of the disease. Your surgeon might recommend that a peritonectomy be performed in tandem with “intraperitoneal hypothermic perfusion,” a form of heated chemotherapy where the chemotherapy drugs are administered directly into the abdomen during and/or after surgery.

Cytoreductive (or “debulking”) surgery

During cytoreductive or debulking surgery, the surgeon opens the abdominal cavity (a procedure known as a “laparotomy”) to look for all signs of cancer and attempt to remove as much of the tumor as possible. This surgery can be quite long in duration because of the amount of detail the surgeon must use to search for and remove signs of cancer in the abdominal area. Your surgeon might recommend that this surgery be performed in tandem with “intraperitoneal hypothermic perfusion,” a form of heated chemotherapy administered into the abdominal cavity.

Pericardial Mesothelioma Surgeries

Pericardiocentesis

This is the process for drawing fluid out of the affected area to help to relieve the discomfort associated with pericardial mesothelioma. For this procedure, a needle is inserted into the pericardium (the sac around the heart) to drain the fluid and relieve circulatory problems. The draining of this fluid can be associated with complications, however.

Extrapleural pneumonectomy

An aggressive surgery also used in appropriate situations to treat pleural mesothelioma, an extrapleural pneumonectomy involves removal of the pleura, diaphragm, pericardium, and the entire lung on the side of the tumor.

Coping With Cancer

When you hear that you have been diagnosed with cancer, your first inclination will probably be that your “normal” life is about to change, and in some respects, this may be true. You will have to come to terms with your diagnosis in your own mind, and then tell family and friends. There will be appointments to keep, treatment decisions to make and medical bills to pay. Familiar routines may become disrupted or absent altogether. How you successfully contend with these difficulties, or how you “cope”, can be one of the most important steps you will take in maintaining a positive outlook on life.

The first step in making your life “normal” again is to realize that you will most likely cope with your mesothelioma in the same manner you have handled other aspects of your life. The person you have always been, whether laid back or in control, is the person you will continue to be. You will learn to substitute new roles for lost ones, and will continue to adapt to the changes life will bring your way.

In this section, three areas in which you will use your coping skills will be discussed. These include:

Emotional Coping

When you are facing a serious illness, your emotions can play an important role in how you feel about life, and these emotions can extend to your family and friends as well. You can minimize the impact by understanding that your feelings are normal, and then by moving ahead and becoming proactive in your treatment and care.

Physical Coping

Many people think of coping as only an emotional process, but dealing with treatment regimens and their potential side effects, as well as quality of life concerns must also be addressed. While you can’t control the fact that you have been diagnosed with mesothelioma, you can learn to minimize its effects on your health and wellness.

Financial Coping

Serious illnesses like mesothelioma can deplete your life savings quickly. Most cancer treatments such as surgery, chemotherapy and radiation can be costly, and because of the rarity of mesothelioma, you may feel you want to travel to a specialist for a second opinion or for treatments not available in your local area. By being aware of the financial resources available, including compensation from the asbestos industry, you can help ease the stress on yourself and your family and, therefore, maintain control over your life.

Mesothelioma Legal Advice

Mesothelioma was recognized as a legitimate cause of death by the US government in 1989 and consequently commercial use of asbestos was banned. It was done after numerous researches unquestionably proved that mesothelioma is a deadly cancer caused by asbestos exposure. For people who are suffering from mesothelioma, the good news is that now they can get compensated for all their medical expenses and treatment. But, it is not as easy as it sounds. You cannot fight the legal battle on your own for you will require a professional, experienced and a reputable mesothelioma lawyer to help you fight your case and get you fair compensation from the responsible source of asbestos exposure.

In case you decide to not go for a full fledged legal battle your lawyer can also assist you in getting an out of court settlement from the liable asbestos source. To file a case against the offender, you need to have a number of evidences with you which will make your lawsuit strong. This evidence may be your employment record with a company, your medical reports proving mesothelioma as well as witnesses who can testify for you.

Mesothelioma patients or their family members can file a claim against the negligent employers who did not ensure protective workplace safety measures against an asbestos filled environment. The compensation thus obtained can help the patient with the treatment and medical bills and it can help make up for some of the anguish and distress which the patients and their families suffer. Check out the articles in our mesothelioma legal advice for sound lawful advice before you file your mesothelioma compensation case.

Is Mesothelioma a sleeping dragon?

Mesothelioma is caused by exposure to asbestos. Asbestos is a substance found naturally. It is made of strong flexible fibres. It was used extensively in industry because the fibres are not affected by heat or chemicals and a poor conductor of electricity. It is estimated that over 5,000 products have or had asbestos in them.

Of the six types of asbestos, only four are used commercially. These are chrysotile, crocidolite, amosite and anthrophyllite. Of these, crysotile or white asbestos accounts for 99% used in USA. In it natural state or well contained and maintained in products, asbestos do not pose a real hazard. It is when asbestos is broken down and fibres are released that there is concern.

Asbestos fibres are very thin and sharp. The fibre is 2,000 times thinner than a human hair. It measures under 0.3 microns or one millionth of a millimetre in diameter and five microns in length. It is not visible with the naked eye or through a microscope.

When released, the fibres remain in the atmosphere for a long time and can be carried great distances. When the fibres are inhaled, they stick to the lung tissue and are not expelled by breathing out or coughing. Some remain in the lungs, others gravitate into the pleural lining.

Asbestos exposure can lead to disease and develops over a long period of time. Asbestos related diseases are asbestosis, pleural plaques and lung cancers. The lung cancer can be either cancer of the lung itself or mesothelioma, a cancer of the lung lining. These cancers can take between 20 and 50 years to develop.

A recent article in a UK Newspaper highlighted the case of a Hospital Consultant who developed mesothelioma. He cannot recall any exposure to asbestos. It may well be that he was inadvertently exposed to asbestos without his knowledge i.e. such as living in the vicinity of a factory that leaked asbestos into the atmosphere.

Professor Peto has shown that new cases of mesothelioma will continue to increase in the early part of the twenty first century. He also said, "Every single person in the UK has asbestos in their lungs. It is the level of exposure that is important."

We also know that people who has a history of asbestos exposure has a greater risk of lung cancer if they smoked. In a survey in 1992, 2602 individuals with lung cancer were interviewed. One in eight was exposed to asbestos and of these a third still smoked. A US study suggested that non-smokers exposed to asbestos have a five times greater risk of lung cancer. If they smoked, then the risk increased by a factor of 11. Smoking and asbestos exposure increases the risk of developing lung cancer to 52 times that of the general population.

At present no one knows how many lung cancers are due to asbestos exposure because of the long latency period and that cigarette smoking remains the major cause. Mesothelioma, however, is caused by asbestos exposure and this has been the basis of numerous high value legal claims.

As for the future, in the USA and Europe, asbestos related diseases will gradually increase to a peak. Of concern, however, are areas of conflict. In the Middle East, when a building was bombed, or when numerous buildings were bombed during the invasion of Iraq, do we have any idea how much asbestos was released into the atmosphere?

We are, however, certain that during the 9/11 disaster, asbestos fibres were released. When the Twin Tower collapsed, there were 400 tons of asbestos in the structure. The toxic cloud that hung over Manhattan, contained high level of asbestos. It is estimated that over 100,000 people suffered asbestos exposure. The greatest exposure was amongst first responders. Deborah Reeve was the first to die from asbestos related disease after 9/11. She was a first responder and paramedic. She died in March 2005 from mesothelioma. This concerned experts because mesothelioma takes a very long time to develop. They concluded that her exposure must have been excessive.

A study result showed that 70% of recovery and rescue workers who were active during and after the World Trade Centre collapse had some form of respiratory problem. A six year follow up study showed that sufferers with respiratory problems continue to have the same ailments.

"In the six years since the attacks," Nadler said, "We have accumulated a mountain of evidence that thousands of those exposed are suffering from chronic respiratory disease and, increasingly, a variety of rare cancers."

Hopefully, as experts predict, within the next few years asbestos related diseases will peak and the annual new cases will drop. If not, could it be a sleeping dragon about to wake up?

Article Source: ArticlesMaker.com

About the Author: Dr. Phil Hariram is a retired General Practitioner. He has treated various medical conditions. His website on asbestos and mesothelioma is intended to help anyone who is looking for comprehensive information on the asbestos related diseases. Visit his website: http://www.themesothelioma-info.com and learn about this very serious condition.

Symptoms of Mesothelioma

Mesothelioma has a poor prognosis, especially since by the time the doctor has determined a patient has mesothelioma, the cancer has progressed greatly. The symptoms of mesothelioma are common with other types of health conditions. Unless the doctor is aware that someone was exposed to asbestos, he or she will not necessarily be looking for mesothelioma. Being exposed to asbestos is the only known manner of contracting this cancer.

Symptoms of mesothelioma will vary based on the type of mesothelioma, the progression of the cancer, the location of the tumor, the health status of the patient, and so on. A person can experience symptoms such as back aches and muscles aches. Their breathing can be interrupted or the patient can experience shortness of breath in general. Other symptoms could be a bad cough that persists for a prolonged period, chest pain, weight loss, or general fatigue. Again, unless the doctor is aware there has been exposure to asbestos, these symptoms can be a result of numerous health conditions, which may not lead to a clear diagnosis.

What's the treatment for mesothelioma?

Like most cancers, the outlook for recovery (prognosis) for people with mesothelioma depends on when the disease is diagnosed and how aggressively it is treated. The treatment plan depends on the stage and location of the cancer, as well as the age and desires of the patient. Treatment for mesothelioma depends on the location of the cancer, the stage of the disease, and the patient's age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined.

Surgery is a common treatment for mesothelioma. Before any surgery is considered for the treatment of malignant mesothelioma, the patient's overall health has to be evaluated. Tests are done to make sure the cancer has not spread to distant sites, and to evaluate how well the patient's lungs and heart are functioning. Lung tests look for any signs of lung damage from tobacco or from other diseases, including asthma and chronic obstructive pulmonary disease (COPD). These tests determine how risky surgery would be, especially if a lung needs to be removed. The doctor may remove part of the lining of the chest or abdomen and some of the tissue around it. For cancer of the pleura (pleural mesothelioma), a lung may be removed in an operation called a pneumonectomy. Sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed. Surgery is a common treatment of malignant mesothelioma.

Radiation therapy, also called radiotherapy, involves the use of high-energy rays to kill cancer cells and shrink tumors. Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy). Radiation therapy affects the cancer cells only in the treated area. The radiation may come from a machine (external radiation) or from putting materials that produce radiation through thin plastic tubes into the area where the cancer cells are found (internal radiation therapy).

Chemotherapy uses drugs to kill cancer cells. Most drugs used to treat mesothelioma are given by injection into a vein (intravenous, or IV). Doctors are also studying the effectiveness of putting chemotherapy directly into the chest or abdomen (intracavitary chemotherapy). Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells throughout the body. In mesothelioma, chemotherapy may be put directly into the chest (intrapleural chemotherapy).

To relieve symptoms and control pain, the doctor may use a needle or a thin tube to drain fluid that has built up in the chest or abdomen. The procedure for removing fluid from the chest is called thoracentesis. Removal of fluid from the abdomen is called paracentesis. Drugs may be given through a tube in the chest to prevent more fluid from accumulating. Radiation therapy and surgery may also be helpful in relieving symptoms.

Intraoperative photodynamic therapy is a new type of treatment that uses special drugs and light to kill cancer cells during surgery. A drug that makes cancer cells more sensitive to light is injected into a vein several days before surgery. During surgery to remove as much of the cancer as possible, a special light is used to shine on the pleura. This treatment is being studied for early stages of mesothelioma in the chest.

Because mesothelioma is very hard to control, the U.S. National Cancer Institute (NCI) is sponsoring clinical trials (research studies with people) that are designed to find new treatments and better ways to use current treatments. Before any new treatment can be recommended for general use, doctors conduct clinical trials to find out whether the treatment is safe for patients and effective against the disease. Participation in clinical trials is an important treatment option for many patients with mesothelioma.

New treatments for malignant mesothelioma and possible preventive measures, such as a vaccine, are being evaluated in clinical trials, and the future holds some promise. Clinical trials are research studies that evaluate new treatments for safety and effectiveness. There are no guarantees that a new treatment will work, and there are some risks. However, a clinical trial is not undertaken unless the researchers believe the treatment may have some value.

Some treatments for malignant mesothelioma that are being evaluated. Different combinations of chemotherapy drugs have been tried with mixed results. Putting chemotherapy drugs directly into the pleural or peritoneal space is being researched because of its advantage over traditional chemotherapy. Because the drug is placed directly into the cavity, much greater doses can be given to patients without causing severe side effects. Some studies have shown this therapy to control effusions and reduce tumor size. In brachytherapy (intracavitary radiation therapy), a radioactive substance is placed directly into the pleural or peritoneal space. Multimodality therapy is any combination of surgery, radiation therapy and chemotherapy. In gene therapy a virus that has been genetically altered is introduced into the tumor. The virus infects the cancerous cells and makes them vulnerable to anticancer drugs. Treatments that stimulate the body's immune system to fight cancer cells are called immunotherapy.

Because mesothelioma now represents less than one percent of cancers and and are infrequently seen in the practice of most community oncologists, finding the correct treatment can be very difficult. Proper management of mesothelioma often requires evaluation at larger tertiary hospitals or Comprehensive Cancer Centers by specialists in medical, surgical and radiation oncology with experience in all aspects of the clinical care of mesothelioma patients, including the newest experimental treatments. Because treatment has resulted in modest benefit, patients may question the treatment options suggested. It is often a good idea to seek a second opinion. A second opinion can provide more information and help you feel more confident about the treatment plan that you choose. Also, some insurance companies require a second opinion before they will agree to pay for certain treatments.

Cancer Update from Johns Hopkins University

This information is being circulated at Walter Reed Army Medical Center as well.
Please circulate to all you know; Cancer update
Johns Hopkins - Cancer News from Johns Hopkins

No plastic containers in micro

No water bottles in freezer.

No plastic wrap in microwave...


A dioxin chemical causes cancer, especially breast cancer.

Dioxins are highly poisonous to the cells of our bodies. Don't freeze your plastic bottles with water in them as this releases dioxins from the plastic.



Recently, Edward Fujimoto, Wellness Program Manager at Castle Hospital , was on a TV program to explain this health hazard. He talked about dioxins and how bad they are for us.
He said that we should not be heating our food in the microwave using plastic containers.. .

This especially applies to foods that contain fat.

He said that the combination of fat, high heat, and plastics releases dioxin into the food and ultimately into the cells of the body...
Instead, he recommends using glass, such as Corning Ware, Pyrex or ceramic containers for heating food... You get the same results, only without the dioxin. So such things as TV dinners, instant ramen and soups, etc., should be removed from the container and heated in something else.
Paper isn't bad but you don't know what is in the paper. It's just safer to use tempered glass, Corning Ware, etc.
He reminded us that a while ago some of the fast food restaurants moved away from the foam containers to paper. The dioxin problem is one of the reasons...



Also, he pointed out that plastic wrap, such as Saran, is just as dangerous when placed over foods to be cooked in the microwave. As the food is nuked, the high heat causes poisonous toxins to actually melt out of the plastic wrap and drip into the food.
Cover food with a paper towel instead.




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