Mesothelioma is an uncommon form of cancer almost always linked with exposure to asbestos. It is sometimes referred to as asbestos cancer or 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.
Asbestos can cause mesothelioma when fibers become airborne and are inhaled or ingested into the body. Once the fibers enter the body, they can become lodges in the protective sacs surrounding the lungs, heart or abdomen. Ten to forty years later, they cause tumors to form in the mesothelium, or lining of the sacs. Because the symptoms are hard to recognize and take so long to appear from time of initial exposure, mesothelioma is often not diagnosed until it has reached advanced stages of the disease. Prognosis is poor and many do not live past a year after diagnosis, especially if the disease is extensive.
Currently there is no known cure for mesothelioma and treatment options are limited for those with advanced disease. Because of this, interventions are generally not curative but focus on extending survival times and increasing quality of life. Front line therapy refers to the first kinds of medical interventions tried and are usually considered the standard clinical practice. Front line therapies for mesothelioma are surgical resection, chemotherapy and radiation therapy. An even more common practice is to combine two or more of these methods.
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.
Surgery, chemotherapy and radiation treatments are generally palliative but do not result in extended survival times.
After front line approaches have been tried, second line treatments can be explored. Second line treatments are offered as part of clinical studies investigating new and hopefully more effective ways of fighting or even curing cancer. Second line treatments investigate new approaches to surgery and radiation, new anti-cancer drugs, and new combination of methods or drugs. Therapies involving diet, exercise and alternative healing modalities are referred to as supplementary treatments versus secondary.
Not all mesothelioma patients will be eligible for clinical trials researching new therapeutic interventions since they each have their own requirements. After completing standard treatments, patients who wish to participate in a clinical trial involving the use of second line treatments will need to see if they are eligible. Some eligibility requirements are whether the tumors are resectable, whether or to what extent patients have been pretreated with pemetrexed or other chemotherapy agents, and what type or stage of disease the patient currently has.
Several second line treatments involving new drugs (chemotherapy agents) are currently being investigated. These therapies are increasingly being used in clinical practice as more patients are being diagnosed at earlier stages and are still healthy at time of disease progression. Second line treatments can include testing new drugs, anti-angiogenic compounds, molecular antibodies, and other unexplored alternatives. First and second line treatments should be initiated as early as possible for best 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 lawyers 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.