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Abdominal Mesothelioma Treatment
Doctors and researchers are working together to improve the treatment of mesothelioma. The most common treatment is radiation therapy, surgery, and chemotherapy.
Doctors diagnose peritoneal mesothelioma with a physical exam and a tissue sample. A surgeon inserts a needle into the skin in the abdomen or chest, and collects fluid or tissue for analysis.
Cytoreduction
Cytoreduction is the most effective treatment for patients suffering from peritoneal Msothelioma. During this procedure, surgeons remove the abdominal cavity's lining and any visible tumors or cancerous tissue. The procedure is carried out by a surgeon by making an incision inside the bellybutton, or small incisions that are made around the abdomen. The procedure can take up to 12 hours. It is usually performed in conjunction with HIPEC which involves heating chemotherapy drugs being pumped through the abdominal cavity following surgery.
Cytoreduction in conjunction with HIPEC is a complex mesothelioma treatment only available in mesothelioma centres. It can dramatically improve the patient's prognosis. It is not recommended for all mesothelioma sufferers, especially those with advanced cancer.
Mesothelioma specialists employ a medical test to determine if a patient is eligible for this treatment. They will use the results of a CT scan and biopsy results to determine how far mesothelioma has spread in the body. Then, they will determine if the patient qualifies for HIPEC cytoreduction.
Doctors may also add systemic chemotherapy to the surgical plan. This is typically done prior to surgery to treat cytoreductive cancer or within the first few weeks following the procedure. Patients should not return to work for a minimum of six weeks following this type of mesothelioma treatment.
Doctors may require combining five surgical procedures during mesothelioma cytoreduction in order to completely eliminate cancer cells. They'll also have to remove the fluid and mesothelioma cancer cells that are dead. Doctors typically perform a procedure referred to as a laparotomy, or open abdominal surgery, to open the peritoneal cavity. They may need to resort to a different procedure, such colocectomy or bowel removal.
A recent study published in the Journal of Gastrointestinal Surgery found that mesothelioma patients who delay cytoreductive surgery and HIPEC results in lower long-term survival rates. Researchers suggest that patients suffering from peritoneal adenocarcinoma should be referred to a hospital that provides this treatment. In addition, the authors suggest that health insurance companies provide coverage for this surgery for mesothelioma patients. Veterans may be able benefit from this procedure through VA benefits.
Hyperthermic intraperitoneal chemotherapy (HIPEC).
As part of cytoreduction surgically, HIPEC involves bathing the abdominal cavity with heated chemotherapy to destroy any cancerous cells that are left after surgery. During this procedure, surgeons insert catheters into the abdomen and connect them to an infusion pump that circulates the drug solution to and from the patient's body. This process usually takes between 30 and 120 minutes. During treatment, doctors will move back and forth on the patient's abdomen to ensure that the medicine is absorbed into every part of the cavity. After the chemotherapy is finished, doctors will drain the body of fluid and then stitch the wound and transport patients to a hospital for intensive care.
Doctors typically use a combination of chemotherapy drugs during HIPEC such as carboplatin cisplatin and doxorubicin. Depending on the type of drug and stage, they might also employ a different type of chemotherapy drug. They can also alter the dosages to improve their effectiveness. During HIPEC the surgical team will keep track of the patient's temperature and blood pressure to ensure these vital body functions aren't affected.
During HIPEC the surgeons also use cooling devices to maintain the patient's temperature. This is important because the high temperatures can cause a higher toxicity for certain chemotherapy drugs.
As part of a multimodal approach HIPEC has demonstrated promising results for mesothelioma patients. It can increase survival rates by significantly, particularly in younger patients with smaller tumors. It can also be used to treat malignant ascites which is an accumulation of fluid in the abdominal cavity caused by mesothelioma of various types. However, it is a heavy procedure that should only be performed in university centers with highly experienced mesothelioma experts. Patients should also be aware that this kind of treatment may take months to be completed. In this time, patients should make sure to have plenty of rest and follow the advice of their treatment teams to promote healing and avoid any complications. Patients should also exercise within their limits, and consume an appropriate diet to aid in the healing process of their body.
Therapy with a specific goal
Mesothelioma, a tumor that is cancerous, develops in a thin layer of tissue that covers the majority of your internal organs. It affects the lining around the abdomen and chest. Mesothelioma is usually found in the pleura surrounding your lungs, but it can also be found in the peritoneum that surrounds your testicles or your heart. Exposure to asbestos fibers can cause mesothelioma decades before symptoms develop.
The symptoms of peritoneal mesothelioma are abdominal pain, swelling of the abdomen, weight loss, the accumulation of fluid in the abdomen (ascites) and fatigue. The majority of patients experience these symptoms for several months before their doctor diagnoses mesothelioma.
There are many treatments for peritoneal mesothelioma, but targeted therapy is the most promising. This type of treatment works by targeting the genetic mutations that cause mesothelioma. These medications can kill cancer cells without harming healthy ones.
Your doctor will determine if you are eligible for targeted treatment by performing biopsies or analyzing the results of other tests. The doctor will then determine if the tumor is the molecular target that the medication was developed to target. This can be determined using blood tests and a sample of the tumor, or computed (CT) scans.
If the doctors find a target, they will match it to one of a variety of targeted treatments. These drugs can stop cancer cells from growing, or tell them to self-destruct. These drugs can be taken in the form of pills or delivered via an intravenous drip.
Targeted therapy can be used on its own or with other types of treatment, including surgery and radiation. In some cases, it may be used in conjunction with immunotherapy drugs such as Yervoy, Opdivo or Tecentriq. These drugs can activate your immune system and help fight cancer.
Your doctor will set up regular appointments to track your improvement. They will evaluate your condition by conducting tests for blood and X-rays, and determine the effectiveness of the targeted therapy has been. They will also inquire about how you're handling any side effects that may result from the medication. The doctors will decide whether you should continue on targeted therapy or switch to a different medication.
Therapy with radiation
Mesothelioma can begin in the tissues that cover the lung (pleura) or more often, in the tissues in the abdomen (peritoneum). The cancer begins to grow and spread when symptoms appear. The disease is most prevalent for those who were exposed to asbestos at work.
Mesothelioma usually manifests in later stages and is discovered when patients experience persistent symptoms, which could be caused by other illnesses or conditions. Mesothelioma treatment is designed to reduce the tumor while keeping symptoms under control.
Doctors employ a method known as the peritoneal cancer index, to determine how advanced a patient's mesothelioma has become. The system divides the abdomen into 13 sections and assigns a number (0-3) depending on the amount of tumor growth. Doctors then add up the numbers to identify the mesothelioma stage. Stage 1 is the most advanced mesothelioma. Stage 4 represents the most advanced.
For peritoneal mesothelioma doctors also take into consideration the size of the primary tumor and how much it has spread. They also consider whether the cancer has spread to the lymph nodes or other organs, also known as metastasis.
In general the worse the prognosis, more extensive mesothelioma. However, there are many treatment options to improve the patient's quality of life.
The first step to a positive mesothelioma prognosis is to locate a mesothelioma expert specialist. This specialist can select the best treatment for a patient's cancer stage and mesothelioma cell type.
Another option for treatment is targeted therapy, which makes use of drugs to kill cancer cells or stop them from spreading. These drugs are administered through a pill or given intravenously. It can be used in conjunction with other treatments.
At UPMC, doctors offer the most cutting-edge surgical procedure called HIPEC. This procedure involves a surgeon removing mesothelioma cancers that are visible around the abdominal cavity. Then the chemotherapy is heated and pumped into the abdomen. HIPEC is used to remove any microscopic mesothelioma.
The best way to treat mesothelioma is to begin as soon as you can. Patients suffering from peritoneal mesothelioma should seek out an experienced mesothelioma surgeon to set up a consultation.