Aisner J, Belani CP, Aisner SC. Tumors of the pleura and mediastinum. In: Abeloff MD, Armitage JO, Lichter AS, Niederhuber JE. Kastan MB, McKenna WG. Clinical Oncology. Philadelphia, PA. Elsevier: 2004: 1745-1786.
American Joint Committee on Cancer. Pleural mesothelioma. AJCC Cancer Staging Manual. 6th ed. New York, New York. Springer: 179-184.
Chahinian AP, Pass HI. Malignant mesothelioma In: Kufe DW, Pollock RE, Weichselbaum RR, Bast RC, Gansler TS, Holland JF, Frei E. Cancer Medicine 6. Hamilton, Ont: BC Decker; 2003. 1447-1466.
Pan X, Day W, Wang W, et al. Residential proximity to naturally occurring asbestos and mesothelioma risk in California. Am J Resp Crit Care. 2005;172:1019-1025.
Pass HI, Vogelzgang NJ, Hahan SM, Carbone M. Benign and malignant mesothelioma In: DeVita VT, Heilman S, Rosenberg SA, eds. Cancer: Principles and Practice of Oncology. Philadelphia, PA: Lippincott Williams & Wilkins 2005: 1687-1716.
Price B, Ware A. Mesothelioma trends in the United States: An update based on Surveillance Epidemiology and End Results program date for 1973-2003.
Robinson BWS, Musk AW, Lake RA. Malignant mesothelioma. Lancet. 2005; 366:397-408.
Robinson BWS, Lake RA. Advances in malignant mesothelioma. N Engl J Med. 2005; 353:1591-1603.
Friday, November 16, 2007
Can Malignant Mesothelioma Be Prevented?
The best way to prevent mesothelioma is to prevent or limit your exposure to asbestos in homes, in public buildings, and at work. People who may be exposed to asbestos at work include miners, factory workers, insulation manufacturers, railroad workers, ship builders, gas mask manufacturers, and construction workers, particularly those involved with insulation. If there is a possibility of on-the-job exposure, such as renovating old buildings, then you should use all protective equipment, work practices, and safety procedures designed for working around asbestos.
If you live in an older home, there may be asbestos-containing insulation or other materials. A knowledgeable expert can check your home to determine if there is any asbestos and if it poses any risk of exposure. This may involve testing the air for asbestos levels. It is often more dangerous to remove the materials containing asbestos than to leave them alone. You may then decide to have the asbestos removed from your home. You should hire a qualified contractor to perform this job, to avoid contaminating your home further or causing any exposure to the workers. You should not attempt to remove asbestos-containing material yourself.
If you live in an older home, there may be asbestos-containing insulation or other materials. A knowledgeable expert can check your home to determine if there is any asbestos and if it poses any risk of exposure. This may involve testing the air for asbestos levels. It is often more dangerous to remove the materials containing asbestos than to leave them alone. You may then decide to have the asbestos removed from your home. You should hire a qualified contractor to perform this job, to avoid contaminating your home further or causing any exposure to the workers. You should not attempt to remove asbestos-containing material yourself.
Do We Know What Causes Malignant Mesothelioma?
Asbestos exposure is the main cause of mesothelioma. After these fibers are breathed in, they travel to the ends of small air passages and reach the pleura where they damage mesothelial cells. The damage they cause is through inflammation and scarring as well as stimulating the growth of these cells. Finally, they may damage DNA and cause changes that result in uncontrolled growth. In addition, they also cause injury to lung cells that can result in lung cancer and/or asbestosis (replacement of lung tissue by scar tissue). If swallowed, these fibers can reach the abdominal cavity where they have a role in causing peritoneal mesothelioma.
Researchers are studying exactly how asbestos causes mesothelial cells to develop into mesothelioma. It is still not known whether the SV40 virus participates in this process.
Researchers are studying exactly how asbestos causes mesothelial cells to develop into mesothelioma. It is still not known whether the SV40 virus participates in this process.
What Are the Risk Factors for Malignant Mesothelioma?
A risk factor is anything that increases your chance of getting a disease such as cancer. Different cancers have different risk factors. For example, exposing skin to strong sunlight is a risk factor for skin cancer. Smoking is a risk factor for cancers of the lung, mouth, larynx, bladder, kidney, and several other organs. Individuals exposed to asbestos should be encouraged to avoid tobacco exposure because together the risk for lung cancer is significantly higher than from smoking without a history of asbestos exposure. But having a risk factor, or even several, does not mean that you will get the disease.
Asbestos
The main risk factor for developing mesothelioma is exposure to asbestos. Asbestos refers to a family of fibrous minerals made of silicate. Asbestos was once used in many products such as insulation, floor tiles, door gaskets, soundproofing, roofing, patching compounds, fireproof gloves and ironing board covers, and even brake pads. As the link between asbestos and mesothelioma has become well known, the use of this material has almost stopped. Most use stopped after 1989, but it is still used in some products. Experts have linked this drop in asbestos use to the fact that the rate of development of mesothelioma is no longer increasing.
Still, up to 8 million Americans may already have been exposed to asbestos. Exposure to asbestos particles suspended in air and building materials is much less hazardous except when they are being removed.
Since asbestos is a naturally occurring mineral, it can also be found in dust and rocks in certain parts of the United States as well as the world.
According to the U.S. Environmental Protection Agency, as many as 733,000 schools and public buildings in the country today contain asbestos insulation. As many as 10% to 15% of schools in the United States may contain asbestos insulation. People who may be at risk for occupational asbestos exposure include some miners, factory workers, insulation manufacturers, railroad workers, ship builders, gas mask manufacturers, and construction workers, particularly those involved with installing insulation. Several studies have shown that family members of people exposed to asbestos at work have an increased risk of developing mesothelioma, because asbestos fibers are carried home on the clothes of the workers.
The incidence rate for mesothelioma in men is dropping, probably because they are no longer being exposed directly to asbestos in their work. But the incidence rate for mesothelioma in women is steady, which suggests that they are being exposed in a way that is not directly tied to work, but more to their environment either at home or work. One example would be asbestos in buildings where they work or live. A study from California also links mesothelioma to naturally occurring asbestos deposits in mountains.
Another important point about asbestos and mesothelioma is that the risk of mesothelioma does not drop with time after exposure to asbestos. The risk appears to be lifelong and undiminished.
There are 2 main forms of asbestos -- serpentine and amphiboles.
Serpentine fibers are curly and pliable. Chrysotile is the only type of serpentine fiber and it is the most widely used form of asbestos.
Amphiboles are thin, rod-like fibers. There are 5 main types — crocidolite, amosite, anthrophylite, tremolite, and actinolyte. Amphiboles (particularly crocidolite) are considered to be the most carcinogenic (cancer-causing).
However, even the more commonly used chrysotile fibers are associated with malignant (cancerous) mesotheliomas and should be considered dangerous as well.
When asbestos fibers are inhaled, most are cleared in the nose, throat, trachea (windpipe), or bronchi (large breathing tubes of the lungs). Fibers are cleared by sticking to mucus inside the air passages and being coughed up or swallowed. The long, thin, fibers are less readily cleared, and they may reach the ends of the small airways and penetrate into the pleural lining of the lung and chest wall. These fibers may then directly injure mesothelial cells of the pleura, and eventually cause mesothelioma.
Asbestos fibers can also damage cells of the lung and result in asbestosis (formation of scar tissue in the lung), and/or lung cancer. The risk of lung cancer among people exposed to asbestos is increased by 7 times, compared with the general population. Indeed, asbestosis, mesothelioma, and lung cancer are the 3 most frequent causes of death and disease among people with heavy asbestos exposure. Peritoneal mesothelioma, which forms in the abdomen, may result from coughing up and swallowing inhaled asbestos fibers. Cancers of the larynx, pancreas, esophagus, colon, and kidney may also come from asbestos exposure, but the increased risk is small.
The risk of developing a mesothelioma is related to how much asbestos a person was exposed to and how long this exposure lasted. People exposed at an early age, for a long period of time, and at higher levels are most likely to develop this cancer. Mesotheliomas take a long time to develop. The time between first exposure to asbestos and diagnosis of mesothelioma is usually between 20 and 50 years.
Radiation
There have been a few published reports of pleural and peritoneal mesotheliomas that developed following exposure to thorium dioxide (Thorotrast). This material was used in the past by doctors for certain x-ray tests. Because Thorotrast was found to cause cancers, it has not been used for many years.
Zeolite
This is a silicate mineral, chemically related to asbestos, common in the soil of the Anatoli region of Turkey. Many cases of mesothelioma have been described in this region and may have been caused by this mineral.
Tobacco
Although tobacco smoking has not been associated with developing mesothelioma, the combination of smoking and asbestos exposure greatly increases the risk of lung cancer. Asbestos workers who also smoke have a lung cancer risk 50 to 90 times greater than that of the general population. More asbestos workers die of lung cancer than of mesothelioma.
SV40 Virus
Some recent studies have raised the possibility that infection with simian virus 40 (SV40) might increase the risk of developing mesothelioma. Some injectable polio vaccines prepared between 1955 and 1963 were contaminated with SV40. About 10 to 30 million people were probably exposed to the virus.
Intentional infection with SV40 of some laboratory animals, such as hamsters, causes mesotheliomas to develop. Researchers also have noticed that SV40 can cause mouse cells grown in dishes to become cancerous, and that asbestos increases the cancer-causing effect of SV40 on these cells. Other researchers have studied biopsy specimens of human mesotheliomas and detected SV40 DNA. However, similar fragments of SV40 DNA can also be found in noncancerous human tissues and some researchers think the SV40 viruses found are contaminants.
Another study did find SV40 virus in tissues from mesothelioma patients that did not appear to be contaminants. In this study, which also looked at tissue from healthy people, the SV40 virus wasn’t linked to mesothelioma unless the person was also exposed to asbestos. The researchers in this study thought the SV40 infection was not caused by the polio immunization, but occurred naturally as do other viral infections.
So far, the largest studies addressing this issue in humans have not found any increased risk for mesothelioma or other cancers among people who received the contaminated vaccines as children. But, the peak age range for diagnosis of mesothelioma is 50 to 70 years. Some researchers have pointed out that this issue may remain unresolved until more of the people accidentally exposed to SV40 between 1955 and 1963 reach that age range. Research into this important topic is still underway.
A recent study by the Institute of Medicine concluded that we still don’t know whether SV40 is responsible for some mesotheliomas and more research needs to be done.
Asbestos
The main risk factor for developing mesothelioma is exposure to asbestos. Asbestos refers to a family of fibrous minerals made of silicate. Asbestos was once used in many products such as insulation, floor tiles, door gaskets, soundproofing, roofing, patching compounds, fireproof gloves and ironing board covers, and even brake pads. As the link between asbestos and mesothelioma has become well known, the use of this material has almost stopped. Most use stopped after 1989, but it is still used in some products. Experts have linked this drop in asbestos use to the fact that the rate of development of mesothelioma is no longer increasing.
Still, up to 8 million Americans may already have been exposed to asbestos. Exposure to asbestos particles suspended in air and building materials is much less hazardous except when they are being removed.
Since asbestos is a naturally occurring mineral, it can also be found in dust and rocks in certain parts of the United States as well as the world.
According to the U.S. Environmental Protection Agency, as many as 733,000 schools and public buildings in the country today contain asbestos insulation. As many as 10% to 15% of schools in the United States may contain asbestos insulation. People who may be at risk for occupational asbestos exposure include some miners, factory workers, insulation manufacturers, railroad workers, ship builders, gas mask manufacturers, and construction workers, particularly those involved with installing insulation. Several studies have shown that family members of people exposed to asbestos at work have an increased risk of developing mesothelioma, because asbestos fibers are carried home on the clothes of the workers.
The incidence rate for mesothelioma in men is dropping, probably because they are no longer being exposed directly to asbestos in their work. But the incidence rate for mesothelioma in women is steady, which suggests that they are being exposed in a way that is not directly tied to work, but more to their environment either at home or work. One example would be asbestos in buildings where they work or live. A study from California also links mesothelioma to naturally occurring asbestos deposits in mountains.
Another important point about asbestos and mesothelioma is that the risk of mesothelioma does not drop with time after exposure to asbestos. The risk appears to be lifelong and undiminished.
There are 2 main forms of asbestos -- serpentine and amphiboles.
Serpentine fibers are curly and pliable. Chrysotile is the only type of serpentine fiber and it is the most widely used form of asbestos.
Amphiboles are thin, rod-like fibers. There are 5 main types — crocidolite, amosite, anthrophylite, tremolite, and actinolyte. Amphiboles (particularly crocidolite) are considered to be the most carcinogenic (cancer-causing).
However, even the more commonly used chrysotile fibers are associated with malignant (cancerous) mesotheliomas and should be considered dangerous as well.
When asbestos fibers are inhaled, most are cleared in the nose, throat, trachea (windpipe), or bronchi (large breathing tubes of the lungs). Fibers are cleared by sticking to mucus inside the air passages and being coughed up or swallowed. The long, thin, fibers are less readily cleared, and they may reach the ends of the small airways and penetrate into the pleural lining of the lung and chest wall. These fibers may then directly injure mesothelial cells of the pleura, and eventually cause mesothelioma.
Asbestos fibers can also damage cells of the lung and result in asbestosis (formation of scar tissue in the lung), and/or lung cancer. The risk of lung cancer among people exposed to asbestos is increased by 7 times, compared with the general population. Indeed, asbestosis, mesothelioma, and lung cancer are the 3 most frequent causes of death and disease among people with heavy asbestos exposure. Peritoneal mesothelioma, which forms in the abdomen, may result from coughing up and swallowing inhaled asbestos fibers. Cancers of the larynx, pancreas, esophagus, colon, and kidney may also come from asbestos exposure, but the increased risk is small.
The risk of developing a mesothelioma is related to how much asbestos a person was exposed to and how long this exposure lasted. People exposed at an early age, for a long period of time, and at higher levels are most likely to develop this cancer. Mesotheliomas take a long time to develop. The time between first exposure to asbestos and diagnosis of mesothelioma is usually between 20 and 50 years.
Radiation
There have been a few published reports of pleural and peritoneal mesotheliomas that developed following exposure to thorium dioxide (Thorotrast). This material was used in the past by doctors for certain x-ray tests. Because Thorotrast was found to cause cancers, it has not been used for many years.
Zeolite
This is a silicate mineral, chemically related to asbestos, common in the soil of the Anatoli region of Turkey. Many cases of mesothelioma have been described in this region and may have been caused by this mineral.
Tobacco
Although tobacco smoking has not been associated with developing mesothelioma, the combination of smoking and asbestos exposure greatly increases the risk of lung cancer. Asbestos workers who also smoke have a lung cancer risk 50 to 90 times greater than that of the general population. More asbestos workers die of lung cancer than of mesothelioma.
SV40 Virus
Some recent studies have raised the possibility that infection with simian virus 40 (SV40) might increase the risk of developing mesothelioma. Some injectable polio vaccines prepared between 1955 and 1963 were contaminated with SV40. About 10 to 30 million people were probably exposed to the virus.
Intentional infection with SV40 of some laboratory animals, such as hamsters, causes mesotheliomas to develop. Researchers also have noticed that SV40 can cause mouse cells grown in dishes to become cancerous, and that asbestos increases the cancer-causing effect of SV40 on these cells. Other researchers have studied biopsy specimens of human mesotheliomas and detected SV40 DNA. However, similar fragments of SV40 DNA can also be found in noncancerous human tissues and some researchers think the SV40 viruses found are contaminants.
Another study did find SV40 virus in tissues from mesothelioma patients that did not appear to be contaminants. In this study, which also looked at tissue from healthy people, the SV40 virus wasn’t linked to mesothelioma unless the person was also exposed to asbestos. The researchers in this study thought the SV40 infection was not caused by the polio immunization, but occurred naturally as do other viral infections.
So far, the largest studies addressing this issue in humans have not found any increased risk for mesothelioma or other cancers among people who received the contaminated vaccines as children. But, the peak age range for diagnosis of mesothelioma is 50 to 70 years. Some researchers have pointed out that this issue may remain unresolved until more of the people accidentally exposed to SV40 between 1955 and 1963 reach that age range. Research into this important topic is still underway.
A recent study by the Institute of Medicine concluded that we still don’t know whether SV40 is responsible for some mesotheliomas and more research needs to be done.
What's New in Malignant Mesothelioma Research and Treatment?
There is always research going on in the area of mesothelioma. Scientists are looking for causes and ways to prevent mesothelioma. Doctors are working to improve accuracy of diagnosis and effectiveness of treatment. Despite recent progress, much remains to be learned about the best way to treat these cancers.
Causes and Prevention
Much of the research on mesothelioma has focused on learning exactly how asbestos changes mesothelial cells and their DNA to cause these cancers. Understanding how these fibers produce cancer might help us develop ways to prevent those changes.
The risk of asbestos in developing mesothelioma is a definite public health concern. We are continuously learning more about which fibers can produce cancer, how they cause these cancers, and what levels of exposure can be considered safe. Now that we know about the dangers of asbestos, we can limit or stop exposure in homes, public buildings, and the workplace. Unfortunately, regulations protecting workers from asbestos exposure are much less stringent in some countries and nonexistent in others.
Research is also underway to clarify the role (if any) of SV40, a virus that has been linked to mesothelioma in some studies.
New Drugs
Because chemotherapy drugs have not been very effective against advanced mesothelioma, several new approaches to cancer treatment are now being studied. These include anti-angiogenesis drugs (which kill cancers by stopping their blood supply) such as Bevacizumab (Avastin) and anti-growth factor drugs (which interfere with substances some cancer cells produce to stimulate their own growth) such as Erlotinib (Tarceva).
Multimodality Therapy
Doctors are always learning more about the best way to treat patients with mesotheliomas. The roles of surgery, radiation therapy, and chemotherapy in the treatment of mesothelioma are highly debated. Treatments that use some combinations of surgery, radiation therapy, and chemotherapy, called multimodality therapy, are now being studied and may provide the most promising option for some patients. New chemotherapy drugs are currently being tested in clinical trials, together with other types of treatment.
Ranpirnase (Onconase) is an enzyme that breaks down RNA and in preliminary studies has helped some patients with mesothelioma to love longer. Larger clinical trials are currently in progress. Another new drug being tested in mesothelioma clinical trials is suberoylanilide hydroxamic acid (vorinostat, [SAHA]), which may reduce growth of mesothelioma cells by inhibiting an enzyme that controls certain proteins called histones, which regulate DNA.
Gene Therapy
A new approach to cancer therapy being tested on mesothelioma is gene therapy. One of these approaches to treating mesothelioma uses special viruses that have been modified in the laboratory. The modified virus is injected into the pleural space and infects the mesothelioma cells. When this infection occurs, the virus injects a gene into the mesothelioma for interferon-beta, an immune system hormone (cytokine) that may help activate immune system cells to attack the cancer.
Causes and Prevention
Much of the research on mesothelioma has focused on learning exactly how asbestos changes mesothelial cells and their DNA to cause these cancers. Understanding how these fibers produce cancer might help us develop ways to prevent those changes.
The risk of asbestos in developing mesothelioma is a definite public health concern. We are continuously learning more about which fibers can produce cancer, how they cause these cancers, and what levels of exposure can be considered safe. Now that we know about the dangers of asbestos, we can limit or stop exposure in homes, public buildings, and the workplace. Unfortunately, regulations protecting workers from asbestos exposure are much less stringent in some countries and nonexistent in others.
Research is also underway to clarify the role (if any) of SV40, a virus that has been linked to mesothelioma in some studies.
New Drugs
Because chemotherapy drugs have not been very effective against advanced mesothelioma, several new approaches to cancer treatment are now being studied. These include anti-angiogenesis drugs (which kill cancers by stopping their blood supply) such as Bevacizumab (Avastin) and anti-growth factor drugs (which interfere with substances some cancer cells produce to stimulate their own growth) such as Erlotinib (Tarceva).
Multimodality Therapy
Doctors are always learning more about the best way to treat patients with mesotheliomas. The roles of surgery, radiation therapy, and chemotherapy in the treatment of mesothelioma are highly debated. Treatments that use some combinations of surgery, radiation therapy, and chemotherapy, called multimodality therapy, are now being studied and may provide the most promising option for some patients. New chemotherapy drugs are currently being tested in clinical trials, together with other types of treatment.
Ranpirnase (Onconase) is an enzyme that breaks down RNA and in preliminary studies has helped some patients with mesothelioma to love longer. Larger clinical trials are currently in progress. Another new drug being tested in mesothelioma clinical trials is suberoylanilide hydroxamic acid (vorinostat, [SAHA]), which may reduce growth of mesothelioma cells by inhibiting an enzyme that controls certain proteins called histones, which regulate DNA.
Gene Therapy
A new approach to cancer therapy being tested on mesothelioma is gene therapy. One of these approaches to treating mesothelioma uses special viruses that have been modified in the laboratory. The modified virus is injected into the pleural space and infects the mesothelioma cells. When this infection occurs, the virus injects a gene into the mesothelioma for interferon-beta, an immune system hormone (cytokine) that may help activate immune system cells to attack the cancer.
Thursday, November 1, 2007
This page is about research into mesothelioma causes, prevention and treatments. You can scroll down the page to read all the information here. Or you can use these links to go straight to sections on
Why research?
Causes and prevention
Finding a tumour marker for diagnosing, screening or monitoring treatment
Genetics
Chemotherapy
Chemotherapy for controlling symptoms
Treating fluid collection around the lung (pleural effusion)
Surgery
Gene therapy
Anti-angiogenic therapy (to disrupt the blood supply to the cancer)
Immunotherapy
Photodynamic therapy
Why research?All treatments have to be fully researched before they can be adopted as standard treatment for everyone. This is so that
We can be sure they work
We can be sure they work better than the treatments that are available at the moment
They are known to be safeFirst of all, treatments are developed and tested in laboratories. For ethical and safety reasons, experimental treatments must be tested in the laboratory before they can be tried in patients. If a treatment described here is said to be at the laboratory stage of research, it is not ready for patients and is not available either within or outside the NHS.Tests in patients are called clinical trials. There are 4 phases of clinical trials. This is fully explained in the understanding clinical trials section of CancerHelp UK. If you are interested in taking part in a clinical trial, click the button on the left of your screen to visit our searchable database of clinical trials recruiting in the UK. If there is a trial you are interested in, print it off and take it to your own specialist. If the trial is suitable for you, your doctor will need to make the referral to the research team. All the new approaches covered here are the subject of ongoing research. Mesothelioma is one of the hardest types of cancers to treat. Progress has been made in treating this type of cancer. But we need to learn a lot more about this disease and how best to treat it. Until research studies are completed and new effective treatments are found, the treatments covered here cannot be used as standard therapy for mesothelioma.
Causes and preventionMesothelioma is most often linked to exposure to asbestos. So much of the research into this disease is based on finding out exactly how asbestos affects the normal cells of the lining of the chest and abdominal cavities. If we can have a better understanding of how asbestos fibres cause cancer and how exposure to this chemical affects us, then we may be able to help prevent the disease. Researchers know that there can be an incredibly long time lag between exposure to asbestos and developing mesothelioma. It can be 40 years or more. This probably meant that it took longer to spot the connection between asbestos and cancer than it otherwise would. But we know now, and the use of asbestos in many countries is now illegal.There has been talk for the past few years about a link between a virus called the simian virus (SV40) and developing mesothelioma. Some polio vaccine preparations were contaminated with SV40 between 1955 and 1963 and doctors were concerned that people who'd had them may be at increased risk. One large study has indicated that these people are not at an increased risk of mesothelioma or other types of cancers. The study was published in 2003 and found that mesothelioma rates were actually falling in this group of people. If there is a link between SV40 and mesothelioma, it is likely to be much less important that the link with asbestos.There is some evidence that your genetic make up could affect your risk of mesothelioma. As well as asbestos, exposure to a mineral called erionite is a risk factor. Researchers in Turkey found that in families exposed to this mineral, in some families all the family members developed mesothelioma and in other families, no one developed it. They think that there is a gene in some families in Turkey that increases their risk. (This article is published in The Lancet, volume 357, issue 9254, page 444.) This could explain why some people are exposed to asbestos and do not develop mesothelioma, while others who are exposed do. There is a lot more research to be done before we will know if there are specific gene changes that can increase your risk of mesothelioma. It will be some years after this has been completed before there will be any chance of testing for such a gene.In the past, asbestos was used widely in the
Building industry
Ship building industry
Manufacture of household appliances
Motor industry
Power stations
Telephone exchangesThere is a study going on in the UK looking at the occupations of men and women and the development of mesothelioma and lung cancer (MALCS). There is information about this trial on our clinical trials data base. Choose Lung: Mesothelioma from the drop down menu of cancer types to find mesothelioma trials.
Finding a tumour marker for mesotheliomaMesothelioma can be very difficult to diagnose. This is because there are many different types of cells that can make up a mesothelioma tumour. Mesothelioma tumour cells are very similar to some types of lung cancer cells. Sometimes it can be very difficult for a pathologist to decide whether or not the cancerous cells are mesothelioma cells, lung cancer cells or even, sarcoma cells. To help with diagnosis, scientists are trying to find a tumour marker for mesothelioma. A tumour marker is a chemical given off by cancer cells that can be found in the blood and picked up in a blood test. If a definite tumour marker could be discovered for mesothelioma this would be of great benefit for doctors in making more accurate diagnosis of this disease and may also be helpful to monitor the success of treatment. An Australian paper, published in The Lancet in November 2003, is about this search. The researchers were looking into tests for proteins related to mesothelioma. This is early research, but they have had promising results. In their study, 84% of people with mesothelioma tested positive, compared to 2% with other cancers or other lung disease. In a group of people who had been exposed to asbestos but did not have mesothelioma, 7 out of 40 tested positive. 3 of these 7 developed mesothelioma and another got lung cancer within 5 years of the positive test. None of the 33 people who tested negative got mesothelioma within the 8 years following the study. It may be that researchers can build on this work to develop a test for screening for mesothelioma and tests for monitoring the disease in people who already have it.
ChemotherapyIt has been a major challenge for doctors to find chemotherapy drugs that work well in treating malignant mesothelioma. Many trials have been done using epirubicin, doxorubicin, cisplatin and methotrexate, but no standard treatment has been set. This has led researchers to look at newer chemotherapy drugs in combination with some already tried. Drugs and combinations in trial include
Gemcitabine and cisplatin
Vinorelbine (Navelbine)
Topotecan
Irinotecan, cisplatin and mitomycin C
Pemetrexed
Raltitrexed (Tomudex)
OnconaseMost studies giving gemcitabine alone have not been successful. A small number of trials using gemcitabine in combination with cisplatin, have produced some promising results. Many doctors now use this combination of drugs to treat malignant mesothelioma. But more trials are needed before it may be considered as standard treatment. There is information on the side effects of gemcitabine in the side effects of cancer drugs page of CancerHelp UK. In one study 29 patients were given vinorelbine alone, 6 (24%) patients disease improved and 16 (55%) patients disease remained stable. This has led to further trials using this drug. A trial called MS-01 has been comparing active symptom control (ASC) with ASC and vinorelbine and with ASC, mitomycin, vinblastine and cisplatin. This trial has now closed and we are waiting for the results. You can find information about the side effects of vinorelbine, cisplatin, mitomycin C and vinblastine in the cancer drugs section of Cancerhelp UK.Topotecan and irinotecan have not shown significant responses when given by themselves. But in combination with other drugs, there have been some good results. There was a trial looking at irinotecan, cisplatin and mitomycin C (IPM). The results were encouraging, but more investigations are needed. There is information about the side effects of topotecan, cisplatin and irinotecan in the cancer drugs section of CancerHelp UK.Pemetrexed is a type of chemotherapy drug. It is also called Alimta. It is a little similar to another drug in regular use called methotrexate. It has been used in the largest phase 3 clinical trial ever conducted for malignant pleural mesothelioma. This international trial began in 1998 and results were reported on in May 2002. The study was aimed at finding out whether pemetrexed plus cisplatin was more effective in treating malignant mesothelioma than cisplatin alone. All patients were given supplements of vitamin B12 and folic acid to help reduce side effects (such as diarrhoea). The outcome of this trial was promising. A number of recent trials are now looking at the use of pemetrexed in combination with other chemotherapy agents.Pemetrexed has now been licensed in the UK for use in combination with cisplatin to treat mesothelioma. This was announced by the company who developed it on 1st November 2004. In August 2005 pemetrexed was approved for use in Scotland by the Scottish Medicines Consortium. In July 2007 NICE (National Institute for Health and Clinical Excellence) announced that they would recommend it for use in England and Wales, for people with advanced mesothelioma which is not suitable for surgery, who are fit enough to look after themselves. Others who are already receiving pemetrexed will be able to continue their treatment while they and their doctors agree that it is helpful. NICE's final decision is expected in September 2007.There is more about pemetrexed in the question and answer section of CancerHelp UK.
Chemotherapy for controlling symptomsA trial reported in 2004 on the combination of raltitrexed (Tomudex) and cisplatin. The researchers believe that this combination is better for advanced mesothelioma that cisplatin on its own. But the actual difference between the two groups in this trial was quite small.
OnconaseOnconase is an experimental chemotherapy drug, made from leopard frog eggs. It is not available in the UK. We have included it here because you may have come across information about it on the web. Onconase may have fewer side effects than many other chemotherapy drugs. But not all the side effects may be known as yet. A phase 3 clinical trial has been going on in the USA and Germany comparing the use of Onconase with doxorubicin to doxorubicin alone for people with mesothelioma. Unfortunately, the trial reports aren't very promising. The researchers say that onconase may be better than doxorubicin for some patients, but doxorubicin isn't the chemotherapy drug of choice for mesothelioma now anyway.
Treating fluid around the lungIn mesothelioma, fluid can collect inside the chest. This makes it more difficult for your lung to expand and so it is harder to breathe. Doctors call this pleural effusion. It is usual to treat this by drawing off the fluid and 'sticking' the pleura together. Doctors do this by putting in some sort of irritant, usually bcg vaccine, talc or chemotherapy. You can also treat pleural effusion by operating to remove the pleura (a pleurectomy). This is called a pleurectomy. There is a trial that is comparing these two approaches to see which is better. While this trial is open and recruiting patients, it will be listed on our clinical trials database. To find it and other trials, go to the database and choose 'lung - mesothelioma' from the drop down menu of cancer types.
SurgeryMajor surgery for people with mesothelioma has not always been thought a good idea by surgeons. This is because surgery cannot cure the disease. And because many people with mesothelioma are not fit enough to get through a very large operation. But the point of surgery in mesothelioma is to slow the cancer down, rather than cure it. The operation that can be done to remove mesothelioma is called an extrapleural pneumonectomy (EPP). This means removing the lung and the lining of the chest cavity (the pleura) on the affected side. It may help people to live more comfortably for longer. But this has to be tested because, on the other hand, it could mean that having such major surgery means people die sooner than they would have.In 2001 a programme was started in the UK to look at patients with mesothelioma and see who would benefit most from this type of surgery. 45 patients have been evaluated and 21 patients have been operated on. Of these patients, so far 16 of these patients (about 75%) have lived for at least 6 months and 13 of them have lived for at least 12 months (about 60%). This programme has led to a trial called 'MARS' which opened in 2005. The MARS trial is looking at the benefits and risks of EPP for mesothelioma patients who have had chemotherapy. Results from some studies in the USA suggest that giving a course of radiotherapy after the EPP will help to keep the disease under control for even longer. Some patients in the MARS trial will have an EPP operation combined with radical radiotherapy. Others will have other treatments, such as radiotherapy or less major surgery. There is more information about the MARS trial on our clinical trials database. Either follow the link or click on the blue button to the left of your CancerHelp UK screen. Then choose lung, and select mesothelioma, from the drop down list of cancer types.
Gene therapyThere are a number of new types of treatments being researched that can be put under this heading. Some doctors and researchers are now calling this type of treatment 'molecular therapy', which is a more general term including research into
Oncogenes
Tumour suppressor genes
Gene therapy and repair genesBy studying how changes in these genes cause normal cells to become cancerous, scientists aim to eventually develop gene therapy where damaged genes in the cancer cells can be replaced with normal ones. The main focus of gene therapy research for mesothelioma involves injecting a virus that has been modified in the laboratory. The virus is injected into the pleural space in your chest, where mesothelioma develops. The idea is that the virus infects the mesothelioma cells with a gene. The gene makes the cancer sensitive to a specific drug that will kill the mesothelioma cells. Without the virus carrying this gene into the cells, the drug would not usually kill them. Much gene therapy research is still centred on how to get the virus into the cancer cells reliably and it will be a while before we will be able to see whether this will develop into a useful treatment. We don't know of any current mesothelioma gene therapy trials that are open and recruiting patients in the UK.
Anti-angiogenic therapyAngiogenesis means growth of new blood vessels. As they get bigger, cancers need to grow their own blood vessels. Without its own blood supply, a cancer cannot continue to grow. Two of the most important chemicals controlling blood vessel growth are called vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (FGF-2). People with mesothelioma have much higher levels of VEGF than people with any other type of cancer. If the VEGF can be blocked, this could control the growth of blood vessels supplying the mesothelioma tumours. This treatment is a type of biological therapy. These are treatments that use natural body substances (or drugs that block them) to treat cancer. There is more about biological therapies in our cancer treatments section. A drug called bevacizumab is a treatment that stops production of VEGF.Bevacizumab has been studied in a number of cancers, including mesothelioma, and bowel, kidney, breast, ovarian, non small cell lung, and prostate cancers. One trial recently reported that this drug may increase survival for patients with lung cancer. An American phase 2 trial tested bevacizumab for mesothelioma, in combination with the chemotherapy drugs gemcitabine and cisplatin. This trial closed in 2005, and we are waiting for the results.Bevacizumab is still very experimental and much larger trials are needed before we will know how effective it will be in treating mesothelioma and other types of cancers.
ImmunotherapyImmunotherapy is treatment with natural substances that the body uses to fight infection and disease. Immunotherapy works by encouraging the body's natural defence system - the immune system - to attack cancer cells. Immunotherapy is really a type of biological therapy. These are a group of treatments that use natural body substances (or drugs that block them) to treat cancer. There is a separate section about biological therapy (including immunotherapy) in CancerHelp UK.The types of immunotherapies being researched for mesothelioma include
Interferon and interleukin 2
Vaccines
Interferon and interleukin 2Two types of immunotherapy in trials for mesothelioma are interferon and interleukin-2 (also called IL-2 or aldesleukin). Interferon has been used in trials both on its own and in combination with various chemotherapy drugs. The results of the combination treatment haven't been any better than the chemotherapy drugs on their own. More trials have to be done before we know how useful interferon will be in treating mesothelioma.IL-2 is made naturally as part of the body's immune response. But now it can be made in the laboratory and used in much larger quantities as cancer treatment. IL-2 can be injected directly into the pleural cavity (intrapleurally) or into the bloodstream. Clinical trials using both these methods have shown some success in stage 1 and 2 mesothelioma. Unfortunately most mesothelioma patients are diagnosed at a later stage than this, when this treatment is not very effective.
Photodynamic Therapy (PDT)This is a relatively new treatment that is used for a few types of cancers. In PDT, a drug called a photosensitising agent is injected into the bloodstream and absorbed by the body's cells. The drug makes cells sensitive to light. When the area to be treated is exposed to laser light, the cells are killed. PDT has to be combined with an operation to treat mesothelioma. This has been tried for early stage mesothelioma. The photosensitising drug is injected into your bloodstream a few days before surgery. During surgery, the surgeon then shines the laser light directly onto the pleura.PDT has been shown to be a safe type of treatment with other types of cancer. But in phase 1 and phase 2 clinical trials for mesothelioma, there were some major complications on a few occasions and so doctors have not widely accepted this treatment. It is particularly likely to be risky when used with major surgery and this combination of treatments is not available in the UK. There are no claims that this treatment will cure anyone of mesothelioma. It is very experimental. We have included it here because it is something you may have read or heard about.
Why research?
Causes and prevention
Finding a tumour marker for diagnosing, screening or monitoring treatment
Genetics
Chemotherapy
Chemotherapy for controlling symptoms
Treating fluid collection around the lung (pleural effusion)
Surgery
Gene therapy
Anti-angiogenic therapy (to disrupt the blood supply to the cancer)
Immunotherapy
Photodynamic therapy
Why research?All treatments have to be fully researched before they can be adopted as standard treatment for everyone. This is so that
We can be sure they work
We can be sure they work better than the treatments that are available at the moment
They are known to be safeFirst of all, treatments are developed and tested in laboratories. For ethical and safety reasons, experimental treatments must be tested in the laboratory before they can be tried in patients. If a treatment described here is said to be at the laboratory stage of research, it is not ready for patients and is not available either within or outside the NHS.Tests in patients are called clinical trials. There are 4 phases of clinical trials. This is fully explained in the understanding clinical trials section of CancerHelp UK. If you are interested in taking part in a clinical trial, click the button on the left of your screen to visit our searchable database of clinical trials recruiting in the UK. If there is a trial you are interested in, print it off and take it to your own specialist. If the trial is suitable for you, your doctor will need to make the referral to the research team. All the new approaches covered here are the subject of ongoing research. Mesothelioma is one of the hardest types of cancers to treat. Progress has been made in treating this type of cancer. But we need to learn a lot more about this disease and how best to treat it. Until research studies are completed and new effective treatments are found, the treatments covered here cannot be used as standard therapy for mesothelioma.
Causes and preventionMesothelioma is most often linked to exposure to asbestos. So much of the research into this disease is based on finding out exactly how asbestos affects the normal cells of the lining of the chest and abdominal cavities. If we can have a better understanding of how asbestos fibres cause cancer and how exposure to this chemical affects us, then we may be able to help prevent the disease. Researchers know that there can be an incredibly long time lag between exposure to asbestos and developing mesothelioma. It can be 40 years or more. This probably meant that it took longer to spot the connection between asbestos and cancer than it otherwise would. But we know now, and the use of asbestos in many countries is now illegal.There has been talk for the past few years about a link between a virus called the simian virus (SV40) and developing mesothelioma. Some polio vaccine preparations were contaminated with SV40 between 1955 and 1963 and doctors were concerned that people who'd had them may be at increased risk. One large study has indicated that these people are not at an increased risk of mesothelioma or other types of cancers. The study was published in 2003 and found that mesothelioma rates were actually falling in this group of people. If there is a link between SV40 and mesothelioma, it is likely to be much less important that the link with asbestos.There is some evidence that your genetic make up could affect your risk of mesothelioma. As well as asbestos, exposure to a mineral called erionite is a risk factor. Researchers in Turkey found that in families exposed to this mineral, in some families all the family members developed mesothelioma and in other families, no one developed it. They think that there is a gene in some families in Turkey that increases their risk. (This article is published in The Lancet, volume 357, issue 9254, page 444.) This could explain why some people are exposed to asbestos and do not develop mesothelioma, while others who are exposed do. There is a lot more research to be done before we will know if there are specific gene changes that can increase your risk of mesothelioma. It will be some years after this has been completed before there will be any chance of testing for such a gene.In the past, asbestos was used widely in the
Building industry
Ship building industry
Manufacture of household appliances
Motor industry
Power stations
Telephone exchangesThere is a study going on in the UK looking at the occupations of men and women and the development of mesothelioma and lung cancer (MALCS). There is information about this trial on our clinical trials data base. Choose Lung: Mesothelioma from the drop down menu of cancer types to find mesothelioma trials.
Finding a tumour marker for mesotheliomaMesothelioma can be very difficult to diagnose. This is because there are many different types of cells that can make up a mesothelioma tumour. Mesothelioma tumour cells are very similar to some types of lung cancer cells. Sometimes it can be very difficult for a pathologist to decide whether or not the cancerous cells are mesothelioma cells, lung cancer cells or even, sarcoma cells. To help with diagnosis, scientists are trying to find a tumour marker for mesothelioma. A tumour marker is a chemical given off by cancer cells that can be found in the blood and picked up in a blood test. If a definite tumour marker could be discovered for mesothelioma this would be of great benefit for doctors in making more accurate diagnosis of this disease and may also be helpful to monitor the success of treatment. An Australian paper, published in The Lancet in November 2003, is about this search. The researchers were looking into tests for proteins related to mesothelioma. This is early research, but they have had promising results. In their study, 84% of people with mesothelioma tested positive, compared to 2% with other cancers or other lung disease. In a group of people who had been exposed to asbestos but did not have mesothelioma, 7 out of 40 tested positive. 3 of these 7 developed mesothelioma and another got lung cancer within 5 years of the positive test. None of the 33 people who tested negative got mesothelioma within the 8 years following the study. It may be that researchers can build on this work to develop a test for screening for mesothelioma and tests for monitoring the disease in people who already have it.
ChemotherapyIt has been a major challenge for doctors to find chemotherapy drugs that work well in treating malignant mesothelioma. Many trials have been done using epirubicin, doxorubicin, cisplatin and methotrexate, but no standard treatment has been set. This has led researchers to look at newer chemotherapy drugs in combination with some already tried. Drugs and combinations in trial include
Gemcitabine and cisplatin
Vinorelbine (Navelbine)
Topotecan
Irinotecan, cisplatin and mitomycin C
Pemetrexed
Raltitrexed (Tomudex)
OnconaseMost studies giving gemcitabine alone have not been successful. A small number of trials using gemcitabine in combination with cisplatin, have produced some promising results. Many doctors now use this combination of drugs to treat malignant mesothelioma. But more trials are needed before it may be considered as standard treatment. There is information on the side effects of gemcitabine in the side effects of cancer drugs page of CancerHelp UK. In one study 29 patients were given vinorelbine alone, 6 (24%) patients disease improved and 16 (55%) patients disease remained stable. This has led to further trials using this drug. A trial called MS-01 has been comparing active symptom control (ASC) with ASC and vinorelbine and with ASC, mitomycin, vinblastine and cisplatin. This trial has now closed and we are waiting for the results. You can find information about the side effects of vinorelbine, cisplatin, mitomycin C and vinblastine in the cancer drugs section of Cancerhelp UK.Topotecan and irinotecan have not shown significant responses when given by themselves. But in combination with other drugs, there have been some good results. There was a trial looking at irinotecan, cisplatin and mitomycin C (IPM). The results were encouraging, but more investigations are needed. There is information about the side effects of topotecan, cisplatin and irinotecan in the cancer drugs section of CancerHelp UK.Pemetrexed is a type of chemotherapy drug. It is also called Alimta. It is a little similar to another drug in regular use called methotrexate. It has been used in the largest phase 3 clinical trial ever conducted for malignant pleural mesothelioma. This international trial began in 1998 and results were reported on in May 2002. The study was aimed at finding out whether pemetrexed plus cisplatin was more effective in treating malignant mesothelioma than cisplatin alone. All patients were given supplements of vitamin B12 and folic acid to help reduce side effects (such as diarrhoea). The outcome of this trial was promising. A number of recent trials are now looking at the use of pemetrexed in combination with other chemotherapy agents.Pemetrexed has now been licensed in the UK for use in combination with cisplatin to treat mesothelioma. This was announced by the company who developed it on 1st November 2004. In August 2005 pemetrexed was approved for use in Scotland by the Scottish Medicines Consortium. In July 2007 NICE (National Institute for Health and Clinical Excellence) announced that they would recommend it for use in England and Wales, for people with advanced mesothelioma which is not suitable for surgery, who are fit enough to look after themselves. Others who are already receiving pemetrexed will be able to continue their treatment while they and their doctors agree that it is helpful. NICE's final decision is expected in September 2007.There is more about pemetrexed in the question and answer section of CancerHelp UK.
Chemotherapy for controlling symptomsA trial reported in 2004 on the combination of raltitrexed (Tomudex) and cisplatin. The researchers believe that this combination is better for advanced mesothelioma that cisplatin on its own. But the actual difference between the two groups in this trial was quite small.
OnconaseOnconase is an experimental chemotherapy drug, made from leopard frog eggs. It is not available in the UK. We have included it here because you may have come across information about it on the web. Onconase may have fewer side effects than many other chemotherapy drugs. But not all the side effects may be known as yet. A phase 3 clinical trial has been going on in the USA and Germany comparing the use of Onconase with doxorubicin to doxorubicin alone for people with mesothelioma. Unfortunately, the trial reports aren't very promising. The researchers say that onconase may be better than doxorubicin for some patients, but doxorubicin isn't the chemotherapy drug of choice for mesothelioma now anyway.
Treating fluid around the lungIn mesothelioma, fluid can collect inside the chest. This makes it more difficult for your lung to expand and so it is harder to breathe. Doctors call this pleural effusion. It is usual to treat this by drawing off the fluid and 'sticking' the pleura together. Doctors do this by putting in some sort of irritant, usually bcg vaccine, talc or chemotherapy. You can also treat pleural effusion by operating to remove the pleura (a pleurectomy). This is called a pleurectomy. There is a trial that is comparing these two approaches to see which is better. While this trial is open and recruiting patients, it will be listed on our clinical trials database. To find it and other trials, go to the database and choose 'lung - mesothelioma' from the drop down menu of cancer types.
SurgeryMajor surgery for people with mesothelioma has not always been thought a good idea by surgeons. This is because surgery cannot cure the disease. And because many people with mesothelioma are not fit enough to get through a very large operation. But the point of surgery in mesothelioma is to slow the cancer down, rather than cure it. The operation that can be done to remove mesothelioma is called an extrapleural pneumonectomy (EPP). This means removing the lung and the lining of the chest cavity (the pleura) on the affected side. It may help people to live more comfortably for longer. But this has to be tested because, on the other hand, it could mean that having such major surgery means people die sooner than they would have.In 2001 a programme was started in the UK to look at patients with mesothelioma and see who would benefit most from this type of surgery. 45 patients have been evaluated and 21 patients have been operated on. Of these patients, so far 16 of these patients (about 75%) have lived for at least 6 months and 13 of them have lived for at least 12 months (about 60%). This programme has led to a trial called 'MARS' which opened in 2005. The MARS trial is looking at the benefits and risks of EPP for mesothelioma patients who have had chemotherapy. Results from some studies in the USA suggest that giving a course of radiotherapy after the EPP will help to keep the disease under control for even longer. Some patients in the MARS trial will have an EPP operation combined with radical radiotherapy. Others will have other treatments, such as radiotherapy or less major surgery. There is more information about the MARS trial on our clinical trials database. Either follow the link or click on the blue button to the left of your CancerHelp UK screen. Then choose lung, and select mesothelioma, from the drop down list of cancer types.
Gene therapyThere are a number of new types of treatments being researched that can be put under this heading. Some doctors and researchers are now calling this type of treatment 'molecular therapy', which is a more general term including research into
Oncogenes
Tumour suppressor genes
Gene therapy and repair genesBy studying how changes in these genes cause normal cells to become cancerous, scientists aim to eventually develop gene therapy where damaged genes in the cancer cells can be replaced with normal ones. The main focus of gene therapy research for mesothelioma involves injecting a virus that has been modified in the laboratory. The virus is injected into the pleural space in your chest, where mesothelioma develops. The idea is that the virus infects the mesothelioma cells with a gene. The gene makes the cancer sensitive to a specific drug that will kill the mesothelioma cells. Without the virus carrying this gene into the cells, the drug would not usually kill them. Much gene therapy research is still centred on how to get the virus into the cancer cells reliably and it will be a while before we will be able to see whether this will develop into a useful treatment. We don't know of any current mesothelioma gene therapy trials that are open and recruiting patients in the UK.
Anti-angiogenic therapyAngiogenesis means growth of new blood vessels. As they get bigger, cancers need to grow their own blood vessels. Without its own blood supply, a cancer cannot continue to grow. Two of the most important chemicals controlling blood vessel growth are called vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (FGF-2). People with mesothelioma have much higher levels of VEGF than people with any other type of cancer. If the VEGF can be blocked, this could control the growth of blood vessels supplying the mesothelioma tumours. This treatment is a type of biological therapy. These are treatments that use natural body substances (or drugs that block them) to treat cancer. There is more about biological therapies in our cancer treatments section. A drug called bevacizumab is a treatment that stops production of VEGF.Bevacizumab has been studied in a number of cancers, including mesothelioma, and bowel, kidney, breast, ovarian, non small cell lung, and prostate cancers. One trial recently reported that this drug may increase survival for patients with lung cancer. An American phase 2 trial tested bevacizumab for mesothelioma, in combination with the chemotherapy drugs gemcitabine and cisplatin. This trial closed in 2005, and we are waiting for the results.Bevacizumab is still very experimental and much larger trials are needed before we will know how effective it will be in treating mesothelioma and other types of cancers.
ImmunotherapyImmunotherapy is treatment with natural substances that the body uses to fight infection and disease. Immunotherapy works by encouraging the body's natural defence system - the immune system - to attack cancer cells. Immunotherapy is really a type of biological therapy. These are a group of treatments that use natural body substances (or drugs that block them) to treat cancer. There is a separate section about biological therapy (including immunotherapy) in CancerHelp UK.The types of immunotherapies being researched for mesothelioma include
Interferon and interleukin 2
Vaccines
Interferon and interleukin 2Two types of immunotherapy in trials for mesothelioma are interferon and interleukin-2 (also called IL-2 or aldesleukin). Interferon has been used in trials both on its own and in combination with various chemotherapy drugs. The results of the combination treatment haven't been any better than the chemotherapy drugs on their own. More trials have to be done before we know how useful interferon will be in treating mesothelioma.IL-2 is made naturally as part of the body's immune response. But now it can be made in the laboratory and used in much larger quantities as cancer treatment. IL-2 can be injected directly into the pleural cavity (intrapleurally) or into the bloodstream. Clinical trials using both these methods have shown some success in stage 1 and 2 mesothelioma. Unfortunately most mesothelioma patients are diagnosed at a later stage than this, when this treatment is not very effective.
Photodynamic Therapy (PDT)This is a relatively new treatment that is used for a few types of cancers. In PDT, a drug called a photosensitising agent is injected into the bloodstream and absorbed by the body's cells. The drug makes cells sensitive to light. When the area to be treated is exposed to laser light, the cells are killed. PDT has to be combined with an operation to treat mesothelioma. This has been tried for early stage mesothelioma. The photosensitising drug is injected into your bloodstream a few days before surgery. During surgery, the surgeon then shines the laser light directly onto the pleura.PDT has been shown to be a safe type of treatment with other types of cancer. But in phase 1 and phase 2 clinical trials for mesothelioma, there were some major complications on a few occasions and so doctors have not widely accepted this treatment. It is particularly likely to be risky when used with major surgery and this combination of treatments is not available in the UK. There are no claims that this treatment will cure anyone of mesothelioma. It is very experimental. We have included it here because it is something you may have read or heard about.
Questions for your doctor
How long will it take me to get over my treatment?
What precautions will I have to take while I am recovering?
What practical help is available?
Can I go back to work?
Can I take up my usual hobbies and sports again?
Can I go abroad on holiday?
Can I drink alcohol?
My partner and I would like to see a counsellor. Can you put us in touch with someone? How much will this cost?
Can you help me with claiming compensation for my illness from my former employers?Note: To print these questions, go to our printer friendly version using this link or the link at the top of the page. Then use the PRINT button at the top of your browser screen. If there is no PRINT button, there is advice on how to print on CancerHelp UK
What precautions will I have to take while I am recovering?
What practical help is available?
Can I go back to work?
Can I take up my usual hobbies and sports again?
Can I go abroad on holiday?
Can I drink alcohol?
My partner and I would like to see a counsellor. Can you put us in touch with someone? How much will this cost?
Can you help me with claiming compensation for my illness from my former employers?Note: To print these questions, go to our printer friendly version using this link or the link at the top of the page. Then use the PRINT button at the top of your browser screen. If there is no PRINT button, there is advice on how to print on CancerHelp UK
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