Receiving a Mesothelioma Diagnosis
Receiving a mesothelioma diagnosis can feel devastating, and the prognosis isn’t favorable in many instances. Even so, advances are being made every day in terms of new treatments for mesothelioma that are increasing the sense of hope people with this cancer and their families might feel.
What is Malignant Mesothelioma?
Malignant mesothelioma is a type of cancer that’s both rare and aggressive. It occurs in the chest or abdomen lining. The only known risk factor for developing mesothelioma is asbestos exposure.
Asbestos is a mineral that naturally occurs and was used in construction and industrial applications for years because of its durability and heat resistance. Unfortunately, the fibers of asbestos settled in different parts of the body when someone was exposed, often on their jobs. The fibers then cause inflammation and irritation that can result in mesothelioma.
Asbestos was banned in the U.S. in 1980, but there’s a very long latency period with mesothelioma. That means many people diagnosed were exposed to asbestos decades ago.
Mesothelioma most often occurs in the tissue lining the chest, known as the pleura. The pleura both lines the cavity of the chest and covers the lungs. It less commonly can occur in the peritoneum, the tissue lining the abdomen and covering most organs.
Very rarely, mesothelioma can occur in the pericardium, the tissue surrounding the heart, or the testes.
As with other cancers, once mesothelioma is diagnosed, further tests are done to learn more about the specific cell type and determine if the cancerous cells have spread elsewhere. Cancer can spread through blood, the lymph system, or tissue.
In Stage I mesothelioma, the cancer is found on the lining of the chest wall on one side of the chest or the tissues covering the abdomen.
Stage II mesothelioma is found on the chest wall’s inside lining on one side of the chest. The cancer can be in other places on the same side of the chest and may have also spread to lymph nodes on the same side as the original tumor.
Stage III mesothelioma means the cancer is in the lining of the chest wall, in each layer of tissue covering the lung and organs between the lungs, and at the top of the diaphragm on one side of the chest. On the same side, the cancer may have spread to other places, like the soft tissues making up the chest wall.
Stage IV mesothelioma indicates that the cancer has spread to the tissue that covers the lung or the lung located on the opposite side of the chest from the original tumor. It may have spread to the lymph nodes, bones, liver, or the peritoneum.
Standard Mesothelioma Treatments
The standard course of treatment for mesothelioma can include:
- Radiation therapy,
Many new options are becoming more widely available and appear promising to help treat mesothelioma. Even when the goal isn’t to cure the cancer, newer treatments tend to have fewer side effects and can extend a person’s life and increase their comfort and quality of life.
Immunotherapy has been one of the most exciting developments in cancer research over the past decade.
For mesothelioma, immunotherapy can help immune cells identify and destroy cancerous cells. Currently, immunotherapy is approved to treat pleural mesothelioma, and it may also be accessible to patients with peritoneal mesothelioma if they enroll in a trial.
The benefits of immunotherapy compared to chemotherapy include fewer and less severe side effects and the fact that it harnesses the ability of your natural immune cells to fight the cancer.
Pembrolizumab, available under the brand name Keytruda, is one of the most widely used immunotherapies for cancer treatment. You’ll also see it called a checkpoint inhibitor.
Also recently approved by the U.S. Food and Drug Administration were nivolumab (Opdivo) and ipilimumab (Yervoy).
With targeted therapy, there are two main categories—monoclonal antibodies and small-molecule drugs. Using monoclonal antibodies, the immune system can recognize and attack immune cells. Other monoclonal antibodies will stop growth or cause them to die.
The two targeted therapies approved in the U.S. to treat mesothelioma are Yervoy and Opdivo.
Yervoy targets a protein known as CTLA-4, promoting the growth of T cells. Those T cells then attack cancer cells. Opdivo targets a protein, PD-L1, which prevents the ability of cancer cells to hide from T cells. The therapies work together, improving the immune system’s ability to identify and kill mesothelioma cells.
Some oncology groups recommend adding Avastin, a monoclonal antibody, to improve chemotherapy outcomes. Avastin inhibits vascular endothelial growth factor or VEGF, limiting new blood vessels that would otherwise allow tumors to grow and spread.
Kinase inhibitors are a targeted therapy being looked at for treating mesothelioma. Tumors need blood vessels to continue growing. Kinase inhibitors block new blood vessels from growing.
Cancerous cells, like healthy cells, contain DNA. There are mutations in the DNA that can cause normal cells to become cancerous tumors. The objective of gene therapy is to repair or replace genes in DNA that lead to cancer.
Gene transfer is a relatively new development in treating mesothelioma, which can help suppress tumors. It’s also possible to transfer what are called suicide genes into cancerous cells, improving the effectiveness of chemotherapy.
Epigenetic therapy is a way to treat cancer by shifting how cells use the DNA they already have. New DNA isn’t added to target cells, which is one of the differences between epigenetic therapy and gene therapy.
CAR T-Cell Therapy
CAR T-cell therapy immunotherapy helps immune cells recognize and attack cancer. As it currently stands, this is an experimental mesothelioma treatment.
During this therapy, a doctor starts by collecting a patient’s T cells, which are immune cells. Then, the T cells are reprogrammed in a lab setting, transforming them into CAR T cells. At that point, the T cells can recognize and combat cancerous cells. The CAR T cells are returned to the patient after being programmed to recognize certain components of cancer cells.
In mesothelioma, the cells are programmed to recognize mesothelin, a protein made in large amounts by mesothelioma cells.
In one study, patients with mesothelioma were given CAR T-cell therapy along with Keytruda, and they survived a median of 23.9 months. All participants were receiving the combination as a second-line treatment. Patients survived a year longer than in other second-line treatment studies.
Photodynamic therapy uses light as a way to kill cancer cells. A drug that acts as a photosensitizer makes cancer cells sensitive to a particular type of light. The light can then kill the cells.
What’s compelling about this new mesothelioma treatment is its few side effects, and studies thus far show it may positively affect life expectancy. In one trial, photodynamic therapy was effective even in advanced mesothelioma. Many participants received surgery, then photodynamic therapy; some also had chemo. The entire group survived three years after treatment, and patients whose cancer hadn’t spread to lymph nodes lived around seven years.
Vaccine therapy is a variation of immunotherapy where a vaccine instructs the immune system to make antibodies to fight cancer cells. It’s similar to a flu vaccine because your body is prepared to identify and attack the virus. Clinical trials are ongoing for mesothelioma vaccines.
Tumor Treating Fields
Tumor Treating Fields or TTFields is a new area of research and a potentially effective treatment option for patients with mesothelioma. TTFields use a mild electrical current to interfere with the growth of cancer cells, slowing or stopping tumor growth.
The treatment is received through a device called the Optune Lua, which the FDA approved to treat certain mesothelioma patients.
In a clinical trial of patients with pleural mesothelioma, the Optune Lua therapy helped 62% of patients live at least a year, and 57% saw their tumor growth stop.
The term multimodal therapy refers to a combination of treatment approaches. For example, it could be that the ideal treatment approach for some mesothelioma patients is a combination of traditional treatments like surgery and chemotherapy with new and emerging treatments.
How Do You Access New Mesothelioma Treatment Options?
You can speak with your oncologist if you’re interested in new treatments for mesothelioma. Someone who specializes in treating this cancer can be your most helpful resource.
Some of the treatments listed above are already approved, but others are being given to mesothelioma patients in clinical trials. The eligibility requirements for clinical trials may assess the cell type, cancer stage, overall health, and treatment history.
Get Compensation For a Mesothelioma Diagnosis
Both traditional treatments, like chemotherapy and newer treatments, can be costly, even when you have insurance. Along with the treatments, many indirect expenses must be factored in, like travel time and taking time off work.
Contacting a mesothelioma attorney is important. When you work with our expert mesothelioma attorneys, they can help you get compensation because of your asbestos exposure. We can file a claim on your behalf against asbestos manufacturers and employers for direct and indirect expenses.
If you aren’t sure where you were exposed to asbestos, our investigative professionals will work on your case to make a definitive link between that exposure and your mesothelioma diagnosis.
Asbestos companies established dozens of trust funds in the 1980s to help compensate exposure victims. We can also identify the trust funds you might qualify for.
We only work with mesothelioma victims—it’s our area of expertise, and we can help you hold asbestos companies and employers liable for your exposure. Reach out today for a free consultation.