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The dream of anyone living with mesothelioma, or who loves someone with this terrible disease, is to have a cure. Curing cancer of any type has proven difficult for researchers. Some types of cancer can be treated effectively to achieve remission, and essentially a cure, while others spread so quickly, that treating it is difficult and remission is a hope, but not a reality, for many patients.
For mesothelioma there is no cure yet. Research, clinical trials, and developments in treatment have not yet found a cure, but have greatly improved the quality of life for patients with this type of cancer. Better combinations of treatments, more radical surgeries, and advanced technology with focused radiation and gene therapy are helping mesothelioma patients live longer and enjoy greater comfort in the time they have left. The hope of a cure eventually being developed is higher than ever.
Potentially Curative Treatments
While there is no cure for mesothelioma, there are several treatment strategies that give some patients the hope that they will go into remission, which in cancer is essentially the same thing as a cure. Remission means that no more cancer can be found in the body, but it does not mean that the cancer is not going to return. For mesothelioma patients, those diagnosed in the early stages have the greatest hope of achieving remission with certain treatments:
- Surgery. Radical surgeries that aim to remove as much cancerous tissue as possible, as well as nearby healthy tissue to which the cancer may spread, are among the most hopeful strategies for curing early-stage mesothelioma. These include extrapleural pneumonectomy, which removes an entire lung, and pleurectomy/decortication, which removes part of a lung. These surgeries may be curative for a few patients but they come with serious risks.
- Multimodal treatment. What boosts survival rates even higher for early-stage patients is combining surgery with other treatments, like chemotherapy or radiation, or even both. These other treatments help kill any remaining cells that the surgeon cannot see after the surgery removes the bulk of cancerous tissue.
- Gene therapy. Among the most exciting new areas for all types of cancer research is gene therapy. Great promise has been seen in early clinical trials using inserted genes in cancer cells to activate drugs. Allowing patients to get large doses of chemotherapy drugs targeted at the tumor instead of at all cells in the body would greatly improve the situation.
Controlling vs. Curing Mesothelioma
For many illnesses, not just cancer, research is beginning to focus more on the control of the disease rather than finding a cure. To find, detect, and kill all cancer cells, especially in a cancer that spreads as aggressively as mesothelioma does is a major challenge. Many treatment specialists and experts are trying to focus on helping patients control this cancer and to live with a small tumor or several small tumors.
Controlling mesothelioma could potentially help patients live much longer than they have in the past and to do so with greater quality of life. Treatment plans may focus on managing symptoms, and on shrinking and managing tumors as well as. Treatment success is when patients can live comfortably, with an extended life expectancy.
The Most Promising Emerging Treatments
The current treatments most often used are imperfect, at least those with the hope of a cure or at least of extending a patient’s life significantly. They rarely cure a patient and they may cause side effects or serious complications. The surgery used to remove a lung, for instance, may cure a patient, but it also may lead to complications that kill the patient. So researchers continue to search for better treatments.
Some of the most promising lines of new treatment include gene therapy. By adding in new genes to cancer cells, researchers have seen some success in helping improve the effectiveness of anti-cancer drugs. The main challenges include actually being able to get the new gene into the cancer cells’ DNA. The transfer rate is not high currently, but if researchers can get around this problem, gene therapy could potentially be curative.
Immunotherapy has also has been used for some time and is starting to show promise in research labs. For mesothelioma, immunotherapy may be used by using cancer vaccines to stimulate the body’s immune system to attack cancer cells. Drugs are also being developed, sometimes called biologics that boost the immune system function.
Photodynamic therapy is another exciting area of mesothelioma research. It involves injecting a drug into the vein. The drug travels throughout the body, but accumulates the most heavily in cancer cells. After a few days a tube with a light is inserted into the chest cavity to reach the tumor. The light activates the drug, which then kills cancer cells. Because the drug does not become active until exposed to light, this treatment causes fewer side effects than traditional chemotherapy, which uses active drugs that can kill healthy cells as well as cancer cells. The targeting of this treatment also means that higher, more toxic doses can be used.
The Importance of Early Detection
Early diagnosis of mesothelioma is crucial in giving patient’s the hope of a cure through treatment and in being able to manage this cancer. Mesothelioma has always been difficult to diagnose. It develops over decades; it mimics symptoms of other illnesses; and it is a rare disease, so it is often misdiagnosed once or more times before an accurate diagnosis is made. If, however, mesothelioma could be diagnosed during stage I, a patient has a much better chance of being treated successfully.
For this reason, some researchers have focused on better ways for diagnosing mesothelioma early. One promising way of doing this is through the detection of biomarkers, which are molecules that are unique to mesothelioma. Several markers have been found, and while they have improved diagnoses, none are foolproof ways of detecting the disease. They include proteins osteopontin and mesothelin. One blood test, called Mesomark, can be used to detect concentrations of mesothelin that may be the closest way to unambiguously diagnose the cancer.
Clincal trails are crucial in the search for the cure or better treatments for managing mesothelioma. These are studies that test new drugs, surgical procedures, treatment strategies, and treatment combinations using human participants. The new treatments are first tested in laboratories and in animals and then in increasingly larger clinical trials to determine if they are effective and safe.
There are risks associated with participating in clinical trials, but for patients with incurable cancer, those risks are often worth the possible benefits. These participants are also important in helping to advance new treatments. Developments could not be made without them taking the risk. Clinical trials are currently testing gene therapies, new immunotherapies, targeted drugs, and other exciting new treatments for mesothelioma that could eventually lead to a cure.
Page Medically Reviewed and Edited by Anne Courtney, AOCNP, DNP
Anne Courtney has a Doctor of Nursing Practice degree and is an Advanced Oncology Certified Nurse Practitioner. She has years of oncology experience working with patients with malignant mesothelioma, as well as other types of cancer. Dr. Courtney currently works at University of Texas LIVESTRONG Cancer Institutes.