Peritoneal Mesothelioma Patients Benefit from Multi-Modal Treatment
Many clinical trials assessing the efficacy of treatments for patients with malignant mesothelioma in the last 20 years have made no distinction between peritoneal mesothelioma and the more common pleural mesothelioma. This has led Richard Alexander, Jr., M.D., of the University Of Maryland School Of Medicine, to state that it has become increasingly clear that patients with malignant peritoneal mesothelioma have a distinct disease for which specific therapies should be tailored.
Both peritoneal and pleural mesothelioma are rare, incurable cancers. Peritoneal mesothelioma is a form of cancer that affects the lining of the abdomen. While there are close to 3,000 cases of mesothelioma diagnosed in the United States each year, less than 10% of those are peritoneal. Pleural mesothelioma is most commonly found in the outer lining of the lungs.
Alexander noted that physicians are increasingly turning to multi-modal therapy, involving surgery to remove visible tumors, followed by chemotherapy. Mesothelioma has a complex growth pattern making complete surgical removal a difficult task requiring follow up with a high-dose of targeted chemotherapy. For peritoneal mesothelioma this involves bathing the patient’s abdomen with heated high-dose chemotherapy drugs to reach the remaining microscopic cancer cells.
The use of chemotherapy baths uniformly distributes the medication throughout the abdominal cavity and heating the drugs increases their toxicity to cancer cells. Alexander adds that there are a number of factors that have been recognized as helpful in predicting a mesothelioma patient’s outcome including their age and the ability of surgeons to remove all tumors.
He said that to make further meaningful advances in treatment of this rare disease, collective and cooperative efforts among medical institutions are needed to study the disease.