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Multimodal Therapy Helps Improve Survival in Mesothelioma Patients

Published: June 21, 2024

Malignant pleural mesothelioma is an aggressive cancer mainly caused by asbestos exposure. It is a cancer of the mesothelium, which is the lining of certain areas of the body including the lungs. The cancer is aggressive and hard to treat. There is hope though in new surgical and therapy methods. A new study looks at pleurectomy and decortication, a type of surgery, and how multimodal therapy helps those suffering from mesothelioma.

Pleurectomy and decortication surgery removes the tumors and tough lung and chest wall tissue. The surgery involves removing the tumors and pleura (mesothelium that covers the lungs). Doing this allows the lungs to fully expand. The surgery is very precise and ensures tumor removal with minimal damage. The surgery is advanced and requires surgeons operating in specialized centers. After the surgery, hyperthermic intrathoracic chemotherapy, also known as HITHOC, is administered. The procedure involves circulating heated chemotherapy through the chest to kill cancer cells. Heating the chemotherapy boosts the overall cancer killing ability of the chemotherapy. Chemotherapy is administered directly to the tumor, which also has the added benefit of reducing side effects. It can take anywhere from 60 to 90 minutes to perform the procedure.

Multimodal therapy is a treatment approach that involves combining multiple separate treatments into one treatment for a patient. It can provide better outcomes for patients, including those suffering from pleural mesothelioma. A multimodal approach to treating mesothelioma includes surgery, chemotherapy, and radiation. Pleural decortication surgery removes as many tumors as possible while HITHOC targets any remaining cancer cells left in the body. This can help prevent tumors from coming back. Post-surgery radiation can also be helpful. It helps kill any remaining cancer cells and lowers the risk of cancer coming back.

Multimodal therapy can be beneficial to those suffering from pleural mesothelioma. The first thing it does is boost survival in patients. Studies prove that it can extend survival in some patients with pleural mesothelioma, especially those suffering with the epithelioid subtype. It can also cut recurrence. Approaching cancer treatment from different angles can make recurrence less likely. It also provides a personalized approach to treating individual patients.

A recent case study shows that pleurectomy/decortication surgery alongside HITHOC was successful in a pleural mesothelioma patient. The patient was able to leave earlier than expected after treatment. When skilled surgeons perform the surgery, the treatment can be safe and effective. Pleural mesothelioma is a tough cancer to treat, but there is hope in new treatments and surgeries like pleurectomy/decortication. The combination of pleurectomy and decortication and HITHOC is a promising way to treat mesothelioma. Multimodal therapy, which combines multiple therapies like surgery, chemotherapy, and radiation into one, lowers the risk of relapse and improves survival.

Nestor Ivan Quiroga et al., “Malignant pleural mesothelioma: Description of pleural decortication and hyperthermic chemotherapy technique in multimodal therapy” Multimedia Manual of Cardiothroracic Surgery (May 15, 2024). [Link]
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