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Should You Do Immunotherapy or Surgery?

Published on Apr 8, 2022 at 12:08 pm in Forms of Treatment.

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After a malignant mesothelioma diagnosis, you and your doctor will need to carefully consider all treatment options. Like every cancer, malignant (cancerous) mesothelioma can be very difficult to treat. An added complication comes from the fact that most mesothelioma cases are diagnosed in the later stages.

For some patients who receive a late diagnosis, treatment can only be palliative (designed to increase the patient’s comfort rather than cure the disease). There may be treatment options like surgery, chemotherapy, immunotherapy, and radiation therapy for other patients.

If you’ve been diagnosed with malignant mesothelioma, it’s important to discuss all possible treatments with your doctor. Surgery may be the best option for qualified patients. These patients should seek surgery options first before undergoing other therapies like chemo, radiation, or immunotherapy. It’s possible these alternate treatments may disqualify a patient from surgical options. Be sure to speak with a qualified surgeon before pursuing alternate treatment.

The best thing you can do is explore all possibilities to be sure you are making an informed decision about your care. An experienced doctor will be able to identify any viable options for surgery before moving to other types of therapy. To learn more about your legal options following a mesothelioma diagnosis, reach out to an experienced mesothelioma lawyer from Frost Law Firm, PC.

Surgery Options for Malignant Mesothelioma Patients

Mesothelioma is a cancer that affects the mesothelium (protective membrane) of four organs in the body:

  • When the cancer forms in the lining of the lungs, the disease is called pleural mesothelioma.
  • This type of mesothelioma is known as peritoneal mesothelioma.
  • Cancer in the lining of the heart is pericardial mesothelioma.
  • This extremely rare type of mesothelioma is referred to as testicular mesothelioma.

Because pleural mesothelioma makes up about 70-75% of all mesothelioma cases, surgical methods to target the lungs have experienced the greatest development and progress.

The University of California, Los Angeles (UCLA) Department of Surgery has been successfully using surgical techniques to fight pleural mesothelioma since 1997. The Department’s Comprehensive Mesothelioma Program uses a combination of surgery and postsurgical therapies to improve survival rates and increase quality of life. Not every mesothelioma patient qualifies for the surgical procedures UCLA offers, but those who do may undergo:

  • Pleurectomy: A surgery to remove part of the lining around the lungs.
  • Decortication: An operation to remove affected fibrous tissue on the surface of the lung.
  • P/D surgery: A combination pleurectomy and decortication to remove the cancer while sparing the lungs, pericardium, and diaphragm.

As surgical technology advances, more tools become available to help oncologists fight mesothelioma. The thoracic surgeons at UCLA use lasers, bronchial and esophageal stents (tubes to hold a passage open), and robotic surgery using video and computer technology.

Even if a surgery is successful, it does not mean that a patient can go on to live a life free of cancer. Mesothelioma is a disease that can never conclusively be considered “cured.” Continual monitoring and therapy are necessary to watch for and target regrowth. Experts consider mesothelioma to be a chronic disease and treat it as such, even if a patient shows signs of recovery.

For patients who have successfully undergone surgery, postoperative therapies such as these may be used during the ongoing Comprehensive Mesothelioma Program:

  • Radiation therapy, which may include:
    • Stereotactic body radiation therapy (SBRT),
    • Intensity-modulated radiation therapy (IMRT), or
    • Radiosurgery using Novalis Tx image-guided technology.
  • Chemotherapy, a treatment that kills cancer cells with the use of powerful drugs.
  • Targeted and biological therapies that use drugs to interfere with cancer growth.
  • Cryoablation, when a device called a cryoprobe is used to freeze and kill abnormal tissue.
  • Immunotherapy, which uses the body’s own immune system to fight cancer cells.

Is Immunotherapy a Good Choice for Mesothelioma Patients?

Immunotherapy may be a viable treatment alternative for some patients. Before pursuing this option, however, it’s important to remember that the first step should be to consult with a qualified surgeon. Before any other treatments are sought, speak with a surgeon with experience treating mesothelioma patients to learn about the surgical procedures that may be appropriate for you.

Compared to other mesothelioma treatment methods, immunotherapy is relatively new. Although the idea itself has a long history, research into its use as a cancer treatment began seriously in more recent years. In 2018, the Nobel Prize in Physiology or Medicine was awarded to James P. Allison and Tasuku Honjo “for their discovery of cancer therapy by inhibition of negative immune regulation.”

There are many different types of immunotherapies using several different drugs. Keytruda (the brand name of the drug pembrolizumab) was one of the first U.S. Food and Drug Administration (FDA)-approved immunotherapy drugs for mesothelioma patients. In October 2020, the FDA approved the use of Opdivo and Yervoy combination immunotherapy for malignant mesothelioma. Clinical studies on this combination therapy have shown greatly increased survival rates for malignant mesothelioma patients.

The goal of immunotherapy is to teach the body’s immune system to recognize and destroy cancer cells most effectively. Drugs are used to stimulate the immune system’s natural processes, targeting only the cancerous cells. Unlike a method such as chemotherapy, none of the healthy cells are attacked.

The results we’ve seen so far are promising. In many cases, immunotherapy has been most effective when it is combined with other therapies. But immunotherapy is not guaranteed to work in every case for every patient. Before undergoing any kind of cancer treatment, you and your doctor need to carefully weigh the pros and cons. If surgery is an option, it is usually best to pursue that course of action first.

One of the primary disadvantages of immunotherapy is the potential for side effects. The more mild and short-term side effects of immunotherapy are generally flu-like symptoms, including:

  • Nausea and vomiting
  • Diarrhea or constipation
  • Fever
  • Fatigue
  • Weight loss
  • Coughing
  • Skin irritation
  • Mouth sores
  • Muscle and joint pain

Immunotherapy can also cause more serious and long-term health complications, although these are rare. Serious health issues resulting from immunotherapy may include:

  • Allergic reactions
  • Immune system hyperactivity, leading to organ damage
  • Pneumonia
  • Hormonal imbalance
  • Inflammation of the colon (colitis) or liver (hepatitis)
  • Kidney malfunction

Serious side effects are a possibility. But in the majority of cases, mesothelioma patients who undertake immunotherapy treatments suffer only mild side effects. Your doctor will be able to advise you if you are a good candidate for this type of treatment as a first-line therapy, in combination with another treatment, or as an ongoing form of postoperative care.

Legal Help for Malignant Mesothelioma Patients

If you’ve received a mesothelioma diagnosis, you have many decisions ahead of you. Choosing a treatment plan with your physician is one of the most important decisions you will make. It’s important to remember that consulting with an experienced surgeon before seeking other therapies is the best way to fully explore the most effective treatment options.

But any mesothelioma treatment is unavoidably costly. Most people aren’t prepared to take on the financial burden of months or years of costly medical care. At Frost Law Firm, PC, we devote our practice to fighting for the rights of victims of asbestos exposure. It’s our goal to make sure mesothelioma patients never worry if they can afford quality medical care.

We represent mesothelioma victims nationwide. To learn more about how we may be able to help you and your family, reach out to our law firm. An experienced mesothelioma lawyer will provide a consultation free of charge.

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