Mesothelioma is a rare cancer and standard therapies are limited. Therefore, most patients consider one or more of three treatment paths. These paths use different types of therapies and they are usually not exclusive. Mesothelioma patients can move from one type to another and, if their doctors agree, can sometimes use them in combination.
The three treatment paths are:
- Standard therapies
- Clinical trials
- Alternative modalities
Standard therapies include chemotherapy, radiation, and surgery. If more than one of these therapies is used it is may be called multi-modality therapy. Oncologists are the doctors who provide chemo and radiation. Of course, surgeons provide surgeries.
- As of this writing, the only FDA approved chemotherapy for pleural mesothelioma is a combination of Alimta (pemetrexed) and cisplatin. Since chemotherapy for mesothelioma consists of essentially the same drugs across the country, the chemo a mesothelioma patient receives in California will probably be exactly the same as what is administered to a similar patient in New York or anywhere else in the U.S.
- Learn more about chemotherapy here.
- Radiation therapy (RT) is seldom used alone in the treatment of mesothelioma. Today, RT is usually part of a multi-modality therapy used with chemotherapy and/or surgery.
- Learn more about radiation therapy here.
- Of all the conventional therapies surgery, alone or in combination with chemotherapy (such as HIPEC) is considered the most effective standard therapy. Most surgeries for mesothelioma are complex and invasive. Therefore, if a surgery is contemplated it is important to get the best and most experienced mesothelioma surgeon you can find.
- Learn more about surgery here.
Clinical trials are essentially experiments done in clinical research. The purpose of the experiment is to test whether new drugs and therapies are as safe and effective or more safe and effective than current therapies. Clinical trials generate data on safety and efficacy and are only conducted after they have received health authority and ethics committee approval. This approval does not mean that the therapy is safe or effective, only that the trial is allowed to go forward. There are three phases to most clinical trials.
- Phase I – asks is the treatment safe?
- Phase II – asks is the treatment effective?
- Phase III – asks is the treatment safer and more effective than the current standard treatment?
Alternative modalities can go by a number of different names: alternatives, holistic medicine, integrative medicine, complementary. At its core, alternative modalities use a different paradigm from conventional therapies and most clinical trials. Whereas, standard therapies seek to kill mesothelioma cancer cells, alternative modalities seek to harness the body’s immune system and other facilities to either eliminate the cancer or stop it from growing and spreading. Alternative modalities include vitamin therapy, herbs, detoxification, dietary therapy, mind-body medicine, Traditional Chinese Medicine, cannabis oil, and others.
Term Meaning Alternative Therapy When alternative (non-conventional) modalities are used alone without standard therapies. Holistic Medicine A form of healing that considers the whole person, body, mind, spirit, and emotions, in the quest for optimal health. Complementary and Alternative Medicine (CAM) A term for medical products and practices that are not part of standard medical care. Complementary Medicine Any of a range of medical therapies that fall beyond the scope of scientific medicine but may be used alongside it in the treatment of disease and ill health. Integrative Medicine A combination of mainstream medical therapies and CAM therapies for which there is some quality scientific evidence of safety and effectiveness.
The most important thing to remember is that the universe of treatment options is large and that as Paul Kraus says, “A diagnosis is not destiny.” Each person must choose their own treatment path to health based on what they believe is best.