Medical Treatments

Management of Mesothelioma

Mesothelioma is a malignant disease which results from asbestos exposure. It is a disease that cannot be considered curable but the new chemotherapeutic agents have resulted in a longer lifespan for many sufferers and also a lifespan associated with less morbidity and consequently a better quality of life.

Unfortunately much of the myth and adverse effects and the reputation concerning this tumor remain. People are terrified when they hear of such a diagnosis and believe that whatever life is left undoubtedly will be miserable and related to a great deal of discomfort and personal suffering. This is not necessarily so.

Modern medical treatment of pain, Dyspnoea (shortness of breath), cough and the other complications is all possible. A patient who suffers from mesothelioma should see an oncologist and a respiratory physician as part of routine team management. These specialists, together with the general practitioner, are able to treat patients appropriately in most cases until the patient dies. If necessary palliation and an appropriate palliation unit can be consulted.

The treatment of mesothelioma can be divided into three stages. Stage one is the time during which diagnosis occurs. Often the tumor is found incidentally when some other condition is being investigated.

Stage two occurs during the period of accelerated tumor growth and stage three is the palliative stage.

Symptoms and treatment of Mesothelioma

After the initial diagnosis the presenting symptom or symptoms which have resulted in the patient’s initial discomfort and diagnosis need to be treated accordingly. Most often shortness of breath and chest pain are the presenting symptoms.

Shortness of breath, which is frequently associated with the collection of fluid in the pleural space (a pleural effusion), is treated by a procedure called a VATS pleurodesis. During this procedure the surgeon obtains a biopsy and can perform a pleurodesis. This prevents fluid accumulating in the pleural space in the future. The patient can then be fairly confident that any further breathlessness will not be related to re-accumulation of pleural fluid.

Pain is another important symptom which needs to be treated by the physician appropriately and if necessary a pain specialist should be consulted. The modern concept of pain control is to treat pain immediately and increase drug doses as necessary. The old concept of only taking a painkiller when the pain is severe is antiquated, outmoded and should not be adopted. Associated with the use of analgesics and in particular opiate analgesics is constipation. This diagnosis needs to be anticipated and if a patient is taking opiates then appropriate aperients need to be prescribed.

Breathlessness can also be treated with oxygen therapy. Patients who suffer from mesothelioma often have another lung disease. This needs to be treated.

Patients frequently suffer from lung disease, asthma and sometimes interstitial disease which needs to be addressed.

Other complications should be diagnosed early and the patient should be encouraged to report any symptom or sign of discomfort, or any concern that he/she has with his/her doctor immediately and not wait until more serious symptoms occur. Nutrition is an important treatment modality. Ongoing weight loss needs to be avoided.

Looking after your health

Dietitians should be consulted. High protein foods are often used to stimulate and maintain appetite and also maintain patients’ energy levels and abilities . In addition to the distressing symptoms suffered by the patient, family members and friends often become quite distressed when they hear of the diagnosis and seeing their loved one suffer the consequences of the illness. Psychological disturbances and depression may result. It is important to consult psychiatrists and psychologists to deal with these problems.
As previously stated, the treatment of mesothelioma is a team approach. Regular visits to the general practitioner and the respiratory specialist are advised. Regular history and
physical exams can detect complications early. Early diagnosis of symptoms often prevents severe complications. The use of home oxygen, increase in analgesia and nutrition-related complications can be anticipated.

Ultimately the patient will need home and portable oxygen. Alterations in the home environment to allow wheelchair and oxygen use may be necessary. Home care from palliative units, Allied Health Professionals and volunteer organisations are advised and encouraged during the palliative stage of the disease.

Mesothelioma, while a serious diagnosis, should not result in patients “retiring from life”. Adopting a team approach, visiting physicians frequently and not ignoring warning signs, will result in a patient suffering less morbidity and having a more enjoyable lifespan. Treatment should be aggressive and progressive so as the remaining life of the patient can be fruitful and enjoyable. Advice should be obtained from the various legal experts concerning any Pension or Compensation entitlements, estate planning and for the wishes of the patient to be fulfilled when he/she has died.

Whilst no physician can yet claim to cure mesothelioma, there are people who are alive many years after treatment with chemotherapy and radiotherapy.

It is important for patients to sleep well and obtain appropriate advice so that worry, anxiety and pain do not convert night-time into daytime sleep. Tired, depressed patients do not do as well as those who face each day awake, alert and optimistic. Patients should be reminded that whilst alive they are not statistics and will not be treated’ as a statistic. The doctors will do their utmost to maintain the best quality of life for patients while life remains.

Management of Lung Cancer

Lung cancer is a cancer originating in the airways of the lung or in the parenchyma, which is the tissue of the lung. Lung cancer is often fatal although in some cases can be successfully treated. Cigarette smoking is generally thought to be the major risk factor although there are potentially other causes such as asbestos exposure.

The causal link between asbestos and lung cancer was identified by the publication in 1955 of the report of Richard Doll, “Mortality from Lung Cancer in Asbestos Workers” in the British Journal of Industrial Medicine.

Cigarette smoke and asbestos are often stated to play a synergistic or multiplicative role in the development of lung cancer. Some studies have shown that those who smoke cigarettes and have been exposed to asbestos have a fifty fold increased risk of lung cancer over the non asbestos and cigarette exposed population while those who have smoked cigarettes but who have had no exposure to asbestos have only an eleven fold increased risk. Regardless of the precise increase risk there does seem to be some interaction between cigarette smoke and asbestos in the development of lung cancer.

The latency period between exposure to asbestos and development of lung cancer is generally believed to be about 15 to 25 years.

Lung cancer caused by asbestos exposure is under notified. The popular conception is that lung cancer is invariably related to cigarette smoking, but in those patients who have also been exposed to asbestos, the risk of developing lung cancer is much higher. There are various types of lung cancer including adenocarcinoma and squamous cell carcinoma and asbestos exposure has been implicated in virtually all types of lung cancer.

Asbestos exposure has also been implicated in other cancers such as oesophageal cancer, kidney cancer, laryngeal cancer as well as other cancers.

How can AMAA help you

For more information on the symptoms, treatments and management of asbestos related diseases, please get in touch with  the Asbestosis and Mesothelioma Association of Australia (AMAA) on 1800 017 758 or via our contact us form today.