HOUSTON 8/7/2009 9:00:00 PM
Mesothelioma multimodality therapy gaining favor
Combining treatments shows promise
Oncologists are increasingly using multimodality therapy to treat mesothelioma, as this approach has been used for other types of malignancies. Cancer specialists have created new therapy routines using multimodality methods for lung cancer, pancreatic cancer, rectal cancer and malignant mesothelioma. Multimodality therapy is defined as the application of two or more processes of cancer treatment intended to deal with certain types of cancer. These methods may include radiation therapy, surgery, gene therapy, chemotherapy, or immunotherapy. Treatment regimens can use a wide range of combinations. Some plans include radiation therapy before surgery to shrink the tumor, while others employ post-surgical chemotherapy to deal with follow-up symptoms. Multimodality is typically personalized to the patient’s disease, symptoms, and responses to conventional treatment. These therapies are also dependent on the stage and type of the patient's cancer. Advocates of the multimodal approach think that the multifaceted plan of attack provides the patient the highest probability of receiving full benefits from treatment.
In the 1970’s, oncologists and cancer researchers started considering the uses and benefits of a multimodal approach to cancer therapy. During those early studies, scientists noted a marked degree of success in treating cancers in lab animals with multimodal techniques. From there, they also saw notable improvements when using the same ideas to treat certain childhood cancers. As effective as these initial tests were, however, the cancer community has still not reached complete agreement on the effectiveness of multimodal therapy routines. Some clinical studies have not shown a noticeable difference in benefits between patients undergoing multimodal therapy versus those experiencing conventional treatments. Other research efforts have established that multimodal therapies can both decrease the incidence of symptoms of the disease as well as increase a patient’s quality of life. Since the idea of multimodal therapy is relatively new to the cancer treatment landscape, more research is underway to determine the efficacy of this approach.
Proponents of this course of action state that multimodality treatment is the best path in terms of both confronting the primary malignant tumor as well as precluding the metastasizing of the disease. The reasoning behind these ideas comes from the fact that particular modes of treatment, such as tumorectomy surgery and radiation therapy, are intended to remove the main cancer site, though other methods, such as chemotherapy, are meant to keep the cancer from spreading throughout the body.
An added benefit of multimodality therapy is that it assures a smaller amount of impairment on the patient's long-term health prospects. Not long ago, surgery was the best cancer treatment option available, with the stated end of withdrawing malignant cells so as to keep the cancer in check. When other modes of treatment, such as radiation and chemotherapy, are applied along with surgery, the patient typically enjoys a much better prognosis. Surgeons understand that they do not need to remove as much tissue, which implies that, by the usage of multimodality therapy, it becomes a possibility for modern cancer patients to save organs and limbs that could potentially have been lost if they had solely undergone surgical treatments. Reports have demonstrated that recurrence rates and mortality rates are both lower with multimodality therapy as compared to surgery alone.
As much promise as the multimodal theory has shown, the nature of the disease and how it varies among individuals creates many difficulties in making a blanket determination on the approach’s effectiveness. Two patients could have the same disease at the same stage and receive the same set of treatments, but could have completely different reactions. The physical demands of undergoing surgery, chemotherapy, radiation and other treatments simultaneously can take a severe toll on some patient populations, such as older patients or those in advanced stages of their disease. These combinations of treatments can also take a financial toll on patients and their families. Mesothelioma clinical trials that are in the process of studying these approaches can alleviate some of the costs involved in using these new treatment avenues and the research staff can tailor the necessary treatments to the patient’s needs.
