The World Health Organization (WHO) defines palliative care as “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness”. Palliative care may be given to those with side effects from “potentially curative” procedures such as surgery or chemotherapy, or may used only for symptom control in those not seeking aggressive treatment.For some mesothelioma patients, aggressive treatment is not an option.

This may be because of the age of the patient, because the disease has progressed to the point where aggressive treatment is not feasible or simply because of the personal wishes of the patient. In these situations, palliative care, which is aimed at improving quality of life by controlling pain and reducing other physical symptoms, becomes important.Two symptoms very common to mesothelioma and addressed by palliation early in a mesothelioma diagnosis are:

• Pleural effusion (fluid build-up) and
• Wound seeding

Because pleural effusion is often acute and leads to extreme shortness of breath, chest tube drainage is most often required to make the patient more comfortable. The procedure used to prevent fluid from recurring once it has been drained is called pleurodesis or in layman’s terms, a “talc treatment”.

In this technique, a sclerosing agent is used to abrade or rough up the pleural surfaces producing an adhesion. This prevents further effusion by eliminating the intrapleural space where the fluid builds. Talc appears to be the most effective agent with a success rate of nearly 95%. Before instilling the talc, all fluid is removed and the lung is completely collapsed. The talc is then administered, and the pleural cavity is inspected to be sure the talc has covered the entire pleural surface.

The second palliative care measure is preventative radiation along sites of invasive procedures such as needle biopsy tracks, thoracoscopy incisions and/or chest tube drainage sites. A French randomized study determined that of those treated with radiotherapy, none developed tumor seeding, whereas in the untreated group, seeding occurred in 40% of patients.Beyond these early controls, other common symptoms managed through palliative care include:

• Pain
• Shortness of breath
• Fatigue
• Dry mouth
• Loss of appetite
• Gastrointestinal problems
• Skin problems
• Anxiety and depression

Tags: Mesothelioma Treatment, Palliative Care by admin
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The purpose of clinical trials is to involve patients in finding new and better treatments for their illnesses. Different clinical trials have different goals which may include the testing of new drugs, comparing various ways to treat an illness or the testing of various techniques for cancer prevention. Clinical trials are divided into three phases. Following are short summaries of what each trial phase seeks to accomplish.

• Phase I trials are the earliest phase of the clinical trial system. At this point, drugs have only been tested in the laboratory, but have had an effect on destroying cancer cells. These trials enroll only a limited number of participants, and are only available at limited cancer facilities. The goal of Phase I trials is to find the maximum tolerated dosage of the drug without causing serious side effects, which side effects are most common and whether the drug continues to have anti-cancer activity when administered to humans. If the drug is proven to have an effect on cancer at a safe dosage, the drug will then be tested in Phase II trials.
• Phase II trials continue to test the safety of drugs or procedures, but also begin to look more closely at their effectiveness for particular types of cancer. These trials accrue somewhat larger numbers of participants, and may be located at more facilities. These trials may be “randomized”, meaning that different groups of participants are chosen by a computer, rather than by a doctor.

• Phase III trials compare promising new drugs or procedures with the current standard of treatment. Large numbers of participants from widespread areas are accrued for these trials, and receive either the new treatment or the standard treatment. One of the primary goals of Phase III trials is to determine whether cancer is reduced or slowed by the drugs, how long patients remain stable without progression of disease and how treatment with the drug affects the patient’s quality of life.

If you are interested in participating in a clinical trial for mesothelioma, your doctor should be able to provide you with information on eligibility and availability in your area.

Tags: Clinical Trials by admin
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