Getting Advice from your Mesothelioma Doctor

Being diagnosed with Mesothelioma cancer is serious. As a life threatening disease, Mesothelioma cancer should be handled with care. Not only is it about the medical treatments you will undergo, but also the mental trauma. Hence, it is important to learn some important information about the disease and the ways to handle it.

What you should ask your Mesothelioma Doctor?

Getting the advice and medical support of your medical practitioner is important in order make sure your progress is along expected lines. You need to know:

• What is the nature of my Mesothelioma cancer?
• What is the specific reference used to describe my problem?
• What is the stage of my cancer?
• What is the life expectancy of my disease?
• Is my Mesothelioma disease in a curable stage?
• Can you explain the treatments and their course applicable to my stage of Mesothelioma?
• What is your area of experience in treating Mesothelioma cases?
• How comfortable are you in treating my Mesothelioma stage of cancer?
• Can you name the specific mesothelioma treatment applicable to my stage of the disease?
• What is the course of this treatment and how long will it take to complete the course?
• Are there any specific side effects I will come across during the course of my treatment?
• What is the possible outcome of the treatment recommended?
• What will happen to my disease and what kind of a relief can I expect?
• Where can I have my treatment done and will you perform the treatment?

While these are an illustrative set of questions you could ask your medical advisor, nothing can stop you from listing anything that comes to mind. It is definitely better to list your questions before hand, so as not miss them while talking to your doctor.

Practice of Mesothelioma Surgeons

Even though there no cure is for mesothelioma, scientists have developed various treatment methods to help reduce the suffering associated with the disease, surgery being the most common method utilized. Mesothelioma specialists may recommend surgery to remove the main mesothelioma tumor and nearby tissues taken over by these cancerous cells. However, if the mesothelioma is at its advanced stage, then mesothelioma surgery may prove difficult, as the tumor is likely to have spread to other areas.

For such a case, surgeons are likely to remove the excessive fluid from around the chest or abdomen area to provide pain relief. Before undergoing mesothelioma surgery or other alternative methods of treatment, patients must discuss any potential risks or adverse side effects that may occur with the mesothelioma specialist prior to taking a decision. Mesothelioma surgery is usually combined with chemotherapy or radiation. Through this combined treatment, the mesothelioma tumor is either reduced or removed and further tumor growth is controlled or stopped.

Surgery for Pleural Mesothelioma

There are different types of surgical practices that mesothelioma surgeons employ based on the type of mesothelioma cancer. They include:

• Pleurectomy or Decortication Surgery: involves the removal of the infected lung and surrounding area. This leads to a reduction of the size of the tumor along with reduced pain due to less pressure on the chest cavity. It also controls fluid accumulation. The treatment is considered to be palliative (reduces pain. but is not a cure). When combined with radiation and chemotherapy, this form of mesothelioma treatment has proved to increase the life expectancy of the patient. Another advantage of this type of mesothelioma surgery is that it has a low mortality rate as compared to more invasive mesothelioma surgery such as extrapleural pneumoectomy. This surgery is not possible if the tumor growth is extensive in the pleural space.
• Pneumonectomy Surgery: involves the removal of the entire lung. This type of surgery is employed when the cancer is in its advanced stages in order to relieve pain.
• Thoracentesis Surgery: involves draining excessive fluid from the lungs with the help of a needle. This eases breathing problems and relaxes the pressure on the lungs.
• Extrapleural Pneumonectomy Surgery: is an advanced type of surgery and complicated procedure performed during the initial stages of mesothelioma. It involves the total removal of the linings surrounding the lungs, linings around the heart and diaphragm to prevent further spreading of mesothelioma. This type of surgical procedure allows for the removal of extensive amounts of tumor cells.

Post- mesothelioma surgery usually involves radiation and chemotherapy to prevent further spreading of the disease. This type of mesothelioma surgery slows down the advancement of mesothelioma and improves the quality of life in some patients. Patients have an average survival time of 35 months as compared to a survival time of 9 months for those treated with palliative or pain–reducing treatment.

Surgical Practices Utilized for Other Types of Mesothelioma

Pericardial Mesothelioma

For pericardial mesothelioma, mesothelioma surgeons employ similar processes such as tissue removal to relieve pain and discomfort. This however does not cure the disease completely. Mesothelioma surgery is usually the last resort for patients as this process is expensive and not covered by most insurance companies.

Peritoneal Mesothelioma

Peritoneal mesothelioma surgery is usually not possible for everyone. If at all it is possible, then patients undergo a peritonectomy surgery to remove the peritoneum (the lining of the abdomen). Recently, doctors have introduced a new technique of surgery called ‘cytoreductive surgery’ for the treatment of this disease. In this technique, they conduct six different types of peritonectomy procedures to extract the maximum amount of the tumor. They then administer post surgery- chemotherapy directly to the peritoneal cavity.

Some doctors also administer a type of chemotherapy that is heated to a few degrees above body temperature referred to as hyperthermic intraoperative intraperitoneal chemotherapy (HIIC). This has proven to be very effective resulting in a survival rate of about 5 years. However, this process is still under clinical trail.

Thoracospic Surgery

Mesothelioma surgeons also utilize a video-assisted surgical technique referred to as ‘thoracoscopic surgery’ (VATS) for mesothelioma diagnosis. In this, various biopsies of the pleural lining, nodules, masses, and pleural fluid are done through a minimal invasive procedure along with other therapies such as pleurodesis for pleural effusions. Several small ports or incisions are made through the chest wall wherein a small camera is inserted along with specific instruments to take samples of tissue. With the help of a video screen, displayed images captured by the camera enables surgeons to complete all the necessary procedures. This procedure is a more viable option as compared to a thoracotomy, which involves a larger incision in order to reach the chest cavity.

Mesothelioma Specialists around US

There are two main treatment options for individuals diagnosed with mesothelioma:

• Standard Treatment: which includes chemotherapy and radiation therapy and is normally cheaper than the specialized types
• Focused Specialized Treatment: normally handled by a mesothelioma specialist which includes surgery

Any well equipped local health care facility will have the necessary equipment needed to perform these procedures, otherwise patients will need not travel to one that offers these services. However, most of the time, the situation is so critical that a mesothelioma specialist is required to administer treatment in order to provide immediate relief for the various symptoms.

Need for Mesothelioma Specialists

Owing to the seriousness of the condition, patients need to get special attention that local hospitals may not be able to provide. Mesothelioma specialists are capable of giving a surgical evaluation as well as suggest internal radiation therapy or other forms of specialized treatment. Some of the various forms of mesothelioma specialists include:

• Oncologists: – are specialists trained in treating cancer patients. There are two types of oncologists. Medical oncologists use chemotherapy while radiation oncologists use in internal or external radiation treatments.
• Pulmonologists: – specialize in treating patients with lung cancer
• Thoracic surgeons: – specialize in chest surgery from their training in removing the mesothelioma growth
• Radiologists: – are specialists who analyze imagings such as X-rays and CAT scans.

Patients require the services of mesothelioma specialist not only for diagnosis and treatment of the disease but also during the recovery period especially if the patient has undergone surgery. In addition, they are well versed with various techniques of post-operative care. They also implement evaluation of the health condition of the patients with emphasis placed on their age, tolerance level and mental health. Surgery done on individuals with good health show a high success rate of recovery, while those with poor health prior to surgery may experience complications, and normally have reduced success rate.

In addition, doctors must administer great care when administrating chemotherapy and radiation treatments as well as any other alternative treatments. These patients require perfect evaluation by the specialists for treatment options such as immunotherapy, gene therapy or clinical trials.

Mesothelioma specialists also offer advice to patients on pre-treatment preparation which is an important part of any medical procedure ranging from surgery to other alternative forms of treatment. They advise patients on the importance of adopting healthier lifestyles which included changes in the diet and medication.

Mesothelioma Specialist in and around the United States

As mesothelioma is considered to be a rare disease, most general physicians are not very familiar with mesothelioma diagnosis, progression and treatment. As a result, individuals diagnosed with the disease travel to far distances to consult with a mesothelioma specialist who can then address the illness in a systematic way. These specialist develop a plan to treat patients based on the developmental stage of the illness. Considering these aspects, it is usually advisable for patients to source a list of mesothelioma specialists in and around their area and analyze their track record prior to deciding on which one to opt for. Below is a list mesothelioma specialists operating within the United States:

• Valerie W Rush (FACS): – is a Thoracic Surgeon working with Memorial-Sloan Kettering Cancer Center and specializes in treating patients with cancer of the lungs, oesophagus, mediastinum or chest wall. She has also successfully conducted research in the area of lung cancer and mesothelioma as well as clinical trials for mesothelioma.
• Paul H Sugarbaker (MD; FACS; FRCS) Director, Surgical Oncology, Washington Cancer Institute: – specializes in peritoneal mesothelioma with a focus on surgery, chemotherapy and radiation therapy.
• Robert N Taub (MD) Professor of Clinical Medicine, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital: – has extensive experience in the field of medical and clinical oncology.
• Mary Louise Keohan (MD), Assistant Professor of Clinical Medicine, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital: – has been treating as well as conducting various studies on patients with mesothelioma.
• Gregory P Kalenkerion (MD), Co-Director of Thoracic Oncology, University of Michigan Comprehensive Cancer Center: – has been developing innovative clinical trials on patients with mesothelioma.
• Joseph S. Friedberg (MD) Chief of Thoracic Surgery, Thomas Jefferson University Hospital: – is responsible for various surgical and therapeutic clinical trials that have had positive effects on mesothelioma.