This legal article explains in detail experimental mesothelioma treatments derived from asbestos exposure. Mesothelioma is a rare and aggressive form of cancer that primarily affects the lining of the lungs, but it can also affect other organs such as the abdomen and heart. Treatment options for mesothelioma typically include a combination of surgery, radiation therapy, and chemotherapy. However, because it is a challenging cancer to treat, researchers have been exploring experimental treatments and medicines to improve outcomes for patients.
Here are some experimental treatment options and emerging therapies for mesothelioma:
- Immunotherapy: Immunotherapy is a promising area of research for mesothelioma. Drugs like checkpoint inhibitors (e.g., pembrolizumab, nivolumab) have shown potential in clinical trials. These drugs work by boosting the immune system’s ability to recognize and attack cancer cells.
- Targeted Therapy: Some studies are investigating the use of targeted therapies that aim to disrupt specific molecular pathways or genetic mutations associated with mesothelioma. For example, drugs targeting the FGFR pathway or the BAP1 gene mutation are being explored.
- Gene Therapy: Gene therapy is an experimental approach that involves modifying a patient’s own genes to combat the cancer. Researchers are exploring techniques such as CRISPR-Cas9 to target and modify genes related to mesothelioma.
- Tumor-Treating Fields: Tumor-treating fields (TTFields) are a novel treatment approach that involves using electrical fields to disrupt cancer cell division. This therapy has shown some promise in extending survival for mesothelioma patients.
- Photodynamic Therapy (PDT): PDT is a treatment that involves injecting a photosensitizing agent into the body and then exposing the tumor to light. This activates the agent, which can help destroy cancer cells. PDT is being investigated as a potential treatment for mesothelioma.
- Oncolytic Viruses: Researchers are exploring the use of oncolytic viruses, which are viruses that selectively infect and destroy cancer cells, as a treatment option for mesothelioma.
- Multimodal Therapies: Some clinical trials are testing combinations of traditional treatments with experimental approaches. For example, combining surgery, chemotherapy, and immunotherapy can offer a more comprehensive approach to treating mesothelioma.
It’s important to note that experimental treatments are typically available only through clinical trials, and participation in a clinical trial is a decision that should be made with careful consideration and in consultation with a healthcare provider. Additionally, outcomes and the effectiveness of these experimental treatments can vary, and they may come with unknown side effects and risks.
If you or a loved one is facing a mesothelioma diagnosis, it’s essential to work closely with a healthcare team experienced in treating this rare cancer. They can provide information on available treatment options and help you explore whether participation in a clinical trial is a suitable choice.
Alimta – Pemetrexed disodium
Experimental Treatment for Mesothelioma
Pemetrexed disodium, powder for solution for infusion, vial 500 mg. Each vial contains 500 mg of pemetrexed as pemetrexed disodium. Each 500 mg vial must be reconstituted with 20 mL of 0.9 % Sodium Chloride Injection (preservative free). The reconstituted Alimta solution contains 25 mg/mL of pemetrexed.
Alimta is supplied as a sterile lyophilized powder for intravenous infusion available in single-dose vials. The product is a white to either light yellow or green-yellow lyophilized solid. Each 500-mg vial of Alimta contains pemetrexed disodium equivalent to 500 mg pemetrexed and 500 mg of mannitol. Hydrochloric acid and/or sodium hydroxide may have been added to adjust pH.
Clinical pharmacology
Pharmacodynamics
Pemetrexed is an antifolate containing the pyrrolopyrimidine-based nucleus that exerts its antineoplastic activity by disrupting folate-dependent metabolic processes essential for cell replication. In vitro studies have shown that pemetrexed inhibits thymidylate synthase (TS), dihydrofolate reductase (DHFR), and glycinamide ribonucleotide formyltransferase (GARFT), all folate-dependent enzymes involved in the de novo biosynthesis of thymidine and purine nucleotides.
Pemetrexed is transported into cells by both the reduced folate carrier and membrane folate binding protein transport systems. Once in the cell, pemetrexed is converted to polyglutamate forms by the enzyme folylpolyglutamate synthetase. The polyglutamate forms are retained in cells and are inhibitors of TS and GARFT. Polyglutamation is a time- and concentration-dependent process that occurs in tumor cells and, to a lesser extent, in normal tissues. Polyglutamated metabolites have an increased intracellular half-life resulting in prolonged drug action in malignant cells.
Preclinical studies have shown that pemetrexed inhibits the in vitro growth of mesothelioma cell lines (MSTO-211H, NCI-H2052). Studies with the MSTO-211H mesothelioma cell line showed synergistic effects when pemetrexed was combined concurrently with cisplatin.
Absolute neutrophil counts (ANC) following single-agent administration of pemetrexed to patients not receiving folic acid and vitamin B 12 supplementation were characterized using population pharmacodynamic analyses. Severity of hematologic toxicity, as measured by the depth of the ANC nadir, is inversely proportional to the systemic exposure of Alimta. It was also observed that lower ANC nadirs occurred in patients with elevated baseline cystathionine or homocysteine concentrations. The levels of these substances can be reduced by folic acid and vitamin B 12 supplementation. There is no cumulative effect of pemetrexed exposure on ANC nadir over multiple treatment cycles.
Time to ANC nadir with pemetrexed systemic exposure (AUC), varied between 8 to 9.6 days over a range of exposures from 38.3 to 316.8 µg·hr/mL. Return to baseline ANC occurred 4.2 to 7.5 days after the nadir over the same range of exposures.
Pharmacokinetics
The pharmacokinetics of pemetrexed administered as a single agent in doses ranging from 0.2 to 838 mg/m 2 infused over a 10-minute period have been evaluated in 426 cancer patients with a variety of solid tumors. Pemetrexed is not metabolized to an appreciable extent and is primarily eliminated in the urine, with 70% to 90% of the dose recovered unchanged within the first 24 hours following administration. The total systemic clearance of pemetrexed is 91.8 mL/min and the elimination half-life of pemetrexed is 3.5 hours in patients with normal renal function (creatinine clearance of 90 mL/min).
The clearance decreases, and exposure (AUC) increases, as renal function decreases. Pemetrexed total systemic exposure (AUC) and maximum plasma concentration (C max ) increase proportionally with dose. The pharmacokinetics of pemetrexed do not change over multiple treatment cycles. Pemetrexed has a steady-state volume of distribution of 16.1 liters. In vitro studies indicate that pemetrexed is approximately 81% bound to plasma proteins. Binding is not affected by degree of renal impairment.
Right usage of Alimta
Before taking Alimta tell your doctor about all of your medical conditions, including if you:
- are pregnant or planning to become pregnant. Alimta may harm your unborn baby.
- are breastfeeding. It is not known if Alimta passes into breast milk. You should stop breastfeeding once you start treatment with Alimta.
- are taking other medicines, including prescription and nonprescription medicines, vitamins, and herbal supplements. Alimta and other medicines may affect each other causing serious side effects. Especially, tell your doctor if you are taking medicines called “nonsteroidal anti-inflammatory drugs” (NSAIDs) for pain or swelling. There are many NSAID medicines. If you are not sure, ask your doctor or pharmacist if any of your medicines are NSAIDs.
How is Alimta given?
Alimta is slowly infused (injected) into a vein. The injection or infusion will last about 10 minutes. You will usually receive Alimta once every 21 days (3 weeks). If you are being treated for malignant pleural mesothelioma, Alimta is given in combination with cisplatin (another anti-cancer drug).Cisplatin is infused in your vein for about 2 hours starting about 30 minutes after your treatment with Alimta.
Your doctor will prescribe a medicine called a “corticosteroid” to take for 3 days during your treatment with Alimta. Corticosteroid medicines lower your chances for getting skin reactions with Alimta.
It is very important to take folic acid and vitamin B 12 during your treatment with Alimta to lower your chances of harmful side effects. You must start taking 350-1000 micrograms of folic acid every day for at least 5 days out of the 7 days before your first dose of Alimta. You must keep taking folic acid every day during the time you are getting treatment with Alimta, and for 21 days after your last treatment. You can get folic acid vitamins over-the-counter. Folic acid is also found in many multivitamin pills. Ask your doctor or pharmacist for help if you are not sure how to choose a folic acid product. Your doctor will give you vitamin B 12 injections while you are getting treatment with Alimta. You will get your first vitamin B 12 injection during the week before your first dose of Alimta, and then about every 9 weeks during treatment.
You will have regular blood tests before and during your treatment with Alimta. Your doctor may adjust your dose of Alimta or delay treatment based on the results of your blood tests and on your general condition.
What should I avoid while taking Alimta?
Women who can become pregnant should not become pregnant during treatment with Alimta. Alimta may harm the unborn baby. Ask your doctor before taking medicines called NSAIDs. There are many NSAID medicines. If you are not sure, ask your doctor or pharmacist if any of your medicines are NSAIDs.
Side effects of Alimta
Most patients taking Alimta will have side effects. Sometimes it is not always possible to tell whether Alimta, another medicine, or the cancer itself is causing these side effects. Call your doctor right away if you have a fever, chills, diarrhea, or mouth sores. These symptoms could mean you have an infection.
The most common side effects of Alimta when given alone or in combination with cisplatin are:
- Stomach upset, including nausea, vomiting, and diarrhea. You can obtain medicines to help control some of these symptoms. Call your doctor if you get any of these symptoms.
- Low blood cell counts:
- Low red blood cells. Low red blood cells may make you feel tired, get tired easily, appear pale, and become short of breath.
- Low white blood cells. Low white blood cells may give you a greater chance for infection. If you have a fever (temperature above 100.4°F) or other signs of infection, call your doctor right away.
- Low platelets. Low platelets give you a greater chance for bleeding. Your doctor will do blood tests to check your blood counts before and during treatment with Alimta.
- Tiredness. You may feel tired or weak for a few days after your Alimta treatments. If you have severe weakness or tiredness, call your doctor.
- Mouth, throat, or lip sores (stomatitis, pharyngitis). You may get redness or sores in your mouth, throat, or on your lips. These symptoms may happen a few days after Alimta treatment. Talk with your doctor about proper mouth and throat care.
- Loss of appetite. You may lose your appetite and lose weight during your treatment. Talk to your doctor if this is a problem for you.
- Rash. You may get a rash or itching during treatment. These usually appear between treatments with Alimta and usually go away before the next treatment. Call your doctor if you get a severe rash or itching.
Talk with your doctor, nurse or pharmacist about any side effect that bothers you or that doesn’t go away. These are not all the side effects of Alimta. For more information, ask your doctor, nurse or pharmacist.
Indications and usage
Mesothelioma : Alimta in combination with cisplatin is indicated for the treatment of patients with malignant pleural mesothelioma whose disease is unresectable or who are otherwise not candidates for curative surgery.
Non-Small Cell Lung Cancer : Alimta as a single-agent is indicated for the treatment of patients with locally advanced or metastatic non-small cell lung cancer after prior chemotherapy. The effectiveness of Alimta in second-line NSCLC was based on the surrogate endpoint, response rate. There are no controlled trials demonstrating a clinical benefit, such as a favorable survival effect or improvement of disease-related symptoms.
Alimta therapy should be discontinued if a patient experiences any hematologic or nonhematologic Grade 3 or 4 toxicity after 2 dose reductions (except Grade 3 transaminase elevations) or immediately if Grade 3 or 4 neurotoxicity is observed.
Elderly Patients –No dose reductions other than those recommended for all patients are necessary for patients >/=65 years of age.
Children –Alimta is not recommended for use in children, as safety and efficacy have not been established in children.
Renally Impaired Patients –In clinical studies, patients with creatinine clearance >/=45 mL/min required no dose adjustments other than those recommended for all patients. Insufficient numbers of patients with creatinine clearance below 45 mL/min have been treated to make dosage recommendations for this group of patients. Therefore, Alimta should not be administered to patients whose creatinine clearance is < 45 mL/min using the standard Cockcroft and Gault formula (below) or GFR measured by Tc99m-DPTA serum clearance method.
How supplied
Alimta ® , pemetrexed for injection is available in sterile single-use vials containing 500 mg pemetrexed. NDC 0002-7623-01 (VL7623): single-use vial with flip-off cap individually packaged in a carton.
Storage
Alimta, pemetrexed for injection, should be stored at 25°C (77°F); excursions permitted to 15-30°C (59-86°F) [see USP Controlled Room Temperature]. Chemical and physical stability of reconstituted and infusion solutions of Alimta were demonstrated for up to 24 hours following initial reconstitution, when stored refrigerated, 2-8°C (36-46°F), or at 25°C (77°F), excursions permitted to 15-30°C (59-86°F) [see USP Controlled Room Temperature]. When prepared as directed, reconstituted and infusion solutions of Alimta contain no antimicrobial preservatives. Discard unused portion. Alimta is not light sensitive.
New Treatments For Mesothelioma
The University of Chicago Cancer Research Center released the results of a yearlong clinical trial of Pemetrexed Disodium — also known as Alimta. Researchers found that patients who combined Alimta with vitamin treatments and the chemotherapy drug, Cisplantin, lived longer and suffered less pain and difficulty breathing than those who only used chemotherapy.
Alimta is scheduled to go to the Federal Drug Administration for fast-track approval in 2003. Given the time it takes for an official FDA approval, the drug’s maker, Eli Lilly, has arranged with the FDA to begin offering compassionate use of the drug in the interim. Patients who are currently not receiving treatment are eligible for the program.
Alimta must only be administered under the supervision of a physician qualified in the use of anti-cancer chemotherapy.
Malignant Pleural Mesothelioma
In patients treated for malignant pleural mesothelioma, the recommended dose of Alimta is 500mg/m2 of body surface area (BSA) administered as an intravenous infusion over 10 minutes on the first day of each 21-day cycle. The recommended dose of cisplatin is 75mg/m2 BSA infused over two hours approximately 30 minutes after completion of the pemetrexed infusion on the first day of each 21-day cycle. Patients must receive adequate anti-emetic treatment and appropriate hydration prior to and/or after receiving cisplatin (see also cisplatin Summary of Product Characteristics for specific dosing advice).
Non-Small Cell Lung Cancer
In patients treated for non-small cell lung cancer, the recommended dose of Alimta is 500mg/m2 BSA administered as an intravenous infusion over 10 minutes on the first day of each 21-day cycle.
More info in Alimta official site Alimta.com
Photodynamic therapy (PDT)
Traditionally, many cancer treatments have been unable to inhibit the metastasis (growth and spread) of mesothelioma, also known as asbestos cancer, requiring further research and development of new modalities through which to combat the disease. There is now an investigational, new treatment currently undergoing clinical trial testing called photodynamic therapy. The process, though still quite experimental, is underway to becoming a defense for the body against mesothelioma cancer.
Photodynamic therapy must be initiated before surgery to be operative. The treatment utilizes the energy emitted from laser light to kill cancer cells from within the body. As aforementioned, since the treatment is in the experimental stages, its ability to assist with the body’s metastasis, though effective, is still highly investigational.
This proactive therapy is especially vital to the treatment of this type of cancer (formed after asbestos exposure) because mesothelioma has proven to be incurable thus far. Once proven effective, photodynamic therapy could be utilized in the treatment of other cancer types as well.
The restorative process of photodynamic therapy uses oxygen as produced by a reaction to light waves. Photodynamic therapy releases photosensitizers into the bloodstream intravenously. In the bloodstream, the drug is then absorbed throughout all cells of the body. The patient is then exposed to specific wavelengths of light during the therapeutic process. Photosensitizers in the bloodstream react to the light exposure by producing a particular oxygen strand that kills neighboring cancer-ridden cells.
Once injected, photosensitizers do not differentiate healthy from cancerous cells. The difference relies in the amount of time the active agent is spent in each cell. Cancerous cells absorb photosensitizers much longer than healthy cells. The active agent is absorbed in all cells of the body; from anywhere between one to three days, the tumors are exposed to measured wavelengths of light. Subjects must receive the injections of the photosensitizing agents two-three days before surgery. Light waves are then absorbed from a laser light the surgeon shines on the pleura (or another localized effected area). The remaining photosensitizers absorb the wavelengths of light and initiate the defensive oxygen enhancement intended to kill cancerous cells. Adverse effects to the treatment are limited and infrequent.
Photodynamic therapy can offer further proactive measures to treat cancer with two alternative activities in the body. The photosensitizer could 1) damage the tumor, thereby cutting off the nutrition supply for the tumor’s need to grow and thrive, and 2) alert the body to naturally attack cancer cells organically.
As a precept to surgery, treatment of mesothelioma with photodynamic therapy is optimistic, but still investigational. Tests were conducted in the early stages of the disease. Although this proactive approach has been shown to be a safe treatment for other types of cancer, concerns arose when clinical trials of mesothelioma in phase 1 and phase 2 sometimes experienced caveats and complications. Therefore, doctors have yet to widely accept this treatment. It should also be said that this treatment is not yet available in the United Kingdom.
Immunotherapy, or biotherapy
Not only impact from outside can be used as a treatment of mesothelioma but also patient’s immune system is in itself can efficient to fight cancer. To direct or restore the body’s natural defenses against cancer different substances made by the body or made in a laboratory can be used. This treatment is also called immunotherapy or biotherapy.
This type of treatment works by encouraging the body’s natural defense system, which is called the immune system, to attack cancer. So we can say that immunotherapy is the only type of biological therapy.
Interleukin-2 (also called IL-2 or aldesleukin) and interferon are two types of immunotherapy that are in trials for mesothelioma. IL-2 is a part of the immune response that is naturally made in the body. It is also possible to make it in the laboratory that’s why it can be used in much larger quantities as cancer treatment. Usually IL-2 is injected into the bloodstream or directly into the pleural cavity (intrapleurally). Despite that usage of these methods have shown some success in stage 1 and 2 mesothelioma, it is almost impossible to use them as a treatment because most mesothelioma patients are diagnosed at a late stage.
Trials of interferon in combination with various chemotherapy and on its own show that the combination treatment haven’t been any better than the chemotherapy drugs on their own. We still need to understand how useful interferon can be in treating mesothelioma.
Colony-stimulating factors are another substances that can initiate an antitumor immune response . Trial that involved intratumoral injection of granulocyte-macrophage colony-stimulating factor (GM-CSF) has been conducted by Robinson’s group122 at the University of Western Australia. They reported intense intratumoral lymphocytic infiltrate that is associated with some local reduction in tumor mass in two patients. Significant therapeutic effects with intraperitoneal delivery of cytokine genes for antisense TGF-, IFN-, IL-2 has been also demonstrated.
A series of phase I and phase II clinical trials of combinations of immunotherapy (cytokines) and chemotherapy have been carried out recently. These trials have as their rationale in vitro synergistic antiproliferative effects on mesothelioma cell lines of cytokines, such as IFN- in combination with standard chemotherapeutic agents. In human trials, most encouraging results have combination of the most active single chemotherapeutic drugs with cytokines with proven antitumor activity (ie, IFN-).
Antineoplastons
Antineoplastons is a unique type of cancer treatment (in addition to fighting HIV infection and certain autoimmune diseases). They were isolated by Stanislaw R. Burzynski, M.D. more than 20 years ago. Antineoplastons are found to occur naturally throughout the body; however, they can also be made in a laboratory. It is a group of 120 peptide fragments, organic acids and amino acid derivatives. Antineoplastons are derived from glutamine, phenylacetate salts and isoglutamine.
Researches of antineoplastons has been conducted by Dr. Burzynski since the late 1960s. Dr. Burzynski believes that special peptides called anticancer peptides cause spontaneous regression of cancerous cells. These peptides can be found in large quantities throughout the blood and urine. Burzynski considers antineoplastons to be capable of reprogramming certain errors in cellular differentiation and in that way “normalizing” cancer cells.
Gene therapy
This new type of mesothelioma treatment combats the rare asbestos cancer by correcting the disease at the DNA level. During this treatment foreign genes are inserted into cells and tissue.
Two basic types of gene therapy are known:
– Knockout gene therapy: Targeting and rendering genes that induce abnormal behavior inactive.
– Replacement gene therapy: Replacing defective genes with a normal copy.
Another mesothelioma gene therapies are:
– Tumor suppressor genes
– Gene therapy and repair genes
– Oncogenes
Gene therapy is based on injecting a specially modified virus into the pleural space of the chest, where mesothelioma most commonly develops. After the injection it can infect the mesothelioma cells with a certain gene that in its turn makes the cancer sensitive to a specific drug.
Now it is not completely clear how to get the virus into the cancer cells reliably. So more and more researches are still needed before scientists will be able to use mesothelioma gene therapy as a practical mesothelioma treatment.
“Combination” Gene Therapy
Another type of treatment is combining elements of both the toxic prodrug and genetic immunopotentiation gene therapy approaches. Several trials are currently underway at the Louisiana State University Medical Center of New Orleans. This approach involves systemic administration of GCV preceding the intrapleural instillation of an allogeneic, irradiated ovarian carcinoma cell line retrovirally transfected with HSVtk (PA1-STK cells). The PA1-STK cells will migrate to areas of intrapleural tumor and in that way it can activate killing of mesothelioma cells after GCV infusion.
This bystander killing is theorized to result from the local generation of proinflammatory cytokines (tumor necrosis factor- and IL-1). They elicit an influx of cytotoxic lymphocytes producing hemorrhagic tumor necrosis passage of toxic GCV metabolites from PA1-STK cells. It can also result from passage of toxic GCV metabolites from PA1-STK cells to mesothelioma cells via gap junctions or apoptotic vesicles. This treatment alters the tumor microenvironment in mesothelioma from inhibitory to stimulatory. This alteration in its way engender an antitumor immune response.
Problems and Future Approaches
The major challenge in gene therapy for mesothelioma is optimization of gene delivery. The ability of current nonreplicating vectors to transduce all (or most) tumor cells in a localized malignancy is limited. To increase the effectiveness of gene delivery to mesothelioma cells replicating viral vectors can be used. These vectors have the capability of killing tumors by primary viral lysis and/or via delivery of therapeutic genes to cancer cells. Replication-competent adenoviruses and mutants of the herpes simplex virus type 1 may be used for this purpose.
Brachytherapy in Mesothelioma treatment
There are three main types of radiotherapy: brachytherapy or sealed source radiotherapy, unsealed source radiotherapy and external beam radiotherapy (XBRT) or teletherapy. They differ from each other in the position of the radiation source. Sealed and unsealed source radiotherapy has radioactive material delivered internally while external is outside the body. Unsealed sources may be administered by injection or ingestion while brachytherapy sealed sources are usually extracted later. Another special case of external beam radiotherapy is a proton therapy where the particles are protons.
Brachytherapy can also be used to deliver postoperative radiation to the tumor (implanted radioactive sources). In contrast to external radiation it takes a much shorter time for initiation and completion of therapy. Another distinction of brachytherapy is that it is usually started within a week of surgery and completed in 4 or 5 days. External beam radiation and brachytherapy and are equally effective when properly administered.
Alternative medicine in Mesothelioma treatment
Sometimes patients try alternative treatment modes in cancer treating. Those modes can be used in conjunction with traditional cure or instead of it. But most types of alternative cancer treatment still have not been studied, so doctors still fill lack of information about their strength.
Some important notes about alternative medicine in mesothelioma treatment:
- The use of alternative medicine may be toxic
- The use of alternative medicine may interact with standard treatment, thus reducing the effectiveness of chemotherapy
- The use of alternative medicine may be costly, reducing the person’s ability to afford standard treatment
It’s necessary to know, that the use of alternative medicine may cause intoxication, it may overcome the results of chemotherapy and sometimes it can be even more expensive than standard treatment. If the person neglects standard treatment in favour of alternative medicine, he will forfeit all the advantages of traditional curing. A patient who suffers mesothelioma and resorts alternative medicine, should warn his doctor. It Concealing the use of alternative medicine may be detrimental.
Types of alternative medicine:
- Acupuncture
- Antineoplaston Therapy
- Gene Therapy
- Herbs
- Homeopathy
- Immuno-Augmentation Therapy
- Photodynamic Therapy
- Therapeutic massage
- Visual or Guided Imagery
Antineoplaston Therapy
Antineoplastons are naturally occurring proteins found in the urine and blood of humans and other animals. According to their discoverer, Stanislaw Burzynski, M.D., Ph.D., some of those proteins are able to retard tumor growth. “Healthy” samples of this type have been detected in urine. Besides of it, patterns concerned with other disease states including cancer have also been discovered. Abnormal patterns involve absence of lack of some of the substances. Restoring the missing or lacking substances to “healthy” levels is thought to actually reprogram diseased cells to become normal again. The effectiveness of this cure appeals to the National Cancer Institute to be determined in treating advanced malignancies.
Gene Therapy
Gene Therapy or Replacement Gene Therapy, that treats cancer at DNA level, is considered to be the way to correct an abnormal gene that causes cancer to grow out of control. Replacement Gene Therapy includes substitution of a mutated or missing gene to avoid cancer growth.
Immuno-Augmentation Therapy
Immuno-Augmentation Therapy (IAT) was discovered by Lawrence Burton, Ph.D. and since 1977 it has been in practice in the Bahamas. The base of the treatment program is an assessment of immunocompetence and using certain blood factors in order to recover the proper immune balance that enables immune system resistance to the cancer cells.
Photodynamic Therapy
PDT is based on cooperation of a laser and a photosensitive drug: the laser kills only the cancer cells that react to the photosensitive drugs. This method is used along with surgery. Laser light hits infected cells through a fiber optic device.
Visual or Guided Imagery
Visual Imagery’s content is creation of mental images which could improve one’s health. Relaxation and mental imaging are being used frequently to reduce negative psychological effect of traditional cancer treatment modes. Imagery is very useful in cancer treatment. It’s very popular among cancer patients and practitioners even in advanced cases of disease. Martin Rossman, M.D, wrote the classic book on this subject, named “Healing Yourself: A Step-By-Step Program for Better Health Through Imagery”.
Guided imagery involves practicing hypnosis in order to reach a deeper state of relaxation, where an imaginary experience seems so real that it contains all senses and emotions.
This therapy is especially effective when images that used to deal with the deepest parts of the mind involve symbols of deep feelings. Positive feelings, such as pleasure, self-worth, healing and simple relaxation help to improve stamina.
Among other alternative therapies in mesothelioma treatment, acupuncture, herbs, homeopathy, and therapeutic massage can be named. These practices are frequently used together with traditional methods. Integrative approach in mesothelioma treatment is preferential because of its positive influence on physical, mental, emotional and spiritual health. However, no treatment should be started without consultation with a specialist in these fields and with attending doctor.
There are no evidences of the effectiveness of alternative practices in mesothelioma treatment and patients often resort that treatment modes because of poor prognosis. But consulting the physicians is always recommended before trying any methods. There are lots of additional time-tried remedies that may improve patient’s health, such as meditation along with relaxation, pain decreasing massage and guided imagery to avoid loathing.
Complementary and alternative medicine can accompany traditional treatment because it supports cure methods that not accepted by conventional medicine, such as Far Eastern medicine, acupuncture, herbs, homeopathy, and therapeutic massage.
These therapies called complementary when they used in conjunction with traditional medicine. Lots of these methods are supposed to be holistic for their ability to improve all types of health: mental, physical, emotional, and spiritual. Medical curriculum rarely includes these treatments, and they generally not covered under insurance policies.
Antiangiogenesis therapy in Mesothelioma treatment
Antiangiogenesis therapy is one of types of experimental treatments that is used along with traditional therapies. Tumor angiogenesis (blood vessel formation) is the growth of blood vessels from surrounding tissue to the tumor. This process is usually caused by the release of chemicals that is induced by the tumor.
A special substance called angiogenesis inhibitor may be used to prevent the formation of blood vessels. It is especially important in anticancer therapy because it can help to stop the growth of blood vessels to a solid tumor. A special protein called angiostatin can be used for this purpose. It can be made either by the body or in the laboratory. Right now it is being studied as a treatment of cancer.
Antiangiogenesis – prevention of the growth of new blood vessels.
Cancer cells as any other cell need blood to thrive and grow. Rapid division and replication of cancer cells require more nourishment that what normal cells use. A special network that consists of capillaries (minute blood vessels), arteries and veins supplies blood to the growing tumor. This process is called angiogenesis.
Tumors compel surrounding tissues’ blood transfer system to supply them with the oxygen-rich blood by using special chemicals called angiogenesis promoters. As tumor grows larger and larger, more and more blood is diverted. After the tumor reaches its maximum size it starts to metastizes into healthy tissues replicating its cells and replacing healthy cells.
Due to the location of mesothelioma close to many oxygen-rich blood vessels it makes angiogenesis very easy. The only way to prevent is using special drugs called angiogenic inhibitors that destroy angiogenesis promoters. These drugs have an ability to shut down the capillary response of tumors. Sometimes it can even cause tumors to completely disappear. Some of them prevent from developing blood vessels entirely while others work by destroying the lining inside the blood vessels in the tumor.
This type of treatment holds great promise for mesothelioma victims despite the fact that the initial stages of angiogenic inhibitors generate modest results. This kind of treatment was recently developed, so years may pass before they are safe enough to be available to the public at large. But right now some brave individuals participate in clinical studies.
There are two most important factors that control blood vessel growth. They are called basic fibroblast growth factor (FGF-2) and vascular endothelial growth factor (VEGF). The levels of VEGF in people with mesothelioma are very high. The blocking of this factor could control the growth of blood vessels that supply the mesothelioma tumours. Natural body substances (or drugs that block them) are used to treat cancer.
There are 2 agents that stop production of VEGF that are used in going on trials:
– SU5416
– Bevaci(z)umab
The safety of this kind of treatment has already been proved. Right now it is necessary to see which types of cancer it may help. Bevaci(z)umab has been tested as a drug for different cancers such as mesothelioma, non-small-cell lung, and prostate cancers and bowel, kidney, breast, ovarian cancers. According to one trial that has been recently carried out, this drug increase survival for patients with lung cancer. Combination of Bevaci(z)umab with the chemotherapy drugs cisplatin and gemcitabine is being tested for mesothelioma. But still much mire trials are needed to understand the effectiveness of Bevaci(z)umab. Another possible drug that is being tested is SU 4561.
There are evidences of that higher VEGF expression is linked to poor outcome for patients with NSCLC. Avastin may effectively neutralize all biologically active forms of VEGF and in that way cause dose-dependent reduction in tumor growth. Despite that the effectiveness of new treatments like photodynamic therapy, angiogenesis therapy and gene therapy is not completely proven it provides new hope for mesothelioma patients.