Yesterday marked the second day of the three-day International Symposium on Malignant Mesothelioma in Bethesda, MD. The symposium brings patients, advocates and doctors together to share their collective experience.
Day two of the symposium focused on clinical discussions presented by mesothelioma specialists from across the globe. Doctors also met in separate sessions to discuss high-level information about their research and the breakthroughs being made in the field.
The clinical discussions led by the specialists were meant to convey the progress of mesothelioma research to patients and advocates. Topics ranged from promising drugs that fight mesothelioma stem cells to more esoteric things such as the potential of flaxseed oil in preventing mesothelioma.
It would be daunting to recap everything from yesterday’s talks, but two concepts came up consistently throughout the day: the current state of surgical treatment and the development of new drugs.
Consensus on Surgery
Surgery for both peritoneal and pleural mesothelioma has been a hot-button topic in the past. Some have felt (and some still feel) that certain surgeries are too radical. But it is widely accepted that surgery generally offers the best chances of survival for patients although it’s not always on the table.
Dr. Joseph Friedberg of the University of Maryland Cancer Center explained that 10 to 20 percent of patients are eligible for surgery, and this is usually their best treatment option. He said that it’s important to proceed with caution, adding his philosophy that ‘do no harm’ be the first mandate.
Doctors agreed that surgery alone is usually not enough. For surgical treatment of mesothelioma to be successful, it requires a secondary form of treatment to attack the microscopic cancerous cells left behind after surgery. This could be intraoperative chemotherapy, intraoperative light-based therapy or varying forms of radiation treatments. Dr. Friedberg stressed that more clinical trials are necessary to pinpoint the most effective surgical methods.
Another topic of consensus was the recognition that pleural specialists are beginning to move from the lung-removing extrapleural pneumonectomy (EPP) to the lung-sparing pleurectomy/decortication (P/D). The EPP used to have more success at increasing survival, but more doctors are beginning to favor the P/D because it has become just as effective.
Even Dr. Raphael Bueno, a proponent of the EPP, conceded that the P/D has become more and more prevalent. While it seemed that he was slightly withheld about a complete move away from the EPP, he did admit the P/D is a better option for some patients depending on how advanced their mesothelioma is.
One of the biggest points specialists made was that surgery is not right for everyone and that some patients may be worse off after surgery. Making sure surgery is appropriate based on the unique patient is essential.
Understanding the role of surgery led into a discussion about how there are so many different things out there now besides invasive operations.
Dozens of New Treatments
A lot of the optimism among the doctors at the symposium centered on the development of new drugs for mesothelioma. Over the past few years, doctors and pharmaceutical companies have pushed for more research into novel drugs to treat mesothelioma. The collaborative research effort that has taken place across the globe has led to many new clinical trials.
Here is a list of some of the drugs currently in development for mesothelioma:
Some of the drugs use the immune system to fight mesothelioma, some attack mesothelioma stem cells, some stop tumor growth by blocking the tumor’s blood supply and some infect mesothelioma cells with genetically modified viruses. The message: creativity in drug development for mesothelioma is better than it’s ever been.
This is amazing considering that not too long ago, the only viable treatments for mesothelioma were surgery, chemotherapy and radiation. These treatments are the future for patients, especially for those who are ineligible for surgery and historically limited in treatment options. For curious minds, most of the drugs listed are still accessible through clinical trials.
Although the doctors who attended the discussions have traveled back to their respective cancer centers, the patients and advocates at the symposium stuck around today to travel to Washington D.C., where they are spreading awareness about mesothelioma and other issues relating to the disease.
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