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We have a strong focus on treating malignant pleural mesothelioma. Our experienced specialists work together as a team to develop the best treatment plan for each of our patients.
The treatment plan will vary from patient to patient. Given our broad experience with mesothelioma and the treatment options, we have choices that can be offered to patients to personalize treatment depending on the tumor and patient. One form of treatment that patients may receive (and is the best chance for cure) is the trimodality approach incorporating chemotherapy, surgery and radiation (in variable order).
Chemotherapy is the only standard treatment for mesothelioma. The combination of Alimta and Cisplatin are recognized as the only approved treatment by the FDA.
We use both the extrapleural pneumonectomy (EPP) to remove all disease and the lung and diaphragm as well as the lung-sparing pleurectomy/decortication (P/D) to remove just the lining of the affected lung. We have extensive experience in surgery for mesothelioma and keep all options open during the evaluation period.
There is a specialized radiation treatment that is given to patients with mesothelioma. Given the importance of this specialized treatment to protect the good, unaffected lung, it is important to be treated here at Swedish if radiation is used. Chemotherapy can usually be done close to home.
Antiangiogenesis Research and Clinical Trials
Clinical trials are fundamentally important to moving mesothelioma treatment forward. One of the most recent clinical trials treated patients with standard chemotherapy and an angiogenesis inhibiting drug, cediranib maleate.
Cediranib maleate is believed to stop tumor angiogenesis, which is the growth and formation of blood vessels in the tumor. This is important because growth of the cancer can be prevented or reversed by cutting off the supply of blood to the tumor. We hope cediranib maleate will be even more effective by prescribing it with chemotherapy. Antiangiogenesis drugs like these are beginning to emerge as viable treatments for mesothelioma and we are advancing the field.
In certain cases, we are now using the "SMART" protocol of radiation first over five days, followed by surgery. Patients may or may not need chemotherapy afterwards (depending on the pathology found at surgery). With this protocol, survival rates reported are dramatically better than published previously. We are one of the only centers in the country with the expertise in both radiation and surgery to be able to offer this protocol to our patients.