“How to Improve Prognosis for Stage 4 Mesothelioma”
by Ashley Stafford
“Mesothelioma is a serious disease where cancer cells form in the tissue lining that covers the heart, lungs, testicles, or in the lining of the chest wall/abdominal wall. There are various factors that can affect a patient’s mesothelioma prognosis and staging is one of them. Every stage calls for different treatments, which in turn, results in a different prognosis. There are four stages: stage 1, stage 2, stage 3 and stage 4.
The mesothelioma prognosis for stage 4 yields the worst results as it is the most difficult to treat. At this stage, the cancer has already spread to multiple organs of the body, which can seriously affect a patient’s health. In such conditions, it is very difficult to perform surgeries and is usually ruled out as a treatment option. But there are some treatment options still available, such as, palliative treatments. These tend to work out very well for stage 4 mesothelioma patients. The following conditions are observed in in patients with stage 4 mesothelioma:
• Aggressive tumors spread from their primary location to other organs in the body.
• The tumors have a definite involvement in the lymph nodes.
• Severe mesothelioma symptoms are occurring frequently.
At stage 4, mesothelioma has already spread into local tissues, organs and the lymphatic system. As mentioned earlier, surgery is not typically possible but it is to be kept in mind that each case is different. The average life expectancy for mesothelioma at this stage is less than 12 months after the diagnosis is given.
Surgery Treatment: If surgery is considered, the intent is to remove all of the tumors visible and capable of being excised. With this, the affected surrounding tissues are also removed.This surgery is known as pleurectomy. There is another surgery that is very similar but a very aggressive option known as, extrapleural pneumonectomy (EPP). This is when the entire lung gets removed along with various lymph nodes that are near by.
It is very important to obtain a great doctor-to-patient relationship, as there are so many treatment options to choose from. Communication is critical. Please take note and never fail to remember that the patient’s wishes should always be respected and always be prioritized.
Palliative Therapy: At stage 4, the mesothelioma is so severe and so widespread that the patient and the doctor should be focusing on treatments that will improve the patient’s quality of life. This is known as ‘Palliative Therapy’. Palliative therapies include treatments aimed to reduce pain and symptoms caused by tumor growth and surgery. The following treatments are hard to pronounce:
• Pericardiocentisis (heart)
• Paracentisis (abdomen)
• Thoracentesis (lungs/chest)
These are performed to relieve pain by removing the fluid build up around the heart, abdomen or chest.
Chemotherapy: If there was a possibility for surgery and if the larger tumors were removed successfully, there will still be multiple cancer cells that are still in the body. This is usually when chemotherapy is the next option. Chemotherapy, also know as systemic therapy, is used to kill all remaining cancer cells that are left over. There have been recent success stories of a new combination of chemotherapies. This combination is when Pemetrexed and Cisplatin are used together and has shown to increase the lifespan of patients by few months. Heated chemotherapy is also used nowadays to improve the life span of patients.
Multimodal Therapy: Multimodal therapy is the combination of several/multiple treatments. When it comes to treating mesothelioma, it is usually the combination of chemotherapy and radiation therapy while sometimes adding surgery to the treatment plan as well. This method has been proved useful in several cases and it has increased the lifespan of patients by several months.”