Mesothelioma Pages

Recent studies, including an article published by Department of Thoracic Surgery at Catholic University in Rome, Italy, show a combination of PET and CT scans are showing higher accuracy in mesothelioma diagnoses. While a PT scan provides a close look at potential abnormalities and details of the body on a molecular level, a CT scan provides a thorough map of the body’s interior. Together these two scans create a cross section of valuable information, which aid health care providers before, during and after mesothelioma treatment.

Mesothelioma is a cancer caused by asbestos fibers that have been inhaled or ingested. Once asbestos fibers become lodged in lung lining, or lining of other abdominal cavities, a process of tumor growth ensues, spreading irregularly through surrounding areas. Mesothelioma begins with an extensive latency stage, often between twenty and fifty years. During this time it can be difficult to diagnose. Following this latency stage, when symptoms do begin to demonstrate, patient life expectancy becomes quite short, averaging just eighteen months.

Combination use of PET-CT scans give treatment providers a thorough look at the patients mesothelioma-affected areas, helping dictate whether patients are good candidates for surgery or other treatments. Mesothelioma treatments are often difficult and hard on the patient, many of which are older and already suffering negative affects from the cancer. With a PET-CT combination, physicians can more accurately identify the extent of the tumor growth, their spread and size, and better decide between available treatment options.

If surgery is scheduled following PET-CT scans, surgeons will be better prepared with an extensive view of tumor size and spread. Rather than subjecting the patient to a long and extensive procedure while searching for all affected areas, surgeons will have detailed knowledge of where to look and for what to look. This could mean shorter surgery time, less incisions and a faster recovery.

Recovery could also benefit from PET-CT combination scans. Following surgery, chemotherapy, radiation therapy or other mesothelioma treatment, providers will be able to follow the internal changes affected by treatment. Potential spread of tumors, metastasis or infection could be painlessly tracked, affording patients more time to rest and heal from their procedures, rather than suffering through invasive follow-up care.

Mesothelioma affects an estimated twenty thousand people worldwide each year. The World Health Organization considers mesothelioma’s cause, asbestos, a type 1 carcinogen, and expects mesothelioma and other asbestos related illness are on the rise. This is greatly due to an increase in asbestos use throughout the developing world, representing a demographic limited in adequate health care facilities able to diagnose and treat mesothelioma.

A new treatment technology has come under scrutiny by the US Department of Health and Human Services (HHS). Stereotactic Body Radiation Therapy (SBRT) is being used for high precision radiation treatment of non-small cell lung cancers (NSCLC), including mesothelioma.

Mesothelioma is caused by exposure to toxic chemical asbestos. Asbestos has been used for decades in building and construction components. Although relatively safe when contained in another material, asbestos fibers become a threat when airborne. If inhaled, asbestos fibers can begin a mutation process in organ lining that develops into mesothelioma cancer. Mesothelioma is characterized by a long latency period and a short life expectancy following diagnosis.

Mesothelioma develops web like systems of malignant tumors through the lining of lungs (called pleural mesothelioma) or other abdominal cavities such as the heart or diaphragm (called peritoneal mesothelioma). Mesothelioma treatments regularly include surgery, chemotherapy and radiation therapy—typically in combination. Due to the irregular tumor formation associated with mesothelioma, SBRT seems a fitting treatment for the disease. However, HHS is questioning SBRTs effectiveness.

Suggesting there is not enough evidence to support SBRT’s alleged value and safety, HHS requested a more thorough explanation of the technology and associated treatment. Directed by Kelley N. Tipton, M.P.H., a brief was prepared by ECRI Institute Evidence-based Practice Center, for the Agency for Healthcare Research and Quality of HHS. The brief discussed SBRT’s advantages and specific treatment highlights. Although SBRT is currently being used in cases of mesothelioma, the brief concluded, “a full systematic review of the current literature cannot answer questions on the effectiveness and safety of SBRT compared to other radiotherapy interventions.”

Over five thousand five hundred pieces of literature were reviewed for the brief; one hundred twenty-four specific to the issue at hand were selected for further study. These hundred and twenty-four detailed cases of malignant tumors treated with SBRT without other forms of radiation therapy.

The brief explained SBRT was a preparation-intensive treatment that “requires rigorous quality control and quality assurance measures for treatment planning and treatment delivery.” Without such careful measures, effectiveness and safety could be lost during therapy administration.

Following study and review of available data, the brief’s research team concluded: “Comparative studies are needed to provide evidence that the theoretical advantages of SBRT over other radiation therapies actually occur in the clinical setting.”

Safety and effectiveness of SBRT on NSCLS treatments will be studied further during clinical trials scheduled for 2013.