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Friday, December 7, 2018

What Is the Average Cost for Mesothelioma Treatment?

What Is the Average Cost for Mesothelioma Treatment?


Treatment of malignant mesothelioma can be expensive if you don’t have health insurance or financial resources. Cost is difficult to pinpoint because every case is unique.
Chemotherapy costs vary depending on the type of cancer, the drugs used and patient-specific factors. The total cost for pemetrexed (Alimta) plus cisplatin — the most used chemotherapy combination for first-line treatment of mesothelioma — was $40,102, according to a 2013 cost-effectiveness study comparing the drug pair with other chemotherapy regimens.
The estimated monthly cost of radiation therapy is $2,000, but the total expense depends on your health coverage and the number of treatments you receive.
According to a 2015 study published in the Journal of Oncology Practice, the median cost of a course of radiation therapy for lung cancer patients was $9,000.
 Fact:
The average cost of treatment for malignant pleural mesothelioma is comparable to lung cancer treatment, which costs $60,709 during the initial year after diagnosis, according to recent projections from the National Cancer Institute.

Mesothelioma Specialists

Mesothelioma Specialists


Doctors who specialize in mesothelioma include oncologists and thoracic surgeons. These doctors know how to treat mesothelioma and they often take leadership roles in mesothelioma clinical trials.
Several other types of doctors play supportive roles in mesothelioma care such as radiologists, palliative medicine doctors, pulmonologists, general practitioners, internal medicine specialists, and occupational medicine doctors. Treating mesothelioma requires a multidisciplinary approach to cancer care.

A small number of oncologists specialize in the diagnosis and treatment of mesothelioma. These oncologists stay up-to-date on all the latest malignant mesothelioma treatment guidelines. Your oncologist will be the primary doctor who oversees your care and any chemotherapy you may receive.

Your oncologist will also coordinate with other doctors involved in your treatment such as your radiologist, surgeon and palliative care doctor.

Thoracic Surgeon

A handful of thoracic surgeons specialize in surgical procedures for mesothelioma. These doctors train under other mesothelioma surgeons for years to acquire the expertise necessary to perform these complex operations.

Treatment Centers

The top specialists work at recognized mesothelioma centers. Some of the best-known mesothelioma specialists, such as Dr. David Sugarbaker at the Lung Institute at Baylor College of Medicine in Houston, trained young surgeons who have moved on to other cities and treatment centers.
Dr. Jacques Fontaine at the Moffitt Cancer Center in Tampa and Dr. Abraham Lebenthal at Brigham and Women’s Hospital in Boston took Sugarbaker’s expertise to others around the country.

New Mesothelioma Treatment Options

New Mesothelioma Treatment Options


Some of the new mesothelioma treatment options in development include immunotherapy and photodynamic therapy. They are being used in clinical trials and could become standard treatment at some point. New treatment for mesothelioma is thoroughly tested in clinical trials to ensure safety and efficacy.
  • Clinical Trials

    Many mesothelioma patients are eligible for clinical trials that test emerging treatments. Clinical trials also test new approaches to multimodal therapy and the combination of different chemotherapy drugs.
  • Immunotherapy

    Immunotherapy helps your own immune system fight cancer. The U.S. Food and Drug Administration already approved some checkpoint inhibitors, such as pembrolizumab (Keytruda) and nivolumab (Opdivo), for the treatment of various cancers. Mesothelioma could be next.
  • Photodynamic Therapy

    This therapy uses light energy to kill cancer cells. Doctors inject a light-sensitive drug into the patient. After a few days, a special light is applied to the area, usually via laser, to activate the drug and kill cancer cells.

Complementary Mesothelioma Treatments

Complementary Mesothelioma Treatments

Most mesothelioma patients elect complementary therapies that improve their overall health and boost their immune system. Examples include palliative care, alternative therapy and taking care of your physical health.

Palliative Care

Palliative care involves any therapy used to relieve symptoms or improve quality of life.
If the cancer already has spread significantly, doctors typically recommend palliative treatment options for mesothelioma that can help alleviate pain, breathing problems and other cancer symptoms that lessen your quality of life.

Alternative Therapy

Complementary and alternative medicine options don’t treat the disease itself but focus on the patient mentally, emotionally and physically. They can be used alongside more traditional approaches to cancer treatment. These types of treatments are not replacements to modern medicine and should not be used in place of a doctor or other medical professional.
Massages, acupuncture, yoga, naturopathy and aromatherapy can be used to relieve pain or reduce stress that comes from traditional treatment. Patients in many states have access to medical marijuana, which can help control cancer pain.

Physical Health Care

Many mesothelioma patients take steps to improve their overall health. Some patients focus on their emotional and mental health by joining a support group.
Others change their diet to boost nutrition. Some patients begin a gentle exercise program to lessen fatigue.

Peritoneal Mesothelioma Treatment Options

Peritoneal Mesothelioma Treatment Options


In addition to cytoreductive surgery and HIPEC, another treatment option called paracentesis is available to relieve pain and pressure caused by excess abdominal fluid.
Paracentesis

Paracentesis

This procedure removes ascites, which is fluid buildup in the abdominal cavity. A tube drains the fluid through a small abdominal incision.
LEARN MORE ABOUT PARACENTESIS

Pericardial Mesothelioma Treatment Options

There are limited treatment options for pericardial mesothelioma, a rare type of the asbestos-related cancer that forms on the linings of the sac around the heart.
Pericardiocentesis

Pericardiocentesis

Removes excess fluid from the sac that surrounds the heart using a needle and a thin drainage tube.
LEARN MORE ABOUT PERICARDIOCENTESIS

Pericardiectomy

A pericardiectomy is a tumor-removing surgery for pericardial mesothelioma. This procedure aims to remove as much cancerous tissue as possible from the linings of the pericardial sac.

Pericardial Window

A pericardial window removes part of the heart lining to drain excess fluid from around the heart.
  • TESTIMONIAL

“The Mesothelioma Center’s website is, in my opinion, the best resource for anyone suffering from cancer due to asbestos. Thank you for helping me determine the best treatment plan for my cancer and being part of my miracle.”

Other Mesothelioma Treatment Options

Other Mesothelioma Treatment Options

Chemotherapy and surgery are primarily used to prolong survival, while radiation therapy and other therapies are primarily used to control symptoms. However, radiation therapy can reduce the risk of local recurrence in addition to improving chest pain.

Radiation Therapy

Radiation therapy uses high-energy particles or waves, such as X-rays, gamma rays or protons, to target cancer cells.
It is used to control chest pain by shrinking mesothelioma tumors that are pressing against the chest wall. When combined with surgery, radiation therapy can reduce the risk of local recurrence.
Some doctors apply radiation before surgery to shrink tumors to make them easier to remove.
Radiation often doesn’t have the strong side effects of chemotherapy, and it can help reduce the physical pain of mesothelioma. It is sometimes used palliatively to reduce mesothelioma symptoms when surgery is no longer an option.
However, because radiation can be toxic to various organs and damages DNA while killing cancer cells, it is used carefully. Pleural mesothelioma patients are more likely to receive radiation than peritoneal patients because it is hard to apply radiation to the abdomen without harming vital organs.

Pleural Mesothelioma Treatment Options

Other mesothelioma cancer treatment options control pleural symptoms and help doctors diagnose the cancer. Noninvasive surgeries are available to drain fluid that builds up in the chest, alleviating troublesome symptoms.
Pleurodesis

Pleurodesis

Treats pleural effusions by removing fluid from the space between the visceral lining and parietal lining of the lungs and closes the pleural space to prevent further buildup.
LEARN MORE ABOUT PLEURODESIS
Thoracentesis

Thoracentesis

This older method of treating pleural effusions drains fluid but does not close the pleural space.
LEARN MORE ABOUT THORACENTESIS

What Are the Chemotherapy Options for Mesothelioma?

What Are the Chemotherapy Options for Mesothelioma?

The standard and most effective first-line chemotherapy regimen for pleural mesothelioma patients is the combination of cisplatin and pemetrexed (Alimta). A related combination of pemetrexed and carboplatin often achieves the same results but with fewer side effects.
These drugs are usually delivered with an IV into the bloodstream. Sometimes, doctors heat up chemotherapy drugs and deliver them locally after surgery rather than throughout the bloodstream.
In a 2016 study, researchers at Wayne State University found mesothelioma patients who received one of the chemotherapy combinations survived three times longer than patients without chemotherapy.

If the cancer grows, patients may undergo second-line chemotherapy with other drugs, including:

  • Carboplatin
  • Gemcitabine
  • Doxorubicin
Other chemotherapy drugs tested on mesothelioma have included onconase, navelbine, raltitrexed and mitomycin.

HIPEC

Heated Intraperitoneal Chemotherapy (HIPEC) is the most effective treatment option for peritoneal mesothelioma patients.
In this procedure, heated chemotherapy drugs are delivered directly into the abdominal cavity after cytoreductive surgery to kill remaining cancer cells.
According to a 2013 study at Moffitt Cancer Center in Tampa, Florida, the median survival rate for peritoneal patients who underwent HIPEC and cytoreductive surgery was 41 months. Those who returned for a second procedure survived an average of 80 months.
Intraperitoneal chemotherapy may also be administered without surgery and with the chemotherapy at normal room temperature.
Quick Fact:
75 percent of peritoneal mesothelioma patients survived at least five years after receiving three types of intraperitoneal chemotherapy: Normothermic intraperitoneal chemotherapy (NIPEC), HIPEC and early postoperative intraperitoneal chemotherapy (EPIC).
HITHOC
Hyperthermic intrathoracic chemotherapy (HITHOC) is an experimental version of HIPEC for people with pleural mesothelioma.
HITHOC delivers heated chemotherapy throughout the chest cavity after a pleurectomy and decortication.
Currently, HITHOC is not as successful as HIPEC, but doctors are optimistic the procedure can be improved. Several studies have reported longer survival among patients who received HITHOC.

What Are the Current Types of Mesothelioma Surgery?

What Are the Current Types of Mesothelioma Surgery?

The current types of surgery for pleural mesothelioma include extrapleural pneumonectomy (EPP) and pleurectomy and decortication (P/D). A thoracotomy is the first part of an EPP or P/D surgery. This allows doctors to operate on organs inside the chest. Surgeons may also use a diagnostic procedure called video-assisted thoracoscopic surgery (VATS), which is inserting a tiny camera through a small cut in the chest to see the lung. VATS allows doctors to see inside the chest and take biopsy samples. The primary surgery for peritoneal mesothelioma is cytoreductive surgery, also known as debulking surgery.
Extrapleural Pneumonectomy (EPP)

Extrapleural Pneumonectomy (EPP)

EPP removes the cancerous lung and all nearby areas where mesothelioma spreads. This can include nearby lymph nodes, parts of the chest lining, heart lining and diaphragm.
LEARN MORE ABOUT EPP MESOTHELIOMA SURGERY
Pleurectomy and Decortication (P/D)

Pleurectomy and Decortication (P/D)

P/D spares the lung and only removes cancerous parts of the pleural lining, the chest wall lining and the diaphragm.
LEARN MORE ABOUT PLEURECTOMY AND DECORTICATION (P/D)
Cytoreductive Surgery

Cytoreductive Surgery

Cytoreductive surgery removes cancerous growths from the lining of the abdomen. Also known as debulking surgery or peritonectomy, this procedure is often followed by heated chemotherapy.
LEARN MORE ABOUT CYTOREDUCTIVE SURGERY

Mesothelioma Treatment

Mesothelioma Treatment

The most common treatment for mesothelioma involves a combination of surgery, chemotherapy and radiation therapy. Supportive treatments can help relieve symptoms and improve quality of life for many mesothelioma patients.


Treatment helps people live longer with malignant mesothelioma. While a curative treatment outcome is rare, a treatment approach called multimodal therapy can help certain patients live for years with cancer.
Multimodal therapy combines treatments to kill cancer cells in multiple ways. Specialists consider it the best treatment for mesothelioma.
Patients diagnosed in an early stage often qualify for a combination of surgery, chemotherapy and radiation therapy. Multimodal therapy for late-stage patients may involve chemotherapy and immunotherapy.

The most common treatment options for mesothelioma include:

  • Surgery
  • Chemotherapy
  • Radiation therapy
New and experimental therapies are available through clinical trials. Some of these therapies include targeted therapy, immunotherapy, and photodynamic therapy.
Different types of mesothelioma require specialized treatment. Varying surgeries and chemotherapy drugs are used in malignant pleural mesothelioma treatment compared to peritoneal mesothelioma treatment.
Mesothelioma life expectancy without treatment is around four to six months for the average patient diagnosed in stage 3 or stage 4. Electing treatment at these stages often helps patients live at least a year.
Those diagnosed in stage 1 or stage 2 who undergo aggressive treatment may live for years with mesothelioma.

Mesothelioma

Mesothelioma


Overview

Malignant mesothelioma (me-zoe-thee-lee-O-muh) is a type of cancer that occurs in the thin layer of tissue that covers the majority of your internal organs (mesothelium).
Mesothelioma is an aggressive and deadly form of cancer. Mesothelioma treatments are available, but for many people with mesothelioma, a cure is not possible.
Doctors divide mesothelioma into different types based on what part of the mesothelium is affected. Mesothelioma most often affects the tissue that surrounds the lungs (pleura). This type is called pleural mesothelioma. Other, rarer types of mesothelioma affect tissue in the abdomen (peritoneal mesothelioma), around the heart and around the testicles.
Mesothelioma doesn't include a form of noncancerous (benign) tumor that occurs in the chest and is sometimes called benign mesothelioma or solitary fibrous tumor.

Symptoms

Signs and symptoms of mesothelioma vary depending on where the cancer occurs.
Pleural mesothelioma, which affects the tissue that surrounds the lungs, causes signs and symptoms that may include:
  • Chest pain under the rib cage
  • Painful coughing
  • Shortness of breath
  • Unusual lumps of tissue under the skin on your chest
  • Unexplained weight loss
Peritoneal mesothelioma, which occurs in tissue in the abdomen, causes signs and symptoms that may include:
  • Abdominal pain
  • Abdominal swelling
  • Lumps of tissue in the abdomen
  • Unexplained weight loss

Other forms of mesothelioma

Signs and symptoms of other types of mesothelioma are unclear, since these forms of the disease are very rare.
Pericardial mesothelioma, which affects tissue that surrounds the heart, can cause signs and symptoms such as breathing difficulty and chest pains.
Mesothelioma of tunica vaginalis, which affects tissue surrounding the testicles, may be first detected as swelling or a mass on a testicle.

When to see a doctor

See your doctor if you have signs and symptoms that may indicate mesothelioma. Signs and symptoms of mesothelioma aren't specific to this disease and, due to the rarity of mesothelioma, are more likely to be related to other conditions. If any persistent signs and symptoms seem unusual or bothersome, ask your doctor to evaluate them. Tell your doctor if you've been exposed to asbestos.

Causes

In general, cancer begins when a series of genetic mutations occur within a cell, causing the cell to grow and multiply out of control. It isn't clear what causes the initial genetic mutations that lead to mesothelioma, though researchers have identified factors that may increase the risk. It's likely that cancers form because of an interaction between many factors, such as inherited conditions, your environment, your health conditions and your lifestyle choices.

Risk factors

Asbestos exposure: The primary risk factor for mesothelioma

Asbestos is a mineral that's found naturally in the environment. Asbestos fibers are strong and resistant to heat, making them useful in a wide variety of applications, such as in insulation, brakes, shingles, flooring and many other products.
When asbestos is broken up, such as during the mining process or when removing asbestos insulation, dust may be created. If the dust is inhaled or swallowed, the asbestos fibers will settle in the lungs or in the stomach, where they can cause irritation that may lead to mesothelioma. Exactly how this happens isn't understood. It can take 20 to 40 years or more for mesothelioma to develop after asbestos exposure.
Most people with years of asbestos exposure never develop mesothelioma. And yet, others with very brief exposure develop the disease. This indicates that other factors may be involved in determining whether someone gets mesothelioma or doesn't. For instance, you could inherit a predisposition to cancer or some other condition could increase your risk.

Risk factors

Factors that may increase the risk of mesothelioma include:
  • Personal history of asbestos exposure. If you've been directly exposed to asbestos fibers at work or at home, your risk of mesothelioma is greatly increased.
  • Living with someone who works with asbestos. People who are exposed to asbestos may carry the fibers home on their skin and clothing. Exposure to these stray fibers over many years can put others in the home at risk of mesothelioma. People who work with high levels of asbestos can reduce the risk of bringing home asbestos fibers by showering and changing clothes before leaving work.
  • A family history of mesothelioma. If your parent, sibling or child has mesothelioma, you may have an increased risk of this disease.

Complications

As pleural mesothelioma spreads in the chest, it puts pressure on the structures in that area. This can cause complications, such as:
  • Difficulty breathing
  • Chest pain
  • Difficulty swallowing
  • Pain caused by pressure on the nerves and spinal cord
  • Accumulation of fluid in the chest (pleural effusion), which can compress the lung nearby and make breathing difficult

Prevention

Reducing your exposure to asbestos may lower your risk of mesothelioma.

Find out whether you work with asbestos

Most people with mesothelioma were exposed to the asbestos fibers at work. Workers who may encounter asbestos fibers include:
  • Miners
  • Factory workers
  • Insulation manufacturers
  • Ship builders
  • Construction workers
  • Auto mechanics
Ask your employer whether you have a risk of asbestos exposure on the job.

Follow your employer's safety regulations

Follow all safety precautions in your workplace, such as wearing protective equipment. You may also be required to shower and change out of your work clothes before taking a lunch break or going home. Talk to your doctor about other precautions you can take to protect yourself from asbestos exposure.

Be safe around asbestos in your home

Older homes and buildings may contain asbestos. In many cases, it's more dangerous to remove the asbestos than it is to leave it intact. Breaking up asbestos may cause fibers to become airborne, where they can be inhaled. Consult experts trained to detect asbestos in your home. These experts may test the air in your home to determine whether the asbestos is a risk to your health. Don't attempt to remove asbestos from your home — hire a qualified expert. The Environmental Protection Agency offers advice on its website for dealing with asbestos in the home.

What Is the Average Cost for Mesothelioma Treatment?

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