Coping with mesothelioma

It can be very difficult coping with a diagnosis of cancer, both practically and emotionally. You are likely to be feeling very confused and upset at first. Mesothelioma is often diagnosed at quite an advanced stage. As well as coping with your diagnosis, you may be trying to cope with the news that your cancer is very difficult to treat and unlikely to be curable.

As well as coping with the fear and anxiety that a diagnosis of cancer brings, you have to work out how to manage practically. There may be money matters to sort out. Who do you tell you have cancer? There may be children or grandchildren to consider.

The ‘coping with cancer’ section of CancerHelp UK contains lots of information you may find helpful.

California Mesothelioma Attorney

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Mesothelioma Vs Cord Blood

In this post I would like to briefly talk about the most common questions that came up about the study in the blog comments and on Twitter.

Why Isn’t Mesothelioma In The Top 20?!

By far the most common question people were asking was about the apparent demise of mesothelioma among the most expensive keywords. Several years ago a study was released that found “Mesothelioma” to be the most expensive keyword in the world. Mesothelioma, a rare form of cancer, usually caused by exposure to asbestos, is very valuable to search marketers because of million-dollar asbestos lawsuit settlements. So why isn’t “mesothelioma” in the top 20?

Our study was different from the older study because we looked for large, high-volume keyword categories, as opposed to looking for just expensive individual keywords. So keywords containing the word “Mesothelioma” wererolled up in several of our top keyword categories, including #19, the “Treatment” category (example search query: “Mesothelioma Treatment”) as well as our “Attorney” and “Lawyer” keyword categories (e.g. “mesothelioma lawsuit”).

What Is Cord Blood? What’s That Doing There?

A lot of people were wondering about cord blood, what it is and why it’s on the list. Take this discussion on Wired for example:

How Can You Say that Mesothelioma Is High Paying Keyword ?

Mesothelioma? I have a hard time even saying the word. This is a health term; one of the main causes is exposure to asbestos. For this reason there are a large number of high dollar law suits out there. And as with any keyword related to something that is high profit comes high dollar clicks from AdSense.

Mesothelioma is one of the highest paying keywords I’ve seen. Key phrase versions of this keyword like the list below have “Estimated Avg CPC”’s in the high double digits, some reaching as high as $94.00.

• causes of mesothelioma
• mesothelioma death
• epithelioid mesothelioma
• mesothelioma causes new york
• mesothelioma lawyers
• mesothelioma cases
• asbestos
• attorneys

Needless to say, the competition for these terms is intense. For that reason unless you plan on spending a fortune on link building and optimization you will never manage to rank very well for the main terms. That doesn’t mean that it is not worth adding a page to your site though. Even an occasional “curiosity” click will pay for your time in creating the page. Often if someone stumbles across the page on your site and an ad catches their attention they may click on it just to see what it is about.

As with any of these high dollar keywords you need to find a way to incorporate a page in your site that doesn’t seem forced. A page that follows the theme of you current SEO and won’t look you were just trying to create a spammy keyword page by the readers of your site.

Using Mesothelioma Keywords

Creating a page to add to your site may not be quite as hard as you think. First do a little research on the causes of this form of cancer. Top of the list is asbestos. Now, where was asbestos used in the past? Actually asbestos was an extremely useful product that had hundreds of applications. Schools used acoustic ceiling blocks that use asbestos, brake pads and other automotive products used asbestos, asbestos was used in insolating pipes, roofing shingles etc. etc.

Now, does any of these products relate to your site? If so, you now have a topic to write a page about. One that is very likely to be of interest to readers of your site as well as encouraging Google’s AdSense to show some extremely high CPC ads on your site.

Some of your site readers that might be affected by this product include ones that have kids that go to an older school, there may be asbestos hidden under years of paint, older contruction workers, automotive workers, especially those that worked on tires and brakes. If your site is related to health, automotive, schooling and many other similar topics a page on mesothelioma could likely be of interest to readers of your site.

As I’ve stated in each one of these keyword articles, if the word doesn’t fit your site topic don’t try to force it. Forcing keywords only makes you site look spammy which will adversely affect your readership. Make sure any of these top AdSense keywords fits the topic of your site before you write an article on it.

Google Places for injury lawyers

Most injury lawyers have not yet grasped the importance of Google Places. Many don’t know what it is, and only a few know how to optimize for it.

This blog post will explain what Google Places is, why it is important, and how to obtain a prominent position on Google Places.

1. Google Places (aka Google Local) contains the listings preceded by a red pushpin containing a letter, lawyer photo, and address. Sometimes the Places listings appear in the middle of Google page one and sometimes at the top, but the position is always prominent. A map shows the location of each letter, so the searcher can see how close each lawyer’s office is.

More website owners have recognized the value of Google Places, so in many cities it has become harder to obtain a page one position. You can see how many total Google Places listings exist for your city by clicking “More Results.”

2. Importance. Prominent placement on Google Places has become more valuable because Google now devotes so much premium space to Places. Placement and quantity of listings will vary per search and location, but Google Places listings are frequently at the top of the free listings, and sometimes occupy half to three quarters of page one

The photos and addresses mean that each Places listing occupies more space than a plain organic listing, and the photos are eye-catching. Bottom line: a good position on Google Places can drive meaningful traffic to your site.

3. Optimization. Obtaining a top position on Google Places requires a different approach than optimizing your website for good organic placement. Good organic page position is driven by a steady flow of properly-keyworded, high-quality content on your website, along with a regular increase in inbound links from relevant sites.

Optimizing for Google Places, on the other hand, occurs primarily through the placement of hundreds of consistent business listings on directory sites. This is tedious, time-consuming, and ongoing work that has to date not been automated with software. It nonetheless remains important labor, for Google Places will only grow more important in generating traffic.

The sooner you create your listing and start optimizing the easier it will be to obtain a prominent position; the later you start the harder it will be to rise to the top. Why? As is the case with organic listings, (1) the field will only get more crowded and (2) Google rewards longevity. For more information, call Travis Hise at 714-918-1848.

If you don’t have the time, interest, or expertise to create and optimize your lawyer Google Places listing, we will do the work for you.

Simple SEO Tips for Personal Injury Lawyers

Maintaining and improving Google page position requires regular effort. The most effective ways to move your website up in position fall into these three categories: (1) inbound links, (2) keyworded content, and (3) website architecture.

Here are a few tips to get you started. These are big topics, so I will be sending you additional suggestions over the next few months.

1. Inbound links
Your goal is to obtain links to your website and its key pages using popular search phrases in the link (called anchor text). If for example “Houston truck accident lawyer” is one of your targeted search phrases, then you want other websites to use that phrase as their link to your site. Here are several ways to obtain those links:

a. Ask your friends, family, and contacts with websites to give you a link using your recommended anchor text. You will receive higher value (“link juice”) when (1) you do not provide a reciprocal link and (2) the linking website has a higher Page Rank than your site does.

b. Ask your friends and top clients to link to your site from their Facebook and Twitter pages. Search engines are beginning to crawl the social media sites.

c. Write articles for others that link back to your site using your targeted anchor text.

2. Keyworded content
a. Ask your staff and your clients which phrases they use to search for lawyers like you. Visit www.googlekeywordtool.com and click Keyword Tool to check the monthly search volume for these phrases. Then search for your website on Google using the more popular phrases. If you do not appear on Google page one or two for an important phrase, you have some writing to do.

b. The best search phrases, or keywords, to target with your writing are ones that have high search volume and weak competition, and for which your website does not rank well on Google. Write 300- word or longer articles using the keywords three times — in the headline, in the first few sentences, and in the last few sentences.

c. Try to write add one article a week to your website. You should begin seeing improved Google page position within a few weeks after your writing program begins. If not, you may have problems with:

3. Website architecture
You are likely dependent upon others for this work, so it is probably hard for you to judge the quality of your website’s construction. Most site designers spend a lot of time making sites pleasing to the human eye, but your folder structure, site map, and HTML readability are far more important.

If you want help, we can (a) evaluate the technical setup of your website to let you know if it has problems, (b) supply a regular flow of keyworded personal injury content, and (c) build inbound links.

For these services our prices tend to be one-half to one-third the cost of the big guys, just like our law books have long been.

Internet marketing for lawyers: How do you compare?

Prospective clients who search for injury lawyers on the web frequently look at several sites before deciding which attorney to contact.  How does your website compare?

Does it:

- Have a reasonably-modern design, or does it instead look like it was created ages ago?

-  Answer common client questions on the home page, or does the home page mistakenly focus on you?

-  Use videos to teach non-readers?

-  Have a case submission form and prominent 800 number?

-  Most important, demonstrate your deep knowledge of injurylawand procedure with detailed articles?

Like lobby furniture, websites periodically need new skins added to maintain a fresh look.

While you are adding that new skin, critically examine the content your site contains.  Is its quality consistent with your expertise level?  If not, how will prospective clients know that you are better than your website indicates?

Prospective injury clients have no more information to judge you than you give them on your website.  If all you have provided are three pages claiming you are good at what you do, don’t expect to land a lot of conscientious clients.  The proactive, engaged clients are more likely to contact the attorney with the content-rich site that answers their pre-engagement questions.

13 More Mesothelioma Keywords

Searches Without “Mesothelioma”

Internet users have a seemingly limitless ability to phrase things in different ways. In fact, about 15 percent of Google searches are totally unique.

This makes sense if you think about it. If I were looking for a mesothelioma lawyer near me, I could conceivably search for “Orange County mesothelioma lawyer,” “injury lawyer Orange County mesothelioma,” or “attorney Orange County mesothelioma lawsuit,” to name a few. (I could come up with 100 similar searches without breaking a sweat.)

Some people search for mesothelioma lawyers without using the word “mesothelioma” at all. I can’t anticipate every possible search phrase, but maybe I can better serve these people by expanding my keywording focus.

I don’t know much about mesothelioma—just that it’s a type of cancer caused by asbestos and that there’s a related disease called “asbestosis.” But this information alone gives me 15 new keywords to investigate:

Keyword	Estimated Avg. CPC	Local Monthly Searches	Searches/CPC
Asbestosis attorneys	$103.70	0	0
Asbestosis lawyers	$79.42	210	2.64
Asbestosis lawyer	$66.55	480	7.21
Asbestosis attorney	$66.43	170	2.55
Asbestos cancer attorney	$60.80	720	11.84
Asbestos attorneys	$55.83	8,100	145.08
Asbestos cancer attorneys	$54.97	590	10.73
Asbestos lawyers	$52.55	8,100	154.14
Asbestos attorney	$45.02	9,900	219.90
Asbestos cancer lawyer	$40.67	880	21.64
Asbestos lawyer	$35.30	9,900	280.45
Asbestos cancer lawyers	$20.64	590	28.59
Lawyer asbestos	$17.78	9,900	556.81
Attorney asbestos	$14.49	9,900	638.23
Lawyers asbestos	$0.00	8,100	Undefined

Looking at this chart, I notice a few things:

1. “Asbestosis” keywords are as competitive as “mesothelioma” ones and have about 1/100 the number of searches. Dump them.
2. “Asbestos cancer” keywords are less competitive than “asbestosis” ones and have more searches. They’re expensive, meaning it might be difficult to rank organically, but local variants will be easier. Keep them.
3. “Asbestos” keywords are cheap and have a high search volume. In fact, they’re better than some of the 13 mesothelioma keywords I already chose. Better still, they all include some variation of “attorney” or “lawyer,” so I know they’ll draw relevant traffic. Definitely keep.

“Mesothelioma” Misspellings

Your website is your business card for the 21st century. It will be your first contact with many potential clients, and you’ll want to make a good impression.

A site that’s riddled with typos reflects poorly on you, but what about intentional misspellings? You may be able to draw more searches this way, but you do so at the expense of appearing unprofessional.

It’s really a matter of preference. I want my personal site to be flawless, but for a lead-generating site that doesn’t have my name on it, I’m not opposed to using misspellings if they’ll get traffic.

There are six misspellings with any measurable search volume:^[1]

Keyword	Estimated Avg. CPC	Local Monthly Searches	Searches/CPC
Mesotheloma	$60.04	390	6.50
Mesotheleoma	$58.90	320	5.43
Mestothelioma	$55.26	<10	0.18
Mesolioma	$55.18	<10	0.18
Mezothelioma	$36.10	16	0.44
Mesothalioma	$21.77	<10	0.46

Because the last four have so few searches overall, they’re unlikely to attract someone looking for a lawyer in my area.

The first two have 710 searches between them—a respectable number. They’re expensive, though, so it might be hard to rank.

I’ll write a page focusing on “Orange County mesotheloma” [sic] and one focusing on “Orange County mesotheleoma” [sic]. If they get some traffic, great. If not, no big deal.

New Mesothelioma Keywords

From favorite to least favorite, here are 13 new mesothelioma keywords to add to your list. Replace “Orange County” with the name of your city.

1. Orange County lawyers asbestos
2. Orange County attorney asbestos
3. Orange County lawyer asbestos
4. Orange County asbestos lawyer
5. Orange County asbestos attorney
6. Orange County asbestos lawyers
7. Orange County asbestos attorneys
8. Orange County asbestos cancer lawyers
9. Orange County asbestos cancer lawyer
10. Orange County asbestos cancer attorney
11. Orange County asbestos cancer attorneys
12. Orange County mesotheloma lawyer [sic]
13. Orange County mesotheleoma lawyer [sic]

TYPES OF TREATMENT FOR MESOTHELIOMA

Once you have found the doctor and treatment facility you feel comfortable with, you and your doctor will discuss the treatment options that are available to you. Some mesothelioma patients may want to investigate treatment options first and then approach a doctor who is known for that type of treatment to determine whether he or she is a candidate. Each individual is different. The course of the disease will vary, and so will the patient’s approach to treatment. Working closely and openly with your mesothelioma treatment team is important to getting the best outcome from treatment, and the first way your treatment team will help you is in assessing the treatment options available to you. Some of the options you discuss may include surgery, chemotherapy and radiation. You may discuss whether a clinical trial is appropriate for you or whether innovative mesothelioma treatments could be helpful in your case.

MALIGNANT MESOTHELIOMA RESEARCH

Malignant mesothelioma is a rare form of cancer, and early detection is nearly impossible, making it a difficult disease to pin down, but exciting discoveries have been made in the field of malignant mesothelioma research during recent years. Research is being conducted on all aspects of the disease including early detection, alternative surgeries and treatments, and palliative measures.

Although malignant mesothelioma is relatively rare as cancers go, scientists are seeing a consistent rise in the number of cases. In addition, the long period between exposure to asbestos and development of the cancer means that the effects from the enthusiastic manufacturing of asbestos products between the 1940s and the 1970s may soon result in an upsurge of cases. Another area of concern is the age and decay of buildings constructed of asbestos. One of the qualities that made asbestos an appealing building material was its virtually indestructible nature. The materials that bonded asbestos into workable materials are not equally indestructible. As decrepit buildings collapse or are destroyed by wind, storms or demolition, the clouds of dust thrown up are often loaded with asbestos. These factors have given malignant mesothelioma research increasing importance.

What’s New?

Chemotherapy is the treatment of choice for asbestos cancer, malignant mesothelioma and other cancer patients for decades, usually as a palliative measure to deal with symptoms. New chemotherapy drugs and treatments are encouraging. The most important advancement for malignant mesothelioma patients is Alimta©. Used in combination with a proven chemotherapy drug called cisplatin, Alimta© is the only drug specifically approved for use on pleural mesothelioma patients by the Food and Drug Administration (FDA).

Another advancement made in recent years that includes chemotherapy is a surgery pioneered by David J. Sugarbaker, MD. Over the past few years, Dr. Sugarbaker has refined a technique for surgical pleural mesothelioma resection that involves removing as much tumor tissue as possible and replacing parts of the membrane with man-made Gore-Tex material. The chest cavity is irrigated with warmed chemotherapy to kill remaining cancer cells before the surgical incision is closed.

A new drug called Onconase© is currently on the FDA’s Fast Track list awaiting final approval. The ground-breaking advantage to Onconase© over other conventional chemotherapy drugs is that it kills cancer cells without damaging healthy tissue.

Anti-Angiogenesis drugs are designed to stop angiogenesis. Angiogenesis is the process that helps facilitate the spread of tumors. One anti-angiogenesis drug for malignant mesothelioma treatment is currently being offered. One such drug already on the market is Avastin, a drug that works by lowering the levels of a protein that starts angiogenesis.

Intensity Modulated Radiation Therapy (IMRT) is a new radiation therapy that uses computerized 3D modeling to deliver specifically targeted high doses of radiation directly to cancerous tumors—and nowhere else. This represents a significant improvement over traditional radiation techniques which typically kill both cancer and surrounding healthy tissue.

Gene therapy is an exciting research that may prove invaluable in the control and cure of many diseases, including malignant mesothelioma. Gene therapy uses special viruses that have been modified to perform a specific task, to infect malignant mesothelioma cells, leaving them “open” and vulnerable. The virus-infected cells are injected with healthy genes containing interferon-beta, a natural or man-made immune system hormone (cytokine) designed to boost immune system function and help the patient’s body fight—and possibly defeat—the cancer.

• 
  

MALIGNANT MESOTHELIOMA TREATMENT

Malignant mesothelioma is a cancer caused by exposure to asbestos that attacks the lining of the lungs, abdomen, heart, or in exceptionally rare cases, the testicles. Treatment options may include surgery, chemotherapy, radiation, and experimental treatments that are sometimes used separately, but more often combined in a comprehensive treatment plan designed to aggressively attack the cancer on several fronts. Generally, malignant mesothelioma has no symptoms and is extremely difficult to detect until the late stages of the disease when fewer treatment options are feasible.

On the bright side, recent scientific research is very encouraging. New therapies and treatments are making the news and previously unheard of successes are becoming more frequent. Clinical trials are available for many patients who might otherwise have little hope, and research is ongoing to study compounds in the blood of malilgnant mesothelioma patients that may soon lead to an early detection screening process.

Many factors help the oncologist and his team to determine a treatment plan best suited for each patient. Things considered include the stage of the cancer, the patient’s age and general health, the patient’s lifestyle choices—smoking, alcohol consumption, exercise habits—and other drugs or treatments the patient may already be on. The oncologist, along with the medical team and the patient, devises a treatment regimen that may include any combination of surgery, chemotherapy, radiation, palliative care, and lifestyle advice.

Malignant Mesothelioma Surgery

Three main types of surgery are used to diagnose and treat malignant mesothelioma.

Diagnostic Malignant Mesothelioma Surgery

Diagnostic surgeries are usually minimally or non-invasive, and are performed to help the medical team reach a definitive malignant mesothelioma diagnosis.

A biopsy is the collection of a small tissue sample used to confirm a malignant mesothelioma diagnosis. This non-invasive procedure uses a long, fine needle inserted into the area suspected to be cancerous to collect cells for examination. An excisional biopsy is a small incision used to take a slightly larger sample for testing. Biopsies help reveal important information of the cancer: what type of cancer it is, how far it has spread and the origin point.

Curative Malignant Mesothelioma Surgery

Curative surgery is performed to remove as much of the cancer as possible. Simply put, the surgeon opens the patient to expose the entire affected area and cuts away the diseased tissue. In recent years, this procedure has been followed immediately by filling the cavity with warm chemotherapy to kill any unseen cancer cells before the patient’s incision is closed. This is a highly effective combination of treatments, but it is not available to most patients. Most malignant mesothelioma is not discovered until it is too late to perform this aggressive level of invasive surgery.

Curative surgery may also include removal of the affected tissues or organs and replacement of linings with a man-made product, which can only be done if enough remaining tissue or organ is healthy and viable and the patient is healthy enough to recover.

Palliative Malignant Mesothelioma Surgery

Palliative surgery is used to lessen pain and usually involves draining fluids that typically build up in the affected area. Fluid that is drained from the patient often assists in diagnostic testing.

Palliative surgery is sometimes performed to ease patient suffering when tumors press on vital organs and interfere with breathing, press on nerves and cause pain, or restrict movement.

Chemotherapy

Chemotherapy is a term that describes hundreds of different medications used in the treatment of cancer and a few other diseases and conditions, specifically the chemicals designed to kill cells. Undergoing chemotherapy is not a pleasant experience. Typical side effects are nausea, vomiting, low white blood cell count, loss of appetite, constipation, fatigue, fever and chills, low platelet count, generalized aches and pains, tingling in the hands and feet, rash, and depression.

When discussing chemotherapy with an oncologist, it is important for the patient to disclose medical history and be honest about lifestyle, prescriptions, vitamins, supplements and over-the-counter medications, including herbal remedies. Undisclosed medicines may impede the chemotherapy, or worse, produce harmful side effects.

Radiation

Radiation is a number of procedures used to deliver radioactive material to the cancerous cells in the hopes of killing the cancer or slowing the rate of growth, either for curative or palliative purposes. The delivery method may be any of the following:

External beam radiotherapy is the most frequently used type of radiation therapy for malignant mesothelioma patients. The skin covering the cancerous area is externally irradiated, or bathed in radiation from the outside. External beam radiotherapy is not specifically targeted and is unlikely to kill all cancer cells, so it is not an effective cure, but like most malignant mesothelioma treatments, it can help relieve symptoms. The side effects are skin irritation, localized pain, and difficulty swallowing.

Another type of radiation therapy, brachytherapy, is used to implant tiny radioactive rods into the cancerous tumors. This method of delivery delivers a tiny dose of radiation right into the cancer itself. Surrounding healthy tissues are unaffected and there are fewer side effects.

A new procedure on the market is called intensity-modulated radiation therapy (IMRT), a procedure that uses a 3-D model constructed by computer imaging to precisely deliver a higher dose of radiation to cancerous areas with far fewer side effects and damage to surrounding tissues.

Experimental Therapies

Several exciting new therapies are currently in the testing stages that may lead to early detection, better treatment, and possibly even a cure for asbestos cancer, malignant mesothelioma and other deadly cancers and diseases. Clinical trials are being performed all over the world, and patients diagnosed with malignant mesothelioma are prime candidates to participate. Participating in clinical trials can be risky. Each patient must weigh the odds to decide whether the risks associated with experimental treatment is worth the possible gain.

A new drug called Alimta® is the first chemotherapy drug specifically developed to treat malignant mesothelioma. In clinical trials, the drug has been very successful in relieving malignant mesothelioma symptoms and decreaseing cancerous tumor size. Alimta® is usually administered in combination with cisplatin, another chemotherapy drug. Used together, these drugs have proven to extend the life of malignant mesothelioma patients by several months, and relieve pain, discomfort, and ease breathing difficulties.

Gene therapy is a ground-breaking treatment offering promising results for a number of diseases, including asbestos cancer, malignant mesothelioma and other cancers. Simply put, the goal of gene therapy is to replace malfunctioning cancerous genes with functioning genes. Clinical trials have been underway for some time, and the results have been encouraging.

Immunotherapy is a treatment that uses the immune system to help combat malignant mesothelioma. It can be administered by two different methods. Active immunotherapy enhances or stimulates the patient’s natural immune system to fight cancer. Passive immunotherapy uses man-made proteins that mimic the natural immune system functions for patients whose immune systems are compromised.

Photodynamic therapy (PDT) uses drugs that are photosensitizing agents along with light to activate them to kill cancer cells and stop the spread of malignant mesothelioma. This innovative treatment causes far fewer side effects than most malignant mesothelioma, asbestos cancer and other cancer treatments. Photosensitizing agents are chemicals that produce oxygen when exposed to a certain kind of light. The oxygen produced kills cancer cells without causing extensive damage to surrounding tissues and without causing debilitating side effects.

PERICARDIAL MESOTHELIOMA TREATMENT

Pericardial mesothelioma attacks the membranous lining of the heart, called the pericardium or the pericardial sac. Pericardial mesothelioma is a very rare form of malignant mesothelioma, totaling only about five percent of all malignantmesothelioma cases. It is caused by exposure to deadly asbestos fibers, but how that happens is a matter of debate. The common belief is that the asbestos fibers start in the lungs and travel to the heart through the bloodstream, where they become lodged in the pericardium and eventually, after 20 to 50 years, lead to pericardial mesothelioma. Malignant tumor cells grow in the pericardium, causing the membranes to thicken and fill with fluid. In the later stages of the cancer, the tumors put pressure on the heart and cause a variety of symptoms.

Treatment options are limited in the case of pericardial mesothelioma, and the prognosis is rarely good. Because the cancer is almost impossible to detect early, and the proximity to the heart often makes surgery difficult of impossible, the average patient dies within six months of diagnosis. Occasionally, pericardial mesothelioma is caught early enough for successful treatment options, usually when a physician is looking for something else.

Surgery

Most pericardial mesothelioma patients do not qualify for any kind of surgery aside from palliative procedures.

The most common surgery for a pericardial mesothelioma patient is a fine needle aspiration, called pericardiocentesis, where a surgeon inserts a thin needle into the pericardial sac and drains the fluid from around the heart. This palliative and diagnostic procedure relieves pain and pressure. The fluid is tested to aid in diagnosis and treatment.

Chemotherapy

Chemotherapy refers to chemical treatments designed to kill cells and may take the form of pills, injections, intravenous treatments. In the case of pericardial mesothelioma, chemotherapy, like any treatment, can prove dangerous or deadly. In addition to a long list of unpleasant side effects, anything used to kill the cancer cells surrounding the heart will also kill heart tissue.

Radiation

Ionizing radiation is a procedure used to kill cancerous cells and slow the growth rate of the cancer. While radiation is effective for some forms of cancer, it can be deadly for pericardial mesothelioma patients, because it kills healthy tissue surrounding the affected area, which includes the heart and the protective tissues around the heart.

Intensity-modulated radiation therapy (IMRT) may prove to be the most viable radiation treatment for pericardial mesothelioma patients. It is a new procedure that uses an advanced computer-controlled, high-precision radiotherapy to deliver radiation exactly where it’s needed, with very little damage to surrounding tissues. Little information is available about the use of IMRT to specifically treat pericardial mesothelioma, possibly because pericardial mesothelioma is so rare.

PLEURAL MESOTHELIOMA TREATMENT

Pleural mesothelioma, a type of malignant mesothelioma caused almost exclusively by exposure to asbestos, attacks the lining of the lungs, called the pleura. There are several treatment options, including surgery, chemotherapy and radiation, that can be used separately, but more often they are combined in a treatment plan called multimodality therapy. Since pleural mesothelioma has no symptoms and there is no effective screening procedure to detect it early, it is usually diagnosed in the late stages when treatment options are limited and often less effective.

The outlook for pleural mesothelioma patients is constantly improving with ongoing research providing new answers and, new hope. Pleural mesothelioma is by far the most common type of malignant mesothelioma and, as a result, more research dollars are spent looking for a cure.

Types of Pleural Mesothelioma Surgery

There are three main types of surgery used in the diagnosis and treatment of pleural mesothelioma.

• A biopsy is often required to confirm diagnosis of the cancer. This is a non-invasive procedure that involves removing a tiny piece of the infected tissue for testing.
• Curative surgery involves removing as much of the cancerous tissue as possible. This procedure is often followed by or combined with radiation therapy or chemotherapy.
• Palliative surgery is used to lessen pain. It also involves the removing of cancerous tissue, with the purpose of relieving pressure on the lungs and other organs to make the patient more comfortable and improve quality of life.

Diagnostic Pleural Mesothelioma Surgery

Several types of biopsy procedures are used to confirm a pleural mesothelioma diagnosis and determine how far the cancer has spread.

A needle aspiration biopsy is performed to take a small sample of tissue. The surgeon inserts a long needle into the chest and scrapes away a few cells from the area suspected to be cancerous. The cells are examined and tested to confirm a pleural mesothelioma diagnosis.

After the diagnosis is confirmed, the surgeon performs an excisional biopsy to remove additional tissue to determine how far the cancer has spread.

Thoracentesis is another minimally invasive surgery used to confirm diagnosis. It is also used to drain fluids to relieve pressure and make the patient more comfortable. Fluid tends to build up in the lungs of pleural mesothelioma patients, making breathing painful and labored. This condition is called pleural effusion. Thoracentesis is a long needle inserted into the lungs to drain away the fluid. The drained fluid is often sent to the lab for testing.

Pleural Mesothelioma Pleurodesis

Pleurodesis is a form of palliative surgery intended to relieve or prevent pleural effusion. Any fluid is drained and the area is treated with a powdery chemical that causes the cells to become inflamed. The pleural spaces swell and close, blocking fluid buildup and making it easier for the patient to breathe.

Pleural Mesothelioma Thoracotomy

Thoracotomy surgery removes part of a cancerous lung. There are three different types of thoracotomy surgeries: wedge resection, lobectomy, and pneumonectomy.

If the cancerous area is relatively small, the surgeon may opt for a wedge resection to remove only the tumors, leaving as much healthy lung tissue intact as possible.

Each lung is divided into five parts, called lobes. During a lobectomy, one or more of the lobes is removed, leaving the remaining uninfected lobes.

Some patients have pleural mesothelioma in only one lung. In that case, the surgeon may elect to perform a pneumonectomy. This involves removing the infected lung, along with the pleura and diaphragm. He then reconstructs the diaphragm using a man-made material called Gore-Tex, which is also used to make heavy outer clothing, like coats and gloves.

Patients who receive these types of surgery are the most likely to recover well and go on to live long lives free of cancer, but only a very small percentage of early-stage patients who are otherwise healthy qualify.

These surgeries have recently been successfully combined with an infusion of warm chemotherapy directly into the cavity immediately following surgery to kill any cancerous cells that may have been missed by the surgeon.

Pleural Mesothelioma Chemotherapy

Chemotherapy is a catchall phrase used to describe medications used in the treatment of cancer and a few other diseases and conditions, and refers to chemicals specifically designed to kill cells. Chemotherapy is a difficult course of treatment with many unpleasant side effects.

There are hundreds of chemotherapy options on the market, but only a few approved for pleural mesothelioma patients. A number of factors determine which therapy is best, including the stage of the cancer, the age of the patient, the patient’s general health, and other drugs and treatments the patient may already be on. The oncologist is most likely to prescribe a combination of chemotherapy drugs that will benefit the patient.

When discussing chemotherapy with an oncologist, it is vitally important for the patient to disclose medical history and be honest about lifestyle, prescriptions, vitamins, supplements and over-the-counter medications, including herbal remedies. Undisclosed medicines may impede the chemotherapy and produce harmful side effects.

Pleural Mesothelioma Radiation

Ionizing radiation is a therapy used to kill existing cancer cells and prevent the cancer from spreading. Radiation therapy may be used by itself or in combination with chemotherapy of surgery. It can be curative, to try and kill the cancer, or palliative, to relieve pressure and pain. Two types of radiation therapy are used to treat malignant mesothelioma,:external beam radiotherapy and brachytherapy.

External beam radiotherapy is the most frequently used radiation therapy for malignant mesothelioma patients. It is an external treatment similar to an X-ray where the exposed skin covering the cancerous area, in this case the chest, is bathed in radiation. External beam radiotherapy cannot kill all cancer cells, and is usually used in conjunction with other forms of therapy to relieve common symptoms, like breathing difficulties that are caused by tumors pressing on the lungs.

During the procedure, healthy tissue around the affected area is also exposed, causing side effects including skin irritation, pain, and difficulty swallowing.

Brachytherapy involves implanting tiny radioactive rods in the cancerous area. This delivery method is specifically targeted to deliver a deadly dose of radiation directly into malignant mesothelioma tumors. It causes less damage to nearby healthy tissues and, as a result, fewer side effects. Brachytherapy may be temporary or permanent. During a temporary procedure, the radioactive particles are inserted and later removed. Permanent procedures leave the rods in place, where they degrade and eventually stop emitting radiation.

PERITONEAL MESOTHELIOMA TREATMENT

Peritoneal mesothelioma attacks the membranous lining of the abdomen, called the peritoneum. Ten to twenty percent of all malignant mesothelioma cases are peritoneal mesothelioma. Like all malignant mesothelioma cancers, peritoneal mesothelioma is caused by exposure to deadly asbestos fibers. It is thought to develop when victims breathe in the tiny fibers, and then cough them up and swallow them. The minute fibers may also be ingested with food or drink, or they may be inhaled and wind up in the abdomen via the lymphatic system. The asbestos fibers stick to the lining and become lodged between the cells that make up the lining of the abdomen. Malignant mesothelioma develops slowly over decades and is usually discovered in its late stages, which limits treatment options.

Peritoneal mesothelioma is one type of malignant mesothelioma, the other types being pleural mesothlioma, pericardial mesothelioma and testicular mesothelioma.

Treatment options include surgery, chemotherapy, and radiation, alone or in any combination. Because there is no effective early detection screening procedure and peritoneal mesothelioma is difficult to identify until the tumors grow large enough to cause discomfort or flood the abdomen with fluid, it is rarely diagnosed early enough to cure. However, recent research focused on early detection using blood markers is encouraging. We may see blood screenings for early detection of malignant mesothelioma in just a few years.

Types of Peritoneal Mesothelioma Surgery

Three types of surgery are used in the diagnosis and treatment of peritoneal mesothelioma.

• Biopsy is a procedure often used to confirm the diagnosis of peritoneal mesothelioma. It is a non-invasive surgical procedure where a surgeon uses a long, thin needle to scrape out cells from the affected area for testing.
• Removing as much cancerous tissue as possible is called curative surgery. Recent advances in curative surgery combine heated chemotherapy drugs introduced to the abdominal cavity immediately after surgery to kill any remaining cancer.
• Palliative peritoneal surgery is used to relieve pain and other symptoms.

Surgery

Several biopsy procedures may be used to confirm a diagnosis of peritoneal mesothelioma and determine the extent of the disease.

During a fine needle aspiration, or laparoscopy, the oncology surgeon inserts a thin needle into the abdominal area where cancer is suspected and nips a small sample of tissue for testing.

If the results of the needle aspiration are inconclusive, the surgeon may perform a peritoneoscopy. A local anesthetic is administered for this procedure, and then the surgeon makes a small incision and inserts a tool called a peritoneoscope that allows him to see inside the abdomen with a light and a tiny camera attached to flexible tubing. A tissue sample is often collected during this exploration. In some cases, a more invasive biopsy is called for, and the surgeon may make a larger incision to collect additional tissue.

There are two linings that make up the peritoneum, called the visceral and parietal peritoneum. The visceral peritoneum protects the internal organs and the intestinal tract. The parietal peritoneum covers the abdominal cavity. The cells that make up these linings secret a fluid that lubricates the organs, allowing free movement without friction, much like oil lubricates the moving parts of an automobile. Cancerous cells from peritoneal mesothelioma cause cells to overproduce, flooding the abdominal cavity with fluid. Oncologists use a long needle attached to tubing with a bag at the end to drain the fluid. This procedure serves two purposes. It relieves the pressure of the excess fluid to make the patient more comfortable, and the fluid is analyzed to add to the physician’s store of knowledge about the patient’s condition. This procedure is called an adoparacentesis or peritoneal aspiration.

Peritonectomy

If peritoneal mesothelioma is detected early, a peritonectomy may be performed. This surgery involves removing all or part of the diseased peritoneum. This is often combined with intraperitoneal hypothermic perfusion or bathing the abdominal cavity with heated chemotherapy immediately following surgery to kill any remaining cancer.

Cytoreductive Surgery

Cytoreductive surgery, also called debulking, is used to remove only the cancerous tissues and tumors. The surgeon opens a large incision in the patient’s abdomen and carefully removes the visible infected cells, then often follows the procedure with intraperitoneal hypothermic perfusion.

Not every patient is a candidate for surgery. The cancer has to be in the early stages so that enough healthy tissue remains to allow the body to function, and the patient has to be strong enough to withstand the procedure before it can be considered.

Chemotherapy

Chemotherapy refers to chemical treatments designed to kill cells and may take the form of pills, injections, intravenous treatments or delivered directly into the body cavity during surgery. Chemotherapy has many unpleasant side effects and is not suitable for patients already in poor health.

Chemotherapy drugs may be used alone or with other drugs, surgery or treatments. While chemotherapy is not a cure for malilgnant mesothelioma, the treatment is used to help slow the growth of the cancer. Other chemotherapy goals are neoadjuvant therapy, used to shrink tumors prior to surgery, adjuvant therapy to destroy tumorous cells following surgery, and palliative therapy to relieve symptoms that cause pain and discomfort to the patient.

It is important for patients to be completely honest about prescriptions, vitamins, supplements and over-the-counter medications, including herbal remedies when discussing chemotherapy with an oncologist. The more information the doctor has, the better the advice he can give.

Radiation

Ionizing radiation is a therapy used to kill existing cancer cells and prevent the cancer from spreading. It may be used by itself or in combination with chemotherapy and/or surgery. Radiation may be curative, to kill the cancer, or palliative, to reduce tumors and make the patient more comfortable. Two types of radiation therapy are used to treat malignant mesothelioma: external beam radiotherapy and brachytherapy.

External beam radiotherapy is the most frequently used radiation therapy for malignant mesothelioma patients. It is an external treatment where the exposed skin over the cancerous area, the abdominal area in the case of peritoneal mesothelioma is irradiated. External beam radiotherapy is not specifically targeted enough to kill all cancer cells, and is most often used in conjunction with other forms of therapy to relieve symptoms and reduce pressure. During this procedure, tissue around the affected area is equally exposed and side effects typically result that include skin irritation, pain, and difficulty swallowing.

Brachytherapy involves implanting tiny radioactive rods, sometimes called seeds, directly into the cancerous area. This delivery method delivers a tiny dose of radiation directly into the cancerous tumors. Less damage is done to surrounding healthy tissues and as a result, there are fewer side effects.

Intensity-modulated radiation therapy (IMRT) is a new procedure involving an advanced mode of delivering computer-controlled, high-precision radiotherapy. IMRT carefully controls the dose of radiation to conform precisely to tumors using three-dimensional (3-D) modeling. This allows a higher dose of radiation, tightly focused on diseased cells, while minimizing impact on healthy surrounding tissues and, as a result, minimizing side effects.