Mesothelioma Treatment Including Phytodynamic Therapy After a Lung-Sparing Operation Improves Survival
While surgery is one of the most common treatments for pleural mesothelioma, the cancer may not always be completely surgically removed. As a result, some surgical treatment plans for mesothelioma are followed by chemotherapy or radiation therapy. Phytodynamic therapy, which uses light energy to destroy cancerous cells, may also be considered as a post-surgical option to promote the death of any remaining mesothelioma cells. In a 2011 study published in the Annals of Thoracic Surgery , researchers at Pennsylvania University’s Penn Medicine found that the combination of a radical pleurectomy (RP) and intraoperative phytodynamic therapy (PDT) yielded superior overall survival than the combination of a modified extrapleural pneumonectomy (MEPP) and PDT. Although the patients’ sexes, ages, diagnoses and treatment histories were all similar, the patients who obtained the radical pleurectomy and PDT responded more favorably to treatment. The median survival rate for the group of patients who received the MEPP was 8.4 months. At a follow-up 2.1 years after the end of treatment, a median survival rate for the patients who received a radical pleurectomy had not yet been reached. The results yielded by the radical pleurectomy and adjuvant (therapy following surgery) PDT were superior to other studies of surgical treatment plans with patients of similar demographics. Between 2004 and 2008, during which the participants obtained their mesothelioma treatment , the preferential surgical approach to managing malignant pleural mesothelioma shifted to lung-sparing procedures. Of the last 16 participants to receive treatment, 13 underwent a lung-sparing operation. Pennsylvania University’s Penn Medicine states that a RP and PDT combination has been shown to reduce the possibility of a recurrence and improve the outcome of mesothelioma patients’ treatment. Penn Medicine cites studies that suggest the immune system can more adequately attack cancer cells that have been treated by PDT. The Penn Mesothelioma and Pleural Program offers the lung-sparing radical pleurectomy as an alternative to an extrapleural pneumonectomy (EPP). During an EPP, a patient’s lung, pleura, diaphragm and pericardium are removed, often placing the patient at a higher risk for post-operative mortality. This risk may be reduced by the less extreme pleurectomy. Penn Medicine asserts that their patients treated by RP and PDT have displayed “impressive” local control and survival rates. Additional information on mesothelioma can be found through the Mesothelioma Center.
In Northampton County, located in the Lehigh Valley of Pennsylvania, County Controller Stephen Barron has claimed that county officials have neglected air quality complaints about possible asbestos exposure in county buildings. However, county councilman Ron Angle has accused Baron of grandstanding and referred to him as, “the most dangerous elected official in the Lehigh Valley.” Before asbestos became more regulated in the late 1980s, it was widely used in the insulation of many older buildings. Because asbestos is friable, over time the insulation can release fibers into the air, potentially causing malignant diseases such as malignant mesothelioma if inhaled. Barron has stated that concerned employees have previously brought these claims to the attention of the county with no resulting action. As a result, he has asked the Environmental Protection Agency (EPA) to investigate any possible asbestos exposure in the buildings. Barron further states on his reasoning behind bringing this issue to light, “I only got involved because (employees) thought the administration was turning a deaf ear.” Because the EPA and many other international health organizations list asbestos as a human carcinogen, finding any trace of the fiber above legal limits is a serious offense. If the EPA were to find asbestos fibers in the air, the county would likely receive fines as a result. The EPA maximum allowable content for asbestos in a product may not exceed one percent. Also, air levels may not exceed 0.1 fibers/ml. The County Executive, John Stoffa, has stated that it has already previously been addressed, “It is something we addressed through our safety committee… We have taken preventative measures.” However, he has also said that employee physicals are not necessary, “Why would we do that? Who do we start with and who do we stop with? There’s the assumption that we’ve done something wrong.” Doctors and physicians have continually stated the most effective way to treat mesothelioma and other asbestos-related diseases is through early diagnosis. Patients are often unaware of the potentially life-threatening substance they were exposed to until many years later. Additional information on mesothelioma and asbestos exposure can be found through the Mesothelioma Center.