Mesothelioma researchers recently published a review in the medical journal Lung Cancer on current measures for preventing tumor growth at sites of chest intervention where surgery occurred or where medical instruments such as a catheter were placed.
Mesothelioma cancer is a rare disease caused almost exclusively by asbestos exposure. In the United States approximately 2,000 to 3,000 people are diagnosed with the cancer each year. Diagnosis can be challenging because the disease has a latency period of 20 to 50 years following exposure to asbestos. Unfortunately, mesothelioma treatment options are also compromised by the long latency period since symptoms do not arise until the cancer has reached late stages of development.
Printed in the November 2009 issue of Lung Cancer, the study assessed current practices for preventing tumor growth at sites of chest instrumentation in pleural mesothelioma patients. A number of chest interventions involving various instruments to gain a biopsy sample may be required for proper diagnosis of mesothelioma. Some of these interventions include thoracoscopy, video assisted thoracic surgery (VATs), thoracotomy, or computerized tomography (CT) guided needle biopsy.
In addition, pleural mesothelioma patients often suffer with pleural effusions and require the fluid to be drained from the chest cavity for symptomatic relief. These drainage procedures are another example of chest interventions that have the potential to develop tumors at the incision site.
Invasive diagnostic procedures of this nature can encourage cancerous cell growth at the intervention site, resulting in a subcutaneous tumor. Researchers theorize that the chest wall interventions result in “tracts” or passages from the pleural cavity to the skin surface. The cancerous cells then migrate through these tracts and form tumor nodules.
To help reduce the risk of metastases at intervention sites, it has been common practice for more than 20 years to prophylactically irradiate intervention sites following the procedure, a practice referred to as prophylactic irradiation of tracts (PIT). In PIT the intervention site is exposed to radiation to help prevent or at least curtail cancerous growth in the future.
The researchers did not reach a consensus to support the use of PIT through this study, however many cancer centers offer PIT and recent widespread interest in a clinical trial on the procedure may shine more light on the efficacy of this preventative measure.
Additional information about mesothelioma may be found through the mesothelioma Center.