Mesothelioma, an asbestos-caused cancer, comes with debilitating pain. Patients and their doctors often try a variety of options to relieve the pain, but still, it persists. Many patients also worry about the addictive side effects of the frequently used opioid drugs. Now, a drug-free, effective relief may soon be on the way if a clinical trial using radiotherapy proves helpful.
Noting that there is an urgent need to improve the treatment of pain in malignant pleural mesothelioma patients, researchers from the Cancer Research UK Clinical Trials Unit, based at the Beatson West of Scotland Cancer Centre, a Scottish cancer center focused on the delivery of non-surgical cancer care, hope to enroll 100 patients in the second round of the ‘Symptoms Study of Radiotherapy in Mesothelioma’ (SYSTEMS) clinical trial. In the first round of 40 patients given a “standard dose” of radiation, the team reports “approximately one third of patients experienced clinically meaningful improvements in pain control with minimal toxicity.”
In the SYSTEMS-2 randomized trial, 50 percent of the patients will receive the standard dose of radiation and the other half will receive a “higher” dose. By conducting a side-by-side comparison, the researchers hope to determine the best dosage for pain control with acceptable side effects. The researchers will also be monitoring the impact on quality of life and overall survival time. The radiation therapy will be given over two weeks.
“In SYSTEMS-2, we are comparing the standard dose of radiotherapy (given in SYSTEMS) with a bigger dose given over 2 weeks,” note the researchers, according to the SYSTEMS-2 website. “The reason for doing this is because we believe that the bigger dose of radiotherapy may be more effective in controlling pain, but because no-one has looked at this before, we cannot be sure.”
Mesothelioma tumors are often located close to other organs which limits the ability of oncologists to order radiation treatment in high enough doses to successfully attack the cancer. However, by using the most current radiation tools, deep-seated tumors can be targeted with greater precision limiting damage to the surrounding tissue.
“Since we will be giving a bigger dose of radiotherapy to some of the patients, we are using more sophisticated methods to plan and deliver the treatments than were used in SYSTEMS,” according to the trial notes. “These techniques allow us to carefully control the doses given to ‘normal’ tissues, ensuring that these are kept at a safe level and don’t cause unacceptable side effects.”
Pain associated with mesothelioma varies from patient to patient and depends on the type of mesothelioma. Over half of the pleural (lung) mesothelioma patients suffer pain in the lower, back and sides of the chest. Sufferers of peritoneal (abdominal) mesothelioma may experience pain in the abdominal area. The pain typically increases over time and can be acute in many patients requiring prescription narcotics to manage the pain. Even with the most potent drugs available, pain continues to impact the quality of life for the patients.
To find out more about the Systems-2 trial visit the SYSTEMS-2 website.
Photo Credit: Beatson West of Scotland Cancer Centre