More than 30 percent of patients with Epithelioid Mesothelioma, the most common cellular strain of this cancer, lived for five years
or more after a multidisciplinary treatment approach in England,
raising hopes and expectations everywhere for this rare and deadly
disease.
The startling success rate stems from a retrospective study of 102
mesothelioma patients who underwent aggressive lung-saving,
pleurectomy/decortication (P/D) procedure performed by U.K. thoracic
surgeon Dr. Loic Lang-Lazdunski.
All patients also were treated with chemotherapy and post-surgery
radiotherapy, along with the controversial hyperthermic povidone-iodine
wash of the chest cavity before surgical closure. "This treatment plan represents an alternative to the classical
trimodality approach," wrote Lang-Lazdunski
"Because of the multiple therapies being used in this study, the exact
impact of povidone-iodine lavage on outcomes and long-term survival is
not possible to precisely know. However, we believe this is a cheap,
safe and possibly useful adjunct after P/D."
Povidone-iodine
is a chemical complex popular since the 1950s as a traditional
antiseptic — often marketed as Betadine, and used by doctors as a
pre-surgery scrub. Recent laboratory work shows it can suppress and
destroy mesothelioma tumor cells.
Although it is part of several clinical trials involving other
cancers, it has not been clinically studied specifically with
mesothelioma patients. Some surgeons, including Lang-Lazdunski, are
using it as an alternative to a chemotherapy wash of the chest cavity
after surgery. They believe it could prevent tumoral seeding following surgical resection and slow any future metastasis.
Yet even in his report, Lang-Lazdunski did not fully endorse the treatment without a trial designed to prove its effectiveness.
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