Mesothelioma Treatment Options

Medical Procedures

The recovery chance or prognosis for the patient depends on the size of the cancer, where the cancer is, how far the cancer has spread, how the cancer cells look under the microscope, how the cancer responds to treatment, and the patient's age and general health. Standard cancer treatment may be considered because of its documented effectiveness in patients in past studies, or participation in a new clinical trial may be considered.

There are now a number of cancer treatment options available to mesothelioma patients. Extrapleural pneumonectomy for selected patients with very early stage disease may improve recurrence-free survival, but the impact it has on overall survival is unknownat this time. Pleurectomy and Decortication can provide palliative relief from symptomatic effusions, discomfort caused by tumor burden, and the pain caused by invasive tumors. The use of radiation therapy in pleural mesothelioma has been shown to alleviate pain in the majority of patients that are treated. But unfortunately, the duration of symptom control is short-lived. Single agent and combimed chemotherapy have reported higher response rates in STAGE II patients, but the toxicity of the treatment reported is also higher, and there is no evidence that combination treatments will result in longer survival or offer longer control of the symptoms.

Standard Treatments

There are treatments for all patients with malignant mesothelioma.

Three kinds of treatment are used:

Chemotheraphy (using chemotheraphy drugs to fight the cancer).

Surgery (removing the cancer).

Radiation therapy (use of high-dose x-rays or other high-energy rays to kill cancer cells to fight the cancer).

Surgery is often a common treatment of malignant mesothelioma. The doctor may remove part of the lining of the chest or abdomen and some of the tissue around it. Depending on how far the lung cancer has spread, a lung also may be removed in an operation called a pneumonectomy. Sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed.

Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. The radiation may come from a large machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the lung cancer cells are found (internal radiation therapy). If fluid has collected in the chest or abdomen, the doctor may drain the fluid out of the body by putting a needle into the chest or abdomen and using a gentle suction to remove the fluid. If fluid is removed from the chest, this is called thoracentesis. If fluid is removed from the abdomen, this is called paracentesis. The doctor may also put drugs through a tube into the chest to prevent more fluid from accumulating.

Chemotherapy uses drugs to kill the cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells throughout the body. In mesotheliomacases, the chemotherapy may be put directly into the chest (intrapleural chemotherapy).

Intraoperative photodynamic therapy is a new type of cancer treatment that uses special drugs and strong light to kill cancer cells during surgery. A special drug that makes cancer cells more sensitive to light is injected into a vein several days before surgery. During surgery to remove as much of the cancer as possible, a special light is used to shine on the pleura. This treatment is being studied for early stages of mesothelioma in the chest.

Side Effects

Most cancer treatments all have side effects of some kind. It is very hard to kill cancer cells when trying to keep all healthy cells safe. The side effects of cancer treatment depends on the type of treatment and the person’s overall health when treatment starts.

Experimental Treatments

Not all patients are cured with standard therapy, and some standard treatments may have much more side effects than are desired. Clinical trials, therefore, are designed to find new and better ways to treat cancer patients and are based on the most up-to-date information. Many clinical trials are ongoing in many parts of the country for many patients with malignant mesothelioma.

These new treatment approaches often combine two or more traditional treatments or consist of other promising innovations.