Mesothelioma Treatment Options

Medical Procedures

The chance of recovery (prognosis) 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
mesothelioma treatment may be considered because of its
effectiveness in patients in past studies, or participation in a clinical
trial may be considered.

There are a number of treatment options available to

mesothelioma patients. Extrapleural pneumonectomy in selected
patient with very early stage disease may improve recurrence-free
survival, but its impact on overall survival is unknown. Pleurectomy
and Decortication can provide palliative relief from symptomatic
effusions, discomfort caused by tumor burden, and pain caused by
invasive tumors. The use of radiation therapy in pleural
mesothelioma has been shown to alleviate pain in the majority of
patients treated. Unfortunately, the duration of symptom control is
short-lived. Single agent and combined chemotherapy have reported
higher response rates in STAGE II patients, but the toxicity reported
is also higher, and there is no evidence that combination treatments
result in longer survival or longer control of the symptoms.

Standard Treatments

There are standard mesothelioma treatments for all patients with

malignant mesothelioma.

Three kinds of treatment are used:

chemotherapy (using drugs to fight the cancer).

surgery (taking out the cancer).

radiation therapy (using high-dose x-rays or other high-energy rays

to kill cancer cells) chemotherapy (using drugs to fight the cancer).

Surgery is a common mesothelioma 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 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. Radiation may come from a machine outside the body
(external radiation therapy) or from putting materials that produce
radiation (radioisotopes) through thin plastic tubes in the area where
the 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
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 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 mesothelioma
treatment, chemotherapy may be put directly into the chest
(intrapleural chemotherapy).

Intraoperative photodynamic therapy is a new type of

mesothelioma treatment that uses special drugs and light to kill
cancer cells during surgery. A 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

Cancer and treatments all have side effects. It is hard to kill cancer
cells at the same time as keeping all healthy cells safe. Side effects of
mesothelioma treatment depend on the type of mesothelioma
treatment and the person’s overall health when treatment starts.

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

These new approaches often combine two or more traditional

mesothelioma treatments or consist of other promising innovations.

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