If you or someone you love has been diagnosed with mesothelioma, you want to know what your best treatment options are and how you can extend and maintain the best quality of life. Our Mesothelioma Care Package gives you all of those answers and more — for free.
As mesothelioma treatments continue to improve every year, patients are living longer. Patients rely on different types and combinations of treatments, from traditional therapies such as chemotherapy and radiation, to emerging clinical trials that may lead to a cure in the future.
In tandem with researchers continuing to create, test, and refine new treatments every day, patients’ hope of an improved prognosis continues to rise.
Based on the patient’s diagnosis, doctors create an optimum course of treatment which accounts for the cancer stage, cell type, and location of the mesothelioma. Considered together, these factors help determine the types of treatment the patient might try.
Designed to remove mesothelioma from a patient’s body, curative treatments are the best course of action for patients diagnosed with early-stage mesothelioma. Patients may have one of the two standard surgeries for pleural mesothelioma: the extrapleural pneumonectomy (EPP) or the pleurectomy with decortication (P/D). Those diagnosed with peritoneal mesothelioma might undergo cytoreduction, which doctors often combine with heated chemotherapy in a procedure called cytoreduction with HIPEC.
Palliative treatments are used to relieve pain and discomfort caused by symptoms of mesothelioma. One of the most common palliative treatments is draining fluid buildup from the chest or abdomen.
Multimodal therapy combines two or more treatments which allows doctors to attack mesothelioma both curatively and palliatively. A study at Dana Farber Cancer Center — one of the highest–rated cancer centers in the U.S. — showed that 22 percent of patients lived at least 5 years after having multimodal therapy.
Surgery for Patients with Pleural Mesothelioma
A pleurectomy with decortication (P/D) is a surgery doctors use to remove the lining of the lung most affected by tumor growth along with any visible tumors on the surface of the lung itself. If mesothelioma has spread beyond the lining of your lung, your doctor may also remove parts of the diaphragm and pericardium, the protective lining of the heart. The goal of using a P/D is to relieve symptoms of mesothelioma without sacrificing the lung. 90 percent of patients who have the procedure experience a reduction of symptoms.
Doctors use an extrapleural pneumonectomy (EPP) to remove the entire lung and nearby tissue affected by mesothelioma. To prevent the disease from coming back, he or she may also remove the diaphragm, nearby lymph nodes, and the lining of the heart.
Surgeons use a peritonectomy to remove any part of the peritoneum — the protective lining of the abdomen — affected by tumor growth. They also remove any visible tumors that may have spread to nearby organs, like the diaphragm or stomach.
Cytoreductive surgery combines multiple peritonectomies to completely remove mesothelioma from the abdominal cavity. Doctors often combine cytoreductive surgery with heated chemotherapy in a procedure called cytoreduction with HIPEC to maximize its effectiveness.
There is a difference in administration between systemic chemotherapy and intraoperative chemotherapy:
Systemic – Given through pills or an IV, systemic chemotherapy travels through your bloodstream, attacking cancer cells it comes in contact with.
Intraoperative – Administered during surgery, intraoperative chemotherapy is applied directly into the lung or abdominal cavity. It’s also usually heated to increase its cancer-killing effectiveness.
Chemotherapy, the use of drugs to attack and kill cancer, is the most effective when administered to match the diagnosis, specifically regarding the cancer stage and location of the mesothelioma. Chemotherapeutic drugs work better when they are combined with other drugs or with surgery.
Chemotherapy can be used before surgery (neoadjuvant), during surgery (intraoperative), or after surgery (adjuvant).
Depending on your tolerance, chemotherapy may affect you severely, mildy, or not at all. Its side effects disappear slowly after treatment and vary according to the type of drug, amount of dose, and length of time it’s given.
Common side effects experienced during chemotherapy are:
The use of high energy rays to kill mesothelioma cells is called radiation therapy. It can be used by itself as a palliative treatment or combined with chemotherapy and/or surgery. Some types of radiation therapy allow doctors to target tumors, minimizing damage to healthy cells and reducing harmful side effects.
Radiation therapies commonly used for mesothelioma patients include:
Using 3D scans of the tumor, doctors customize the amount and intensity of each radiation dose according to the tumor’s size and shape. This customization allows doctors to target tumors more effectively and minimizes damage to healthy, non-cancerous cells surrounding the tumors.
IMRT is an advanced form of 3D-CRT. Doctors use computers to adjust the amount and intensity of a radiation beam as it passes over a tumor. Researchers in a recent study showed that IMRT used after an extrapleural pneumonectomy (EPP) produced a median overall survival rate of just over 2 years. Of these patients, 41 percent survived an additional 3 years after the procedure.
In order to get the same cancer-killing effectiveness as chemotherapeutic drugs, doctors have to use high doses of radiation. The higher the intensity of radiation applied, the higher the chances it could damage healthy cells and the increased likelihood of more side effects.
Radiation therapy can cause the following side effects:
Even if traditional treatments such as surgery or chemotherapy aren’t an option, you can still participate in a clinical trial. Every current drug in use for mesothelioma started as a clinical trial so this may be your best option for improving your prognosis. Clinical trials allow researchers to develop new ways to fight mesothelioma including immunotherapy, a treatment that strengthens your immune system and helps kill mesothelioma cells.
Palliative treatments relieve the pain caused by symptoms at all stages of mesothelioma. They can be used as a complement to curative treatments for patients diagnosed with stage 1 or stage 2 mesothelioma. Palliative treatments can also be used to reduce pain and increase the quality of life for stage 3 and stage 4 patients.
Several types of palliative treatments are available to mesothelioma patients:
A thoracentesis is the draining of excess fluid from the pleural cavity — the space between the inner and outer lining of the lungs — with a needle. It reduces pressure caused by too much fluid, which pushes on the lung and makes it difficult to breath.
Assisted by a camera, the doctor drains excess fluid from the pleural cavity and seals it with talc powder. The talc causes an inflammatory reaction that closes the pleural space. Over time, scar tissue forms and prevents more fluid from collecting there. Doctors use this procedure to reduce chest pain and relieve pressure caused by buildups of fluid.
When tumor growth hardens the lung’s lining, it can make breathing difficult. A partial pleurectomy removes the lining of a lung affected by mesothelioma and lets the lung re-expand to make breathing easier.
A paracentesis uses a needle to drain off excess fluid from the abdominal cavity and ease the pressure caused by the buildup of fluid in this space. Too much fluid in the abdominal cavity creates pressure on the organs, causing intense discomfort and pain.