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Mesothelioma Treatment

Is Surgery Right for Me?
How Can Chemotherapy Help?
How Can Radiation Therapy Help?
What Are My Experimental Treatment Options?
Are There Alternative Treatments?
What’s the Most Successful Mesothelioma Treatment?

The best mesothelioma treatment is one that is tailored specifically to you. Most doctors recommend a mix of procedures depending on your condition, medical history, and cancer stage. Both traditional and alternative options are available, and advances in treatment are being made all the time.

Mesothelioma treatment generally falls into two categories:

  • Curative, which aims to remove cancer from your body.
  • Palliative, which aims to manage your cancer and make you more comfortable.

Sometimes, the treatments used to relieve your symptoms are the same that are used to treat cancer. For example, both surgery and radiation therapy can be used as curative or palliative, depending on the patient.

Before you choose a treatment, talk to a qualified mesothelioma doctor.

Is Surgery Right for Me?

In the early stages of mesothelioma, surgery can be used to slow the advance of the disease and, in some cases, cure it completely. Surgery is often supplemented by chemotherapy and radiation therapy for a more well-rounded approach.

For pleural mesothelioma, surgical options include:

  • Extrapleural Pneumonectomy (EPP): Removes a cancerous lung and parts of the chest lining, heart lining, nearby lymph nodes, and diaphragm.
  • Pleurectomy Decortication (P/D): Removes the lining of the lung along with the mesothelial tumors. It may be “radical,” removing the entire lining, or “non-radical,” extracting up to 70 percent of the affected lining.
  • Pleurodesis: Aims to prevent fluid buildup in the chest by inserting a hollow tube into the chest wall to drain the fluid. It is not a curative treatment, but one that tries to relieve symptoms.

Both EPP and P/D are potentially curative if they’re performed during the early stages of the cancer. However, they are major surgeries that carry potential complications.

Side effects for EPP include internal bleeding, respiratory failure, pneumonia, and even death.

Complications from P/D are rare. Though medical professionals don’t agree on which one is better, both can increase your survival time.

For peritoneal mesothelioma, surgical options include:

  • Cytoreductive surgery (peritonectomy): This involves the removal of cancerous growth from multiple places in the abdomen, including the stomach, bowels, bladder, gall bladder, liver, pancreas, and spleen. It’s potentially curative if performed during the early stages of the cancer.
  • Paracentesis: This aims to remove fluid buildup from the abdominal cavity by inserting a needle or catheter into the peritoneal cavity. It is not a curative treatment, but one that tries to relieve symptoms.

How Can Chemotherapy Help?

Chemotherapy is the use of medicine or drugs to kill cancer cells. While it’s not a cure for mesothelioma, it’s the only treatment proven to improve survival rates in randomized and controlled trials.

Depending on the stage of your mesothelioma, chemotherapy can be the primary form of treatment or act as a supplement to other forms of treatment. Chemotherapy may be used before surgery to make an operation easier or used after surgery to decrease the chance that the cancer will come back.

Newer chemotherapy treatments include:

  • Intrapleural chemotherapy (pleural mesothelioma): Drugs are heated and dispensed directly into the chest cavity.
  • Intraperitoneal chemotherapy (peritoneal mesothelioma): Drugs are heated and dispensed directly into the abdominal cavity.

These newer strategies allow the drugs to reach the mesothelioma without harming healthy cells in other parts of the body, enabling doctors to give higher doses of chemotherapy.

Chemotherapy side effects include nausea, vomiting, and/or diarrhea, and hair loss.

How Can Radiation Therapy Help?

Radiation therapy is one of the most popular forms of mesothelioma treatment, as it has been shown to reduce pain in patients. It uses X-rays that are “sprayed” outside the body through an external beam, targeting cancerous cells. It’s sometimes used as a stand-alone treatment for those who want to manage discomfort.

Because radiation therapy can have dangerous effects on the small intestine, liver, kidneys and other organs, it is not used to treat peritoneal mesothelioma.

Common types of radiation therapy for mesothelioma patients are:

  • Three-Dimensional Radiation Treatment (3D-CRT): Using detailed imaging scans, doctors customize a radiation dose for a three-dimensional tumor. This may protect the liver and heart from receiving as much radiation.
  • Intensity-Modulated Radiation Therapy (IMRT): More complicated than a 3D-CRT, this applies non-uniform radiation beam intensities across the tumor. It can cover more of the tumor while protecting healthy tissue.
  • Brachytherapy: Radioactive material is placed directly into the chest or the abdomen at the site of the mesothelioma. This may be an option for patients who are not physically strong enough to handle surgery.

Radiation therapy side effects include skin changes (dryness, peeling, or itching), tiredness, diarrhea, and hair loss.

What Are My Experimental Treatment Options?

Advances in mesothelioma treatment research have created additional—and promising—options for patients. Clinical trials are continually exploring new methods to cure the disease or increase survival rates. Some emerging treatments include:

Immunotherapy. While not yet a cure for mesothelioma, this treatment continues to be the focus of much research. Immunotherapy uses your body’s own immune system to fight the cancer while leaving healthy cells untouched. Immunotherapy aims to make your immune system recognize antigens on cancer cells as foreign—which your immune system normally cannot do—and therefore destroy those cells.

Gene therapy. This method aims to cure or prevent various diseases by manipulating a patient’s genes. Because of potential complications, the Food and Drug Administration (FDA) hasn’t approved gene therapy for mesothelioma patients. However, the location of pleural mesothelioma tumors is particularly well-suited for gene therapy. Doctors can easily access the membrane surrounding the lungs to perform biopsies, deliver genes, and observe results.

Photodynamic therapy. This procedure uses a photosensitizing agent and light source to attack cancer cells. In the process, it damages the blood vessels inside tumors, rendering them unable to absorb nutrients. Results from clinical trials have shown that this treatment can increase life expectancy in pleural mesothelioma patients, particularly when combined with other treatments such as surgery.

Are There Alternative Treatments?

A variety of alternative treatments exist for the mesothelioma patient. Often referred to as CAM (Complementary and Alternative Medicine), these methods don’t provide a cure, but they may help manage the symptoms and increase survival rates. And with minimal side effects, they’re an attractive option for patients seeking gentler treatment.

Doctors have found the most effective mesothelioma treatment programs incorporate alternative treatments with the traditional options of surgery and radiation/chemotherapy.

Popular alternative therapies include:

Chiropractic care. Chiropractors use their hands or a small tool to apply a controlled force to a spinal joint. Their goal is to treat and prevent pain involving the musculoskeletal system, which controls the body’s movement. For mesothelioma patients, chiropractic adjustments may reduce tension, headaches, and stress.

Yoga. A popular way to reduce stress and increase flexibility, yoga is usually understood to be a physical exercise, though its ancient Indian roots are spiritual. During a series of postures, yoga students are encouraged to develop mindful awareness. Certain types of yoga may also include breathing techniques, visualization, and meditation. Talk with your doctor before starting a yoga practice and tell the instructor about your condition.

Physical therapy. A physical therapist can create a treatment plan and lead you through exercises to increase your strength, flexibility, and endurance. Depending on the type of mesothelioma, this may mean:

  • Cardiovascular training to help with breathing before or after surgery.
  • Exercises to increase chest or abdominal wall mobility.
  • Strategies for scar tissue management and healing.

Acupuncture. A technique that began in China thousands of years ago (and one that is popular in the United States today), acupuncture uses thin needles inserted at specific points on your body. When these pressure points are stimulated, according to the practice, the body’s balance and harmony is restored. For cancer patients, acupuncture may help manage pain and relieve anxiety.

Breath and relaxation exercises. Slowly tensing and relaxing different muscle groups may help you feel more at ease and breathe easier. To manage breathlessness, there are various breathing techniques that can help, such as correct posture, visualization, and physical exercises. Your doctor may refer you to a therapist who can teach you exercises to do on your own.

What’s the Most Successful Mesothelioma Treatment?

This varies from person to person, but studies suggest that combining two or more treatment methods (a “multi-modal” approach) is most effective in increasing survival rates. A popular option is a combination of surgery, chemotherapy and radiation therapy. However, doctors may recommend experimental therapies as well.

When creating a multi-modal treatment plan, doctors consider three stages of treatment:

  • Stage 1: Neoadjuvant therapy. The patient receives treatment—usually chemotherapy—to help shrink the tumor and increase the odds of success in the main treatment.
  • Stage 2: Main treatment. Often, this is surgery that aims to remove as much of the tumor as possible. Chemotherapy is an option for those who don’t qualify for surgery.
  • Stage 3: Adjuvant therapy: A follow-up treatment, this stage aims to manage any tumor recurrence or symptoms. Often, this treatment is radiation therapy or chemotherapy.

Learn how you can get the most effective treatment and create the best prognosis possible. Our complimentary 200-page mesothelioma eBook shares the latest mesothelioma treatment, research, and resources. Request your free eBook now.