Mesothelioma Treatment

Mesothelioma treatment depends on several factors, including the stage of mesothelioma, the location of the tumor, and the age and overall health of the patient.

Conventional Mesothelioma Medical Treatment

Surgery – Removal of Mesothelioma

Surgical removal of the tumor and surrounding tissue may be used depending on how far the mesothelioma has spread (the stage). The more advanced the stage, the less likely that surgery will be effective in treating mesothelioma.

Surgery for malignant mesothelioma can be used for long-term control or to cure the disease (aggressive surgery) or can be used to relieve pain (palliative).

Aggressive surgery

Aggressive mesothelioma surgery involves removal of the pleura, lung, diaphragm, or pericardim. (The type involving removal of the pleura is called extrapleural pheumonectomy.) The goal is to remove as much of the mesothelioma tumor as possible. This type of surgery, also called extraplueral pneumonectomy, typically is performed on younger patients in Stage 1 of mesothelioma.

Because of the complexity and the high risks involved with this type of surgery, some mesothelioma hospitals do not perform the procedure. Also, different mesothelioma treatment centers may have different criteria for accepting patients for surgery. Therefore, it is important to check with a mesothelioma hospital to see if you meet its criteria.

Palliative Surgery

Palliative surgery is typically used in the more advanced stages of mesothelioma. The goal is to relieve or control symptoms caused by fluid collection or by the tumor compressing the lung or other organs. It is not intended to cure mesothelioma.

Pleurectomy/decortization is usually a palliative operation. It is used in situations where the entire tumor cannot be removed. It is effective in controlling the accumulation of fluid in the lungs (effusion), and the pain caused by mesothelioma.

Thoracentesis is also used to treat effusion in pleural mesothelioma. This treatment involves inserting a needle into the chest in order to drain the fluid. Thoracentesis does not involve surgical removal of the mesothelial cells.

Radiation

Radiation therapy uses high-energy x-rays to kill mesothelioma cancer cells and to shrink tumors. There are two types of radiation therapy.

External radiation therapy uses a machine outside the body that beams x-rays to the location of the mesothelioma.

Brachytherapy involves putting chemicals that produce radiation directly into the site of the mesothelioma cancer. This is done by inserting a thin plastic tube into the chest or abdomen.

Because of the location of malignant mesothelioma, it is very difficult to deliver high-enough doses of radiation to kill the tumor without damaging surrounding organs. As a result, it is unclear whether radiation therapy is a successful method of treating mesothelioma. It has, however, been effective in killing remaining tumor cells after surgery has been performed.

Radiation therapy is also used as a palliative therapy to relieve symptoms of mesothelioma, such as shortness of breath, chest pain, and internal bleeding.

Radiation therapy has several side effects, such as fatigue, nausea, and vomiting. Although these side effects are sometimes temporary, you should let your doctor know, since they often can be controlled.

Chemotherapy

Chemotherapy uses drugs to treat mesothelioma cancer. It is administered either orally (through pills) or by injecting the drugs directly into the veins (intravenously), the muscles, the chest cavity (intrapleurally), or the abdominal cavity (intraperitoneally). The goal of mesothelioma chemotherapy is for the drug to enter the bloodstream and circulate throughout the body in order to destroy the cancer cells.

Several drugs have been used, either individually or in combination with others, to treat mesothelioma. Some of the single-agent drugs include:

a) The FDA (in 2004) approved pemetrexed (brand name Alimta) for treatment of malignant pleural mesothelioma. Pemetrexed is usually given in combination with cisplatin.

b) In October 2005 Researchers have reported that the combination of Tomudex (raltitrexed) & Platinol (cisplatin) improves survival of patients with malignant pleural mesothelioma (MPM) compared to Platinol alone

c) In one study 29 patients were given vinorelbine alone, 6 (24%) patients disease improved and 16 (55%) patients disease remained stable

d) Researchers have found that drugs commonly used to reduce cholesterol (such as doxorubicin) can be a useful addition to treatment of mesothelioma.

e) Onconase, delivered to patients intravenously, has shown promising results in treating malignant mesothelioma.

f) Cisplatin, a platinum-based chemotherapy drug used to treat mesothelioma and other forms of cancer, slows or stops the growth of cancer cells in the body

g) Since its introduction in the late 1980's, Carboplatin has gained popularity in clinical treatment due to its vastly reduced side-effects compared to its parent compound cisplatin.

h) Gemcitabine (difluorodeoxycytidine) is commonly used to treat pancreatic, bladder and breast cancer but is sometimes recommended for mesothelioma

Because of the relatively low response rate of single-agent therapy in treating mesothelioma, combinations of these drugs have been used to increase their effectiveness. Although some researchers have reported high response rates to these therapies, these rates have not been consistent, and more research is necessary.

Chemotherapy drugs are generally very toxic. Therefore, a doctor must be very careful in monitoring the condition of a patient during therapy. Some of the more common side effects include nausea, vomiting, loss or appetite, hair loss, and fatigue. Chemotherapy can also result in low blood cell counts, which increases the risk of infection and bleeding or bruising.

Side effects vary depending on the treatment, and generally disappear after treatment is completed.

New Mesothelioma Treatments

New mesothelioma treatments are being evaluated in mesothelioma clinical trials in hopes of a mesothelioma cure. Mesothelioma clinical trials are research studies that evaluate new mesothelioma treatments for safety and efficiency. There are no guarantees that a treatment offered through a mesothelioma clinical trial will work, and because the treatments are in the trial stage, there are some risks. However, a mesothelioma clinical trial is not undertaken unless the researchers believe the treatment may have some value.

Clinical Trials

A mesothelioma clinical trial is a research study used to evaluate a treatment for efficacy and safety. It generally involves a novel approach to treatment, and is conducted by a university-affiliated hospital.

Experimental Treatments

There are a number of experimental treatments for mesothelioma that are currently being evaluated. These include:

Photodynamic Therapy

Photodynamic Therapy (PDT) involves administering photosensitive drugs into the mesothelial cells. Doctors then use a laser light to activate the photosensitive drugs in order to destroy the surrounding cancer cells.

As yet, PDT has not shown success in improving the survival rate for mesothelioma patients.

Gene Therapy

Gene therapy is used to correct disease at the DNA level by compensating for abnormal genes. Several types of gene therapy are currently being studied for the treatment of mesothelioma. Although this treatment has proved successful in animal studies, the results in human studies have been disappointing.

Immunotherapy

Immunotherapy seeks to improve the immune system’s natural ability to fight cancer. Studies have shown that the immune system distinguishes healthy cells from cancer cells in order to eliminate the cancerous cells.

Immunotherapy uses biological response modifiers (BRMs) to improve the body’s natural ability to fight disease. (BRMs currently used include interferons, interleukins, monoclonal antibodies, tumor necrosis factors, and cancer vaccines.) This first involves the removal of healthy cells, which are then exposed to cytokines and antibodies. These enhanced cells are then reinstalled into the peritoneum, where they will enhance the body’s ability to fight cancer.

Preliminary studies have shown significant shrinkage of mesothelioma tumors at very early stages of the disease. Much more research, however, is necessary to determine its efficacy as a treatment for malignant mesothelioma.

Multimodality Therapy

This type of therapy simply means the use of any combination of surgery, radiation therapy, or chemotherapy to treat mesothelioma. The most common form combines surgery with intercavitary radiation or chemotherapy, both before and after, to remove and eliminate mesothelioma.

Alternative Treatment


Given the relatively unsuccessful results of conventional medicine in treating mesothelioma and that there is still no mesothelioma cure, a number of persons have turned to alternative mesothelioma treatments. These have included holistic forms of treatment, such as acupuncture, homeopathy, herbs, and other forms of Eastern medicine to treat mesothelioma.

These alternative approaches can be used alone or in conjunction with conventional treatments for mesothelioma. Most hospitals, however, do not offer these forms of treatment, and insurance companies, generally, do not cover these treatments.

Certain mesothelioma doctors have used unconventional methods to treat mesothelioma patients. Call 1-800-362-1479 or email us to request a list of alternative mesothelioma treatment doctors and centers.