Mesothelioma

Treatment of mesothelioma

Treatments for mesothelioma are based on the stage of the disease and the patient’s age and general health.

The most common treatments are surgery, radiation, and chemotherapy. Multimodality therapy, the combination of surgery, radiation, and/or chemotherapy, is a common therapeutic approach for early stage mesothelioma. Trimodality therapy, in which all three of these modalities are used, is considered the most effective aggressive approach.

Research is ongoing to find a cure and more effective treatments for mesothelioma.

Clinical trials are ongoing to develop and test new and more effective treatments. Clinical trials should be discussed with your doctor before beginning treatment.

Surgery

The mesothelioma tumor is often bulky and spread out which makes it difficult to remove completely. Most of the time surgery alone is not considered as a treatment option, although in some cases it may be used to relieve symptoms.

There are several types of surgery for mesothelioma. There is no consensus among mesothelioma experts as to which surgical procedure is superior to the others. The extent and type of the disease may help determine the type of surgical procedure used.

A pleurectomy is the removal of part of the chest or abdominal lining and some of the tissue around it. The goal is to remove as much of the tumor as possible while preserving underlying lung tissue. In most cases, this procedure is to relieve pleural effusion and discomfort.

Depending on the extent of the cancer, a lung may be removed in an operation called a pneumonectomy.

In an extrapleural pneumonectomy (pleuro-pneumonectomy), the lung is removed along with the lining and diaphragm (the muscle that helps you breathe) on the affected side.

Radiation therapy

Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation can be received from a machine (external radiation) or from putting materials that produce radiation through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy).

In pleural mesothelioma, it is difficult to irradiate tumor tissue successfully without injuring nearby organs like the lungs, heart, and liver. Radiation therapy, however, can be very effective in relieving pain in certain situations.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells throughout the body. Mesothelioma is usually treated by injecting chemotherapy drugs into a vein (intravenous or IV). Researchers are also studying the effectiveness of delivering chemotherapy directly into the chest or abdomen (intrapleural or intraperitoneal delivery).

Historically, doxorubicin has been the most widely used single chemotherapy drug. Other newer drugs, including gemcitabine, cisplatin, carboplatin, epirubicin, cyclophosphamide, ifosfamide, vinorelbine, paclitaxel, and methotrexate, now are often preferred and are usually given in different combinations.

A new chemotherapy, pemetrexed (registered trade name Alimta®) is showing some promise in clincal research studies, but has not been evaluated by the FDA for approval.

Multimodality therapy, the combination of surgery, radiation, and/or chemotherapy, is a common therapeutic approach for early stage mesothelioma. Trimodality therapy, in which all three of these modalities are used, is considered the most effective aggressive approach.

Other Procedures

Fluid that may have collected in your chest or abdomen can be drained out of your body. Your doctor will put a needle in your chest or abdomen and gently remove the liquid.

If fluid is removed from your chest it is called thoracentesis.

The procedure to remove fluid from the abdomen is called paracentesis.

The information presented in this web site is not intended as a substitute for medical care. Please talk with your healthcare provider about any information you get from this web site.