Treatment for mesothelioma depends on the location of the cancer, the stage of the disease, and the patient’s age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined.
Surgery is a common treatment for mesothelioma. The doctor may remove part of the lining of the chest or abdomen and some of the tissue around it. For cancer of the pleura (pleural mesothelioma), a lung 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, also called radiotherapy, involves the use of high-energy rays to kill cancer cells and shrink tumors. Radiation therapy affects the cancer cells only in the treated area. The radiation may come from a machine (external radiation) or from putting materials that produce radiation through thin plastic tubes into the area where the cancer cells are found (internal radiation therapy).
Chemotherapy is the use of anticancer drugs to kill cancer cells throughout the body. Most drugs used to treat mesothelioma are given by injection into a vein (intravenous, or IV). Doctors are also studying the effectiveness of putting chemotherapy directly into the chest or abdomen (intracavitary chemotherapy).
To relieve symptoms and control pain, the doctor may use a needle or a thin tube to drain fluid that has built up in the chest or abdomen. The procedure for removing fluid from the chest is called thoracentesis. Removal of fluid from the abdomen is called paracentesis. Drugs may be given through a tube in the chest to prevent more fluid from accumulating. Radiation therapy and surgery may also be helpful in relieving symptoms.
What treatment you undergo for mesothelioma depends on your health and certain aspects of your cancer, such as its stage and location. Unfortunately, mesothelioma often is an aggressive disease and for many people a cure won't be possible. Mesothelioma is usually diagnosed at an advanced stage — when it isn't possible to remove the cancer through surgery. Instead, your doctor may work to control your cancer and its signs and symptoms to make you more comfortable.
Discuss your treatment goals with your doctor. Some people want to do everything they can to treat their cancer, even if that means enduring side effects for a small chance of a cure. Others prefer treatments that make them comfortable so that they can live their remaining months as symptom-free as possible.
Mesothelioma treatment options may include surgery, radiation, chemotherapy and clinical trials.
Surgery Surgeons work to remove mesothelioma from your body. Sometimes it isn't possible to remove all of the cancer. In those cases, surgery may help to reduce the signs and symptoms caused by mesothelioma spreading in your body. Surgical options may include:
Chemotherapy Chemotherapy uses chemicals to kill cancer cells. Chemotherapy drugs travel throughout your body and kill rapidly growing cells. This works against cancer cells, but also affects other rapidly growing cells in your body, such as those in your hair follicles and those in your gastrointestinal system. Chemotherapy may slow the growth of pleural mesothelioma. Chemotherapy can be used before surgery (neoadjuvant chemotherapy) or after surgery (adjuvant chemotherapy) to reduce the signs and symptoms you may experience from mesothelioma.
People with peritoneal mesothelioma may receive adjuvant chemotherapy drugs that have been heated (hyperthermic chemotherapy). Rather than being distributed throughout the body, chemotherapy drugs are often injected directly into the abdominal cavity (intraperitoneal chemotherapy), where they can reach the peritoneal mesothelioma directly without injuring healthy cells in other parts of the body. This allows doctors to administer higher doses of chemotherapy drugs. Intraperitoneal chemotherapy may also be used to reduce the signs and symptoms of peritoneal mesothelioma that can't be removed through surgery.
Radiation therapy Radiation therapy focuses high-energy radiation to a specific spot or spots on your body. Radiation may reduce signs and symptoms in people with pleural mesothelioma. Doctors aim radiation at the entire chest to obtain the best result. However, many sensitive organs reside in the chest, such as the heart, lungs and spinal cord, so doctors must use low doses of radiation to spare these organs. Radiation therapy is sometimes used after biopsy or surgery to prevent mesothelioma from spreading to the surgical incision.
Radiation therapy is used occasionally in people with peritoneal mesothelioma. Radiation may reduce signs and symptoms of mesothelioma.
Combination therapy Surgery, chemotherapy and radiation therapy may be combined. This aggressive therapy can be grueling and may not be appropriate for everyone. Younger, healthier people and those with earlier stage mesothelioma may be more able to endure this treatment. Combination therapy has shown the most promise in treating mesothelioma. However, most people will eventually experience a recurrence of this cancer despite this aggressive treatment. Combination therapy has been used in both pleural mesothelioma and peritoneal mesothelioma.
Clinical trials Clinical trials are studies of new mesothelioma treatment methods. People with mesothelioma may opt for a clinical trial for a chance to try new types of treatment. However, a cure isn't guaranteed. Carefully consider your treatment options and talk to your doctor about what clinical trials are open to you. Your participation in a clinical trial may help doctors better understand how to treat mesothelioma in the future.
Treatment for other types of mesothelioma Pericardial mesothelioma and mesothelioma of the tunica vaginalis are very rare and can be very aggressive. Early-stage cancer may be removed through surgery. Doctors have yet to determine the best way to treat later stage cancers, though. Your doctor may recommend other treatments to improve your quality of life.
