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Mesothelioma Treatments

There are a variety of treatment options available for mesothelioma patients. Some attempt to find a cure while others aim to improve quality of life and relieve symptoms. Regardless of which treatment approach is chosen, the ultimate goal of mesothelioma treatment is to prolong survival. 

Treatment for mesothelioma is largely dependent on the stage of the cancer. Although there are a number of other factors that may influence treatment options, staging ultimately determines which treatments a patient is qualified to receive. Some of the most common treatments used to improve life expectancy include surgery, chemotherapy and radiation therapy. In some cases, two or more of these treatments will be used to form a multimodal approach to treatment. 

Because pleural mesothelioma represents about 75 percent of cases, most research efforts try to find a cure for this type of mesothelioma. If you or a loved one have mesothelioma and would like to learn more about improving your prognosis, fill out the form on this page and we'll send you a free informational packet in the mail.

Pleural Mesothelioma Surgery

Surgery for pleural mesothelioma patients can either be designed to ease symptoms (called palliative treatment) or be potentially curative. For many patients, surgery has prolonged survival and improved overall quality of life. Depending on the stage of pleural mesothelioma and the overall health of the patient, one of the following surgical procedures may be recommended:

Pleurodesis:

This palliative surgery is used to eliminate fluid that has gathered in the lungs, known as pleural effusion. In this procedure, a tube is inserted into the pleural space to drain the fluid. The next step involves implementing a chemical that irritates the tissue in the pleural space. A doctor then connects a tube to a suction device that causes the two layers of the pleura to come together, closing the gap where fluid once accumulated to prevent future fluid buildup. Patients of all stages can undergo this procedure, but it is typically used on patients in Stage 3 or Stage 4.

Thoracotomy:

A thoracotomy removes a small portion of the lung where tumors appear in imaging scans. This procedure is generally reserved for tumors that appear localized, meaning the cancer has not spread. The removed portion is then analyzed for cancer and if the edges of the removed piece show signs of malignancy (indicating the tumor could be spreading), additional surgery may be needed. The goal of a thoracotomy is to remove tumors with as little surgery as possible. Patients eligible for this surgery either have Stage 1 or Stage 2 pleural mesothelioma.

Pneumonectomy:

This potentially curative surgery removes an entire lung to eliminate all traces of pleural mesothelioma tumors. Doctors will only perform this surgery if they feel it will give a patient the best chance for survival or will significantly reduce symptoms. Patients that may qualify for a pneumonectomy are either in Stage 1 or Stage 2 of development with no signs of distant spreading.

Extrapleural Pneumonectomy:

Similar to a pneumonectomy, an extrapleural pneumonectomy removes the affected lung in addition to parts of the chest lining, heart lining, diaphragm and nearby lymph nodes. This severe surgery is almost exclusively used on pleural mesothelioma patients and is intended to prolong survival for those with either a Stage 1 or Stage 2 diagnosis.

Pleurectomy Decortication:

A pleurectomy decortication attempts to remove all or part of the affected lung lining in addition to any attached mesothelioma tumors, leaving the underlying lung intact. Although this surgery has a higher risk for complications, it has shown to improve prognosis better than many palliative treatments. This procedure is only performed on patients with a Stage 1 or Stage 2.

 

Pleural Mesothelioma Chemotherapy

Often used to treat a variety of cancers, chemotherapy has demonstrated positive results for pleural mesothelioma patients. The goal of chemotherapy is to kill cancerous cells. If mesothelioma is diagnosed during a late stage of development and surgery is not an option, chemotherapy is the next best treatment available.

The most common chemotherapy treatment for pleural mesothelioma is a combination of the drugs cisplatin and pemetrexed (Alimta). This combination can alleviate symptoms and prolong survival. Alimta, approved by the Food and Drug Administration in 2005, is the only chemotherapy medication approved specifically for mesothelioma treatment.

If this combination fails to produce positive results, a number of other chemotherapy medications may be used. Chemotherapy is accompanied by a range of side effects that may include fatigue, vomiting, hair loss, weight loss and more. →Learn More about Chemotherapy

Pleural Mesothelioma Radiation

Radiation therapy can be used to shrink cancerous tumors, ease pain or prevent the recurrence of mesothelioma. It is often used in conjunction with another treatment such as surgery or chemotherapy and it's not recommended for single use because the radiation dose needed to be effective is too toxic for nearby normal tissue. While more than 50 percent of pleural mesothelioma patients experience positive results after receiving radiation therapy, it should be noted that these results are seen when radiation is used after surgery.

During radiotherapy, radiation is directed at the tumor site to kill cancerous cells. One symptom that can be treated with radiation is chest pain, but only half of patients treated experience relief for a short time. In most cases, chest pain relief is felt for about three months. The most common radiation techniques used for pleural mesothelioma include three-dimensional radiation treatment, intensity-modulated radiation therapy and brachytherapy.

Mulitmodal Therapy

Multimodal therapy has become one of the most successful treatment approaches for pleural mesothelioma. This method combines two or more treatments, typically involving surgery, chemotherapy or radiation therapy. The stage and overall health of the patient will determine whether multimodal therapy is a valuable treatment option .
Some common treatment combinations for pleural mesothelioma include:

• Surgery followed by chemotherapy (surgery with heated chemotherapy is one option, but this combination is currently in an experimental phase)
• Surgery with radiation therapy before or after the surgery
• Radiation therapy and chemotherapy
• Radiation therapy before surgery, followed by chemotherapy

Emerging Treatments
Emerging treatments for pleural mesothelioma include experimental therapies that aggressively treat the cancer with new techniques. The most common alternative treatments for pleural mesothelioma include photodynamic therapy, gene therapy and immunotherapy.

• Photodynamic therapy uses special drugs that respond when exposed to light. Called photosensitizing drugs, these medications kill cancer cells once light is introduced to the cancerous area.
• Gene therapy aims to correct defective genes by delivering normal DNA via a virus to cancerous cells. The virus infects the cancerous cells and the normal DNA alters the defective cancerous genes. Gene therapy can be used to make cancer cells more susceptible to chemotherapy or other medications that aim to kill cancer cells.
• Immunotherapy can be active, passive or non-specific. Active and passive immunotherapy uses cancer cells from the patient's body to create a vaccine or antibody that triggers the patient's immune system to attack the cancer. Non-specific immunotherapy uses cytokines (a crucial component of the immune system), which are often administered in combination with another type of immunotherapy to boost the immune system's response to the treatment. The goal of all three types is to kill cancer cells.

These treatments are typically part of clinical trials, which test up-and-coming therapies with the hope of designing new effective regimens. Clinical trials test new procedures, chemotherapy combinations and other variations of treatment that are still under investigation.

Lifestyle Changes

A less invasive alternative option for patients is making lifestyle changes to improve quality of life, ease symptoms and boost the body's immune system. Many patients have strengthened their immune system and fueled their fight against pleural mesothelioma by eating healthier foods and supplementing with vitamins, minerals and herbs. A number of mesothelioma survivors who have surpassed their life expectancy report that making nutritional changes to their diet was pivotal. Other alternative therapies like establishing an exercise plan, trying meditation, doing yoga or receiving regular massages are additional lifestyle changes that can improve quality of life and relieve symptoms.

If you're interested in learning more about pleural mesothelioma treatment and which options are available to you, speak with one of our Patient Advocates by calling (800) 656-6031.

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