Mesothelioma Treatment

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.

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, 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).

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 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).

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.

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

New Treatments for Mesothelioma are constantly being studied. Yes. Because Mesothelioma is very hard to control, the National Cancer Institute (NCI) is sponsoring clinical trials (research studies with people) that are designed to find new treatments and better ways to use current treatments. Before any new treatment can be recommended for general use, doctors conduct clinical trials to find out whether the treatment is safe for patients and effective against the disease. Participation in clinical trials is an important treatment option for many patients with mesothelioma.

People interested in taking part in a clinical trial should talk with their doctor. Information about clinical trials is available from the Cancer Information Service (CIS) at 1-800-4-CANCER. Information specialists at the CIS use PDQ®, NCI's cancer information database, to identify and provide detailed information about specific ongoing clinical trials. Patients also have the option of searching for clinical trials on their own.


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