Treatment of Mesothelioma

See Also: Clinical Trials

Treatment for mesothelioma depends on the location of the cancer, the stage of the disease and the general health and age of the patient.

Sadly, the overall prognosis for malignant mesothelioma is still disappointing even though there have been some improvements from newer chemotherapies and multimodality treatments. Earlier diagnosis and treatment of malignant mesothelioma has a better prognosis, but regretfully cures are very rare.

The standard forms of treatment options include surgery, radiation therapy and chemotherapy; or a combination of treatments.

Surgery

The aim of surgery is to help with symptoms and control the disease rather than cure it. There are three different types of surgery that may be used:

Pleurectomy

This surgery involves the removal of the tumour and part or all of the pleura and the lung tissue around it. This procedure is used to help prevent the build up of fluid in the lung and also helps with the control of breathlessness and pain.

Extrapleural Pnuemonectomy (EPP)

This is a much bigger operation. It attempts to remove all of the tumour and the tissue around it, and removal of the pleura, diaphragm (muscle below the lungs that helps with breathing), pericardium (the lining of the heart) and the whole of the diseased lung on the affected side. Surgery is often combined with chemotherapy and radiotherapy.

Pain and discomfort is likely after a lung operation and it can take many weeks to recover from major surgery. Despite this your doctor or the staff caring for you will be able to help you with your pain control in several ways and you will also be encouraged to start moving around as soon as possible.

Peritoneal Mesothelioma

Surgery for Peritoneal Mesothelioma is rarely used. If it is used the aim is to remove the tumour from the wall of the abdomen and organs nearby, in order to relieve symptoms.

Radiotherapy

Radiotherapy is high energy x-rays that destroy cancer cells and shrink tumours, whilst doing as little harm as possible to normal healthy cells. Radiotherapy can be given to shrink or reduce the size of the mesothelioma and can be used alongside surgery and chemotherapy.

The radiation may come from a machine (external radiation) and only affects the cancer cells in the treated area. Radiation can also be introduced by putting materials that produce radiation through tubes straight to the area that contain the cancer cells. This treatment is known as internal radiation therapy.

When given to the chest wall at the point of a biopsy or a drainage tube insertion, radiotherapy may prevent the tumour from growing through the scar.

Side effects of Radiotherapy

The side effects of radiotherapy can depend on the strength of the dose given and the length of treatment. Nausea, vomiting and general tiredness are quite common side effects. Breathlessness, chest pain and flu-like symptoms can also be experienced for a few days. Anti-sickness drugs can be prescribed, and as much rest as possible will help with these side effects. Fortunately most of these side effects will gradually disappear once treatment is finished.

Chemotherapy

Chemotherapy involves the use of anti-cancer (cytotoxic) drugs to kill the cancer cells in the body. Receiving chemotherapy sooner rather than later can increase the chance of controlling cancer cells that may also be elsewhere in the body.

Most drugs used in the treatment are given by injection into a vein (intravenous) bt doctors are also now studying the effectiveness of putting chemotherapy straight into the chest or abdomen (intracavitary chemotherapy).

Chemotherapy cannot cure mesothelioma but may control the growth of the tumour, reducing symptoms and improving quality of life.

Chemotherapy may be given before surgery for pleural mesothelioma. This is called neoadjuvant chemotherapy. This treatment shrinks the tumour for easier removal during surgery. Chemotherapy can also reduce the re-occurrence of mesothelioma after surgery (adjuvant chemotherapy).

Side effects of Chemotherapy

Chemotherapy can affect people differently and the side effects of chemotherapy may range from nausea, vomiting, diarrhoea and hair loss. Mouth ulcers may also occur and can be treated by regular mouth washes.

Tiredness must be dealt with sensibly, taking things slowly, and only doing what you feel you are able without over tiring yourself.

The side effects of chemotherapy can be hard and very traumatic, but they are temporary and will disappear at the end of treatment. Hair will return after a couple of months.

Complementary Therapies

Many doctors are now quite comfortable with the use of complementary and medical therapies being used together.

Complimentary therapies may include massage, acupuncture, aromatherapy and relaxation techniques. Gentle massages given by family and friends can help with their feelings for supporting you during this worrying time for everyone.

Some people find that complementary therapies can help them feel better and maybe reduce symptoms. It is very important to discuss other therapies with your GP or specialist in order to ensure there are no reasons that they should not be used alongside your medical treatments.