TREATMENT OPTIONS

Mesothelioma Treatment When you get a mesothelioma diagnosis, the next step is to determine the best mesothelioma treatment for you.

All patients diagnosed with mesothelioma have a few things in common. You have a rare cancer affecting the lining or thin membrane around one of your internal organs. This lining is called the mesothelium. You were exposed to asbestos, probably many years or decades ago. Airborne asbestos fibers made their way into your body and lodged there, causing irritation that grew into mesothelioma cancer.

Beyond that, each individual and every mesothelioma tumor is different. Some mesothelioma tumors grow very slowly over many years. Some are made up of cells that replicate quickly and travel to other parts of the body. Some mesothelioma patients don’t have one consolidated tumor: the disease can also take the form of many small nodes or nodules (tiny clusters of cancer cells) across the mesothelial tissue.

Part of your mesothelioma diagnosis will be a determination of which of the four types of mesothelioma you have. Pleural mesothelioma attacks the lining inside your chest and around one of your lungs. This is the most common form of mesothelioma; more than 70% of mesothelioma cancer is found in the pleura, which is the lining around the lungs.

Peritoneal mesothelioma is the second most common mesothelioma type. About one fifth of mesothelioma patients have this form of the disease, which takes hold in the lining of the abdomen. This lining is called the peritoneum.

The final two mesothelioma types are extremely rare. Pericardial mesothelioma is a cancer of the lining around the heart, also known as the pericardium. About 5% of mesothelioma patients have this mesothelioma type. Testicular mesothelioma affects the lining around the testicles, which is called the tunica vaginalis. This diagnosis is so rare that there haven’t been enough cases to fully study and understand it. On the positive side, testicular mesothelioma has some of the best mesothelioma treatments success stories.

It is important to include a mesothelioma specialist in your medical team. A specialist will know the latest research and the most effective mesothelioma treatments. A mesothelioma doctor might also be able to connect you with clinical trials, so you can try cutting edge therapies.

Before Choosing Mesothelioma Treatments

To determine the best mesothelioma treatments for your situation, your medical team will need as much information as possible about your mesothelioma cancer. A biopsy may reveal information about the types of cancer cells in your tumor. This can help determine which mesothelioma treatments will have the greatest effect.

Another important piece of data is mesothelioma staging. As part of your mesothelioma diagnosis, your doctors may stage your cancer. This is a determination of how far the cancer has advanced in your body. Stage I mesothelioma is the earliest stage, where the cancer is limited to the area of the original tumor. By Stage IV, the cancer has spread or metastasized to attack other organs in your body. Different mesothelioma treatments are recommended at different mesothelioma stages.

In some cases, your doctor may not tell you what stage your cancer has reached. Pleural mesothelioma is well researched and can often be staged. Peritoneal and pericardial mesothelioma are less well understood and may be harder to stage. There is no staging system for testicular mesothelioma because it is so rare that doctors don’t have enough information to assess the stages of this mesothelioma type.

Another important factor in choosing the right mesothelioma treatments for you is your overall health. Your doctors will consider other illnesses and your overall health. Your age and your physical fitness will make a difference in whether certain mesothelioma treatments cause more harm than good

Surgical Mesothelioma Treatments

Surgery has the potential to add years to the survival time of mesothelioma patients. There are several different possible surgical mesothelioma treatments. Surgical options range from minor procedures that alleviate symptoms to major surgeries that can greatly slow the progress of the cancer.

The least invasive surgical procedure is fluid removal. Fluid buildup in the mesothelium or lining around your lungs or heart or in your abdomen is a common symptom of mesothelioma. By inserting a small tube into the affected mesothelium, your doctor can drain the fluid. This relieves pressure and reduces some of the symptoms of mesothelioma.

Debulking surgery removes as much as possible of the primary mesothelioma tumor, but none of the surrounding tissue. This is a conservative surgical approach that reduces the number of cancerous cells in your body while keeping surgical recovery time to a minimum.

Extrapleural pneumonectomy or EPP was the first surgical procedure developed for pleural mesothelioma. It is still in use today, though it is not as common as a newer surgical procedure (described below). EPP is a radical surgery that removes not only the tumor and the pleura (membrane around the lungs) but also the pericardium (membrane around the heart), the diaphragm muscle.

At the stage where surgery is recommended, the mesothelioma cancer affects only one lung. The EPP procedure also takes out one entire lung – the one where the mesothelioma tumor is located. Because this is such major surgery and because living with one lung can be challenging, EPP is only performed on mesothelioma patients who are strong enough to bounce back. This surgery is one of the mesothelioma treatments usually is reserved for more advanced or aggressive mesothelioma cancers.

A relatively new procedure has had some good results for patients with pleural mesothelioma. Called a pleurectomy/decortication or P/D, this surgery leaves both lungs intact while removing as much as possible of the cancerous tissue. While the surgery is less radical because it removes less tissue, it is still a major surgical procedure that takes many hours to perform. During the first phase, the pleurectomy, the surgeon removes the outer portion of the pleura, with an option to remove the pericardium and part of the diaphragm. After this is completed, the surgeon carefully removes all visible cancerous growths, large and small, from the lung tissue.

Both EPP and P/D require large incisions and many weeks of recovery. These mesothelioma treatments can add months or even years to mesothelioma survival time. The most common treatments for mesothelioma are much the same as treatments for other forms of cancer. As the arsenal of cancer busting drugs and other therapies grows, mesothelioma patients have benefitted from these new tools.

Nonsurgical Mesothelioma Treatments

The most common treatments for mesothelioma are much the same as treatments for other forms of cancer. As the arsenal of cancer busting drugs and other therapies grows, mesothelioma patients have benefitted from these new tools.

Chemotherapy can reduce the size of mesothelioma tumors and slow their spread. Because cancer cells reproduce quickly, chemotherapy drugs target and kill fast-growing cells. The side effects of chemotherapy happen because the drugs also kill off other fast-growing cells such as those found in the lining of your stomach and your hair follicles. During and after chemotherapy, patients sometimes feel nauseous and lose their hair (the hair grows back!).

Chemotherapy drugs may be administered through an injection or a pill that allow them to work their way through your system. Mesothelioma treatments may also include drugs administered directly to the area of the tumor through a tube inserted into the mesothelial cavity around the lungs or the abdomen.

As doctors learn more about the way cancer cells work, they have refined the amounts and delivery methods for chemotherapy drugs. This allows them to better target mesothelioma treatments and reduce unpleasant side effects.

Some of the chemotherapy drugs commonly used as mesothelioma treatments include Alimta (pemetrexed), Lovastatin, Megace (megestrol), Onconase (Ranprinase) and Vinorelbine.

Peritoneal mesothelioma does not usually respond well to chemotherapy administered system-wide. New mesothelioma treatments using heated chemotherapy drugs called hyperthermic intraperitoneal chemotherapy or HIPEC has delivered good results usually during abdominal surgery for some patients with peritoneal mesothelioma. In HIPEC mesothelioma treatments, the heated chemotherapy drugs are circulated directly into the abdomen through a tube.

Radiation therapy is just what is sounds like: doctors shoot megadoses of x-rays at the site of the tumor to kill as many of the cancerous cells as possible. Modern radiation mesothelioma treatments are more narrowly targeted and may cause fewer side effects than these mesothelioma treatments did in the past. You might still have some side effects, such as mild burn (similar to a sunburn) in the radiated area. Radiation around the lung can damage lung tissue and leave you with breathing problems.

Radiation can shrink the tumor and lessen some mesothelioma symptoms. It is almost always used in combination with other mesothelioma treatments.

Your doctor is likely to prescribe multimodal mesothelioma treatments that combine several therapies. Chemotherapy and radiation can work well together and one or both are often used as follow up mesothelioma treatments after surgery.

New and Experimental Mesothelioma Treatments

Your immune system is one of the most powerful disease-fighting tools known to science. Your immune cells isolate and kill rogue cells in your body all the time, including cancer cells. Some cancer cells have evolved ways to trick the immune system and hide from it. These tricks allow cancerous tumors to grow unchecked. Immunotherapy drugs turn off these sneaky mechanisms and expose cancer cells to your immune system’s powerful disease-fighting cells. Your body’s own immune response attacks the cancer and stops the growth of the tumor.

Immunotherapy has opened an exciting new frontier in mesothelioma treatments. Immunotherapy drugs like Keytruda, Tremelimumab, and Anti-PD-1/Anti-PD-L1
have brought new hope to mesothelioma patients.

There is still much research to be done to determine the best use of immunotherapy drugs as mesothelioma treatments. Researchers are continuously conducting studies to discover new, more effective mesothelioma treatments.

Mesothelioma Treatments: Early Diagnosis

If you have symptoms that could be mesothelioma and you have a history of asbestos exposure, don’t wait to seek medical attention. When you are diagnosed with Stage I or Stage II mesothelioma, you have the widest array of mesothelioma treatments to choose from. This increases your chances of long-term survival.

Surgery can be a good option for early stage mesothelioma patients. P/D surgery has been shown to increase survival time, especially for Stage I patients whose pleural mesothelioma had not spread to their lymph nodes.

Your doctor may also prescribe chemotherapy or radiation to keep the mesothelioma tumor from growing. Mesothelioma treatments that confine the cancerous cells to one part of your body improve mesothelioma survival.

Mesothelioma Treatments: Aggressive Tumors

If you have an aggressive form of mesothelioma cancer, your doctor may choose more aggressive mesothelioma treatments. This could include surgery, if you are a good candidate, to remove as many as possible of the aggressive cancer cells from your body.

If your mesothelioma tumor doesn’t respond to chemotherapy or radiation, immunotherapy may be a good option for treatment. Because immunotherapy sends your immune system into overdrive, some patients will have side effects that can include symptoms that feel like the flu, weight gain, or digestive issues. In others, however, immunotherapy provides a powerful and effective assault on the mesothelioma cancer cells with minimal negative symptoms. The most frequently reported side effects are relatively mild: pain or itching at the spot where the drugs are injected.

Your mesothelioma doctor can help you evaluate whether immunotherapy is a good choice for you. To determine the best immunotherapy mesothelioma treatments for your tumor, you may need a biopsy and lab work to see what tricks the cancer cells are using to evade your immune system.

Mesothelioma Treatments: Late Stage Care

If you are diagnosed with Stage IV mesothelioma, the best mesothelioma treatments may be palliative care. Palliative care is not intended to stop or slow the growth of the mesothelioma tumors. At this stage, your body may be so weakened from the cancer that mesothelioma treatments that would only deplete what little energy you have left.

Palliative care is designed to keep you comfortable and free from pain. Palliative care can include a hospital bed, to make it easier for you to rest comfortably, and medications to relieve pain and reduce inflammation, among other therapies. Hospice provides expert palliative care and support for late stage mesothelioma patients.

Palliative care is not a death sentence. Many patients live for months or even years while in hospice or receiving palliative care. If your cancer will not respond to mesothelioma treatments, palliative care can improve your quality of life and help you enjoy every day that you have.

Clinical Trials for Mesothelioma Treatments

New mesothelioma treatments come from mesothelioma research. As part of that research, promising drugs and other mesothelioma treatments are given to select patients in clinical trials.

New therapies are only approved for human studies after they have been shown to be effective and not harmful in animal studies and other laboratory testing. When you enroll in a clinical trial, you will be closely monitored and receive mesothelioma care from experienced medical professionals during the trial period. At the same time, you have a chance to try out mesothelioma treatments that could be more effective at slowing or stopping the progress of the disease.

Start the discussion of mesothelioma clinical trials with your mesothelioma specialist.