Mesothelioma Treatments

Chemotherapy

Types of Mesothelioma Chemotherapy

There are two main types of chemotherapy employed for mesothelioma treatment:

Systemic chemotherapy: most commonly administered via IV, so it is carried by the blood to all parts of the patient’s body. If a patient’s mesothelioma has reached an advanced stage where it has spread to other parts of the body or it is not surgically removable, systemic chemotherapy may be an effective treatment.

Regional chemotherapy: most often employed to treat patients with pleural or peritoneal mesothelioma whose cancer has not spread. With this method, the chemotherapy drugs are administered through a catheter directly into the body cavity where the cancer is located. This form of chemotherapy allows doctors to directly target mesothelioma tumors and carries fewer side effects because only a very little amount of the drugs enters the bloodstream.

Chemotherapy Drugs used for Mesothelioma Treatment

There are a number of chemotherapy drugs which have proven beneficial for mesothelioma patients. To date, the most effective chemotherapy regimen for mesothelioma patients includes a combination of the drugs Alimta (pemetrexed) and cisplatin.

Still, a number of other chemotherapy drugs may be used for mesothelioma treatment, including:

Carboplatin
Navelbine
Gemcitabine
Onconase

Chemotherapy Side Effects

Unfortunately, chemotherapy drugs designed to target cancer cells can often cause serious damage to healthy cells. This can lead to a number of unpleasant side effects, and can often leave a patient feeling worse than he or she did before beginning chemotherapy. Common chemotherapy side effects include:

Hair loss
Loss of appetite
Nausea
Diarrhea
Vomiting
Infection
Heart arrhythmia
Fatigue
Bloody urine or stools
Compromised hearing
Headaches
Vision changes
Involuntary muscle movement
Lightheadedness
Loss of motor function
Slurred speech
Seizures
Compromised immune system
Constipation
Anemia
Tingling in the extremities
Aches

Mesothelioma surgery can be either curative (to cure or kill the cancer) or palliative (to help alleviate pain and symptoms). While there is no cure for mesothelioma, surgery may help extend a patient’s life or improve his or her quality of life.

Curative surgery for mesothelioma is only an option if the patient is in good health and if the cancer has not yet metastasized, or spread to other areas of the body. Even with potentially curative surgery, some cancer cells often still remain in the patient’s body. To try to kill the cancer cells that remain after surgery, many doctors recommend treatment with chemotherapy, radiation therapy, or both.

If a patient’s cancer has spread to the extent that it is not surgically removable, palliative surgery is often performed to help resolve mesothelioma symptoms that may be causing pain or discomfort. Many of these palliative surgical treatments for mesothelioma are focused on removing fluid that has built up as a result of the cancer.

Surgery

Pleural Mesothelioma Surgery

Doctors may recommend surgery for pleural mesothelioma patients as an attempt to remove all of the cancer or to alleviate symptoms and improve that patient’s quality of life. Unfortunately, pleural mesothelioma is often diagnosed at an advanced stage, which means that the cancer has spread to the extent that surgical removal is not possible. There are two main surgical procedures that may be conducted to treat pleural mesothelioma:

Extrapleural Pneumonectomy

If a patient’s cancer has not spread to the lymph nodes, an extrapleural pneumonectomy may give the surgeon the best chance to remove the mesothelioma. This is a very extensive operation: it involves the removal of the lining of the chest wall (pleura), the pericardium (which surrounds the heart), the diaphragm, some lymph nodes, and all of the lung on the side of the body where the tumor is located. The surgeon will then reconstruct the diaphragm and the pericardium using man-made materials.

Pleurectomy/Decortication

This procedure can be potentially curative, but it is also employed as a palliative treatment to ease fluid buildup and help make it easier and more comfortable for the patient to breathe. During this surgery for pleural mesothelioma, the surgeon will remove all of the pleura on the side of the chest wall affected by the cancer as well as the pleura surrounding the lung on that side. The pleura around the diaphragm and the mediastinum are also removed, and in some cases the pericardium and the diaphragm are also removed.

Peritoneal Mesothelioma Surgery

In some cases, a surgeon will be able to remove a mesothelioma tumor from the digestive organs or the wall of the abdomen. There are two potentially curative surgical procedures employed in the treatment of peritoneal mesothelioma:

Debulking

This procedure allows the surgeon to remove as much of the cancer as possible, and may involve the removal of part of the intestine.

Omentectomy

Peritoneal cancers often spread to the omentum, which is a layer of fatty tissue that covers the abdominal organs. If a patient’s mesothelioma has reached the omentum, it may be surgically removed.

Pericardial Mesothelioma Surgery

While it is possible for pericardial mesothelioma surgery to improve a patient’s prognosis, this is rare and most pericardial mesothelioma surgeries are palliative in nature. There are two main palliative surgical procedures for pericardial mesothelioma:

Pericardiocentisis

Sometimes referred to as a pericardial tap, this procedure involves the insertion of a long needle into the pericardial sac, through which the surgeon is able to remove accumulated fluid. A catheter is then inserted to help manage the future buildup of fluid.

Pericardiectomy

During a pericardiectomy, the surgeon removes the entire pericardium, which decreases pressure on the heart caused by the accumulation of fluid.

Radiation Therapy

Radiation therapy involves the use of X-rays to kill cancer cells, and is often used in conjunction with other mesothelioma treatments. Radiation can help manage tumor growth and reduce pain in mesothelioma patients, and the side effects of radiation therapy are not as severe as chemotherapy side effects. Still, radiation therapy is often applied sparingly in mesothelioma treatment plans because the radiation can harm a patient’s organs and possibly damage his or her DNA.

Goals of Radiation as a Mesothelioma Treatment

There are two main goals for which radiation therapy is used as a mesothelioma treatment: to eliminate the cancer (curative), or to help relieve pain caused by mesothelioma symptoms (palliative).

Curative radiation therapy for mesothelioma patients is often aimed at preventing seeding, or the recurrence of tumors in the area where surgery has been performed or an incision has been made. Since seeding can occur in up to 50 percent of patients who undergo mesothelioma surgery, this is a crucial part of the treatment plan.

In mesothelioma patients whose cancer is at such an advanced stage that surgery is not an effective treatment option, radiation therapy may help alleviate the pain caused by mesothelioma symptoms, mainly by shrinking tumors that can cause significant pain when they apply pressure to the internal organs.

Mesothelioma Radiation Side Effects

According to the Journal of the American Medical Association, the most common side effects experienced by mesothelioma patients undergoing radiation therapy include:

Hair loss
Fatigue
Nausea
Vomiting
Skin irritation near radiation site
Loss of appetite

Alternative Mesothelioma Treatments

Even with significant advances in mesothelioma treatment with surgery, chemotherapy, and/or radiation therapy in recent years, the truth is that mesothelioma treatments don’t have a high success rate. For this reason, many mesothelioma patients choose to complement their traditional treatments with experimental or alternative treatments such as photodynamic therapy, immunotherapy, and gene therapy. There are also a number of mesothelioma clinical trials for patients to enroll in. Your mesothelioma treatment team can help you learn more about alternative treatments and clinical trials.