Treatment Options

Mesothelioma is a difficult cancer to treat. Traditionally, most of the treatments for meso have resulted in only a slightly increased life span and many of the options were just as life-threatening as the disease. However, because the disease has been receiving more attention lately and hence receiving more funding dollars, more and better treatment options are being consistently developed, yet there’s still a long way to go.

One of the factors that affect the outcome of treatments for mesothelioma is the fact that the disease is often not diagnosed until it reaches its later stages because of its long latency period. That means the disease has often metastasized to other parts of the body by that time, eliminating many treatment options. That’s why scientists are working on ways to better diagnose mesothelioma in its early stages, calling upon tests like the Mesomark® Assay, which is a simple blood test that can detect certain markers that indicate the potential for developing the disease.

Treatment for mesothelioma is often multi-modal, which means that more than one type of treatment is recommended. The patient’s oncologist will determine the best course of treatment for the type of meso presented and will periodically assess the results of the treatment(s), making changes when necessary.

Surgery

  • Some patients with mesothelioma are candidates for surgery, but only if the cancer is caught fairly early and if the patient is in otherwise good health. Surgeries for mesothelioma are serious, grueling, and usually require long recovery periods, so older victims of the disease who have other medical problems are usually not considered for these procedures, which include:
  • Pneumonectomy – This involves the removal of the diseased lung. Only those with mesothelioma in one lung are candidates for this surgery, which involves general anesthesia and a long hospital stay. Complications are common and the patient may need help from a respirator in order to breathe after the surgery.
  • Extrapleural pneumonectomy – This surgery, like the pneumonectomy, is performed on those in the early stages of the disease and only when the disease has not metastasized. It involves not only the removal of the lung but also the pleura and other areas around the diseased lung. It is very aggressive and requires a long hospital stay and even longer recovery time. Complications, including heart attack, vocal cord paralysis, and gastrointestinal problems, are frequent. Patients who are a candidate for this procedure may need to visit a hospital outside of their local area for the surgery as not all thoracic surgeons perform the extrapleural pneumonectomy.

Chemotherapy

The most common form of treatment for any type of cancer is chemotherapy and the same is true for mesothelioma. Indeed, chemo is recommended for most patients who have the disease, often in tandem with surgery or radiation.
Some 100 chemo drugs are currently on the market and some work better than others for the treatment of mesothelioma. The most successful chemotherapy drug to date in the fight against meso is Alimta® (pemetrexed), the only FDA-approved drug specifically designed for the treatment of this form of cancer. It is usually administered with another chemo drug, generally a platinum agent like cisplatin. This team of drugs has added months to the lives of mesothelioma patients and as doctors learn how to best use the drug, it continues to lengthen the life span of those with the disease.

Chemotherapy may be delivered two ways: systemically, by intravenous or pill; or intrapleurally or intraperitoneally, injected directly into the affected area in order to deliver the drug to the part of the body that needs it most, avoiding some of the unpleasant side effects of the disease.

Unfortunately, chemo carries lots of side effects, though the newer chemo drugs offer far fewer than the old varieties. Also, doctors have found ways to counteract some of these unpleasant side effects with other drugs, including those that lessen vomiting and diarrhea.  Side effects of chemotherapy might include:

  • Nausea
  • Vomiting
  • Low white blood cell count
  • Loss of appetite and weight loss
  • Constipation
  • Fatigue
  • Fever and chills
  • Low platelet count
  • Achy muscles
  • Tingling hands and feet
  • Rash
  • Depression

Radiation Therapy

The least invasive of all the conventional treatments for mesothelioma, radiation therapy involves the use of ionizing radiation to shrink tumors and kill lethal cancer cells. For meso patients, it is often used in conjunction with chemotherapy. In patients with late-stage mesothelioma, it may also be used for palliative purposes, merely to keep the patient as comfortable as possible.

Radiation can be delivered in two ways: external beam radiation, which aims a beam of radiation directly towards the affected part of the body; and brachytherapy, which involves the implantation of small radioactive seeds or rods right at the site of the tumor. This allows for more targeted radiation and also eliminates the effects of radiation on healthy cells. More and more sophisticated means of delivering radiation are constantly being developed and side effects have diminished substantially. However, the patient should expect some side effects, which might include:

  • Skin damage
  • Fatigue
  • Dry mouth
  • Swelling
  • Nausea and vomiting
  • Some hair loss, especially in the treatment area
  • Sexual changes

Clinical Trials

Clinical trials involve the testing of new drugs and therapies for the treatment of all types of diseases. Frequently, these trials enroll patients who are suffering from mesothelioma. While no guarantee of success is offered, many patients have benefited from participation in clinical trials. The patient’s oncologist can determine whether he or she is a candidate for one of these trials.

Alternative Treatments

More and more, doctors are recognizing the advantage of employing less-traditional therapies for the treatment of mesothelioma. While they may not offer a cure, many do indeed decrease the pain caused by symptoms of the disease or side effects of traditional treatments or lessen the stress cancer brings to someone’s life. These complementary treatments might include:

  • Massage
  • Meditation
  • Acupuncture
  • Herbs and nutritional supplements
  • Chiropractic
  • Yoga