While a cure does not currently exist for mesothelioma, there are many options you and your doctor can discuss to prolong your life as your disease progresses. Three main options are surgery, chemotherapy and radiation therapy. Alternative therapy options have also become more widespread to help alleviate pain, and to aide patients in dealing with stress and emotional issues related to having mesothelioma.
Treatment Options
There are three main treatment options for mesothelioma – surgery, chemotherapy and radiation. However, like many cancers, mesothelioma is a very aggressive disease, and the treatment you and your doctor choose depends largely on the stage of diagnosis and the location of your disease. Mesothelioma can occur in the pleural cavity surrounding the lungs, the peritoneum, which is the wall surrounding the abdomen, and the pericardium which lines the heart.
Surgery
In general, surgery is an option that you and your doctor may choose as a method of treatment during your battle with mesothelioma. Two types of surgery your doctor can perform to reduce the signs and symptoms of mesothelioma are pleurectomy, removal of tissue around your lungs, and a peritonectomy, removal of the tissue of the abdominal cavity.
Debulking, or the removal of as much cancer as possible, is a third type of surgery that may be performed in later stages of cancer combined with chemotherapy and radiation to minimize tumors, or prevent the growth of new cancer cells.
The two main reasons for surgery are palliation, which is making a patient feel more comfortable and trying to relieve pain and discomfort, and trying to cure a patient.
Palliative care is when a tumor has metastasized or spread beyond the mesothelium and is difficult to remove completely. In addition, if a patient is too ill to undergo the necessary extensive operations to remove tumors, doctors will choose palliative care measures instead, such as the removal of excess fluid.
Thoracentesis, the removal of fluid build-up in your lungs decreasing your ability to breath, is one type of surgery that can be performed. The surgeon will insert a needle into your chest cavity and drain away the excess fluid. During this time your doctor may also choose to inject talc or antibiotic medicine into your chest to prevent the fluid from returning, which is known as pleurodesis.
The fluid can compress your lungs and make it very difficult to breath. Removing this fluid can make your more comfortable, but unfortunately is not a cure for your mesothelioma. This type of needle insertion can be performed in the abdomen for peritoneal mesothelioma to remove excess fluid retention in the abdomen, as well as in the pericardium, the sac around the heart.
This can help to drain the fluid away from the abdomen and the heart and to relieve circulatory problems. However, cancer cells can sometimes metastasize, or spread, along the path that was made by the needle, and new tumors can form.
Curative surgeries are for when a patient is in otherwise good overall health and tumors are considered to be localized and thought to be able to be completely removed. In some cases however, the microscopic spread of cancer cells is still possible, and often times undetectable on everyday screenings.
Chemotherapy
Chemotherapy, or treatment with chemicals, is another type of treatment you and your doctor may choose in order to shrink or slow the growth of your tumor cells. Chemotherapy done before surgery is called neoadjuvant chemotherapy and chemotherapy done after surgery is called adjuvant chemotherapy.There are many different types of chemotherapy, but three of the top choices used specifically to treat mesothelioma are pemetrexed IV sold under the brand name Altima, cisplatin and carboplatin.
Radiation Therapy
Radiation therapy is another course of action you and your doctor may choose as a treatment option for your mesothelioma. Radiation therapy is the method of focusing high-energy beams such as X-rays to specific parts of your body to shrink cancer cells. There are two different types of radiation therapy – external beam radiation and brachytherapy.
External beam radiation is the most commonly used type of radiation therapy and has fewer side effects than chemotherapy, and radiation therapy is less invasive. The patient lies on a table while beams of light are aimed at the cancer target. However, healthy cells are occasionally affected as well.
Brachytherapy, which seems to be most effective in treating pleural mesothelioma, involves implanting radioactive seeds into your tumor, directly killing the cancerous cells and avoiding the healthy cells. Depending on the situation and your doctor, the seeds are either removed after a certain period of time, or left in the body even after they have finished emitting radiation.
Side effects of radiation therapy can include skin damage, fatigue, mouth problems, diarrhea, nausea, vomiting, and hair loss. Although these symptoms are minimal and your doctor is aware of them, it is still a good idea to discuss any concerns you have with your physician.
Combination Therapy
It is common for a doctor to suggest a combination of surgery, chemotherapy and/or radiation therapy to treat mesothelioma. This type of therapy is called combination therapy or multimodality treatment and can be administered at any stage during your disease either to work on reducing the size of tumors or to make you feel more comfortable as the disease progresses. You and your doctor can discuss the right combination of treatment options for you.
Alternative Treatment Options
It is possible that what you decide is right for you may not be conventional treatment at all, but there are many alternative treatment options to choose from. Sometimes these may even be used in combination with conventional therapy to help make you more comfortable during the course of your treatment.
Alternative treatments can range from a wide variety of options, each assisting in different ways working on pain management or alleviation, relaxation and stress reduction, reducing side effects, and working to lift the spirits and improve overall quality of life of patients with mesothelioma.
Clinical Trials
A clinical trial is a study of new drugs or methods for a particular disease – targeted drug therapy for specific abnormalities in cancer cells. It is a good idea to discuss with your doctor what clinical trials you may be eligible to enroll in for mesothelioma. Clinical trials are the keys to helping scientists find a cure in the future.
Ranpirnase (Onconase), an enzyme, was successfully tested in recent clinical trials. It was reported by the American Cancer Society to help some patients live longer. Another option being studied is gene therapy where a modified gene virus is injected into the chest of patients with mesothelioma, which then infects the mesothelioma cells. In turn, the immune system creates a hormone that attacks the mesothelioma cells, thereby shrinking or eliminating the tumors.
