Mesothelioma cannot be cured, but various treatment methods can help extend patients’ lives after a diagnosis and alleviate some of its symptoms. Appropriate treatment options depend on the stage of the cancer and personal health factors unique to the patient. The best way to make a treatment plan is to consult with your doctors.
This page offers an overview of the types of mesothelioma treatments that are currently available.
Surgery to Remove Tumors or Lessen Symptoms
Removing Cancerous Growths
In rare cases, when the patient’s mesothelioma is caught at an early stage, a doctor may recommend a pleurectomy to remove the pleura and its tumors or growths. In cases where the cancer is still localized, a doctor may recommend extrapleural pneumonectomy: a procedure that removes portions of the lung, pericardium, and diaphragm on the affected side of the body in order to remove a tumor without dissecting it.
Patients who are older than 55 years old may not be candidates for extrapleural pneumonectomy because of the increased rate of mortality in this patient population in the time between hospitalization for surgery and discharge.
A less extreme surgical option available to patients is pleurectomy (also known as decortication), which involves removing only the parietal and visceral pleura, leaving both lungs intact. This surgery may also remove the pericardium (the membrane around the heart) as pleural mesothelioma often spreads to this surface.
Peritoneal mesothelioma may be treated with a peritonectomy, or the removal of a portion or all of the peritoneum to rid the body of cancerous tissues. As with extrapleural pneumonectomy and pleurectomy, this surgery is only performed in early-stage patients.
Unfortunately, while these surgeries may be able to remove tumors, microscopic cancer cells may have spread to other parts of the body, meaning the cancer can return. A doctor may recommend a patient undergo chemotherapy and/or radiation treatment to kill remaining cancerous cells.
Thoracentesis is a minimally invasive procedure during which a needle is inserted into the chest cavity to drain excess fluid (pleural effusion) and provide relief to the patient suffering from mesothelioma. In some cases, a doctor will also recommend thoracoscopic pleurodesis, or the use of a chemical agent like talcum powder, to help fuse the parietal and visceral pleura, thus removing the space in which the effusion formed.
Similarly, in patients with pericardial mesothelioma, a needle may be inserted into the area around the heart to drain fluid. A pericardial effusion can pressure the heart, thus affecting its function, and therefore needs prompt treatment. In mesothelioma patients, removal of part of the pericardium can help prevent the condition’s reoccurrence.
Radiation therapy is usually given in conjunction with other treatments such as chemotherapy and surgery. Irradiation can kill cancer cells. However, due to mesothelioma’s growth patterns (diffuse rinds rather than a singular tumor), targeting only these cells can be a challenge. Because radiation may also kill normal cells, these therapies can cause serious side effects.
There are 2 types of radiation therapy that have proven effective with mesothelioma cancer patients: external beam radiation therapy (EBRT) and brachytherapy.
External beam radiation entails bombarding cancer tumors with X-rays created in a medical machine. It is the most common type of radiation therapy for mesothelioma patients. With the advancement of the field, techniques like intensity-modulated radiation therapy have made it easier to target only the cancerous cells during EBRT treatment.
Brachytherapy is a newer radiation treatment that involves implanting radioactive material directly into or nearby tumors to provide a stronger dose of radiation while doing very little damage to surrounding healthy tissue. This treatment is still rare outside of clinical trials.
In some cases, radiation therapy is the main form of treatment a patient will receive. This is common in patients whose overall health has declined to a state where they are too weak to endure chemotherapy or invasive surgery. Radiation can be a palliative therapy to relieve mesothelioma symptoms such as pain, difficulty swallowing, shortness of breath, and bleeding.
In other cases, such as a follow-up to mesothelioma surgery, radiation therapy is used as a complementary treatment. As with chemotherapy, radiation therapy damages healthy, normal cells as well as cancerous cells. For this reason, careful planning is needed to ensure the proper dosage to maximize the benefits of radiation therapy while minimizing the damage to healthy cells.
Photodynamic therapy is commonly used to treat skin cancers, some types of lung cancers, and pleural mesothelioma. The first step involves delivering a molecule that will act as a photosensitizer—a catalyst that will respond to a certain type of light. Once these molecules have accumulated in tumors, a patient is exposed to the type of light the photosensitizer is cued to. It creates a molecule that is toxic to the cancer cells, either causing so much damage the immune system will begin to attack the cell or inducing apoptosis or necrosis (two forms of cell death).
Photodynamic therapy is only effective for localized mesothelioma and is unsuitable for patients with other types of mesothelioma.
Chemotherapy usually involves the intravenous administration of drugs designed to interfere with the processes that occur during cell division. These drugs can kill rapidly dividing cancer cells. However, they may also harm or kill some normal cells, meaning your doctor will need to do be careful to minimize the side effects. Depending on the stage of a patient’s mesothelioma, chemotherapy may be given as the primary treatment or in conjunction with other treatments such as surgery or radiation therapy.
The subject of recent and current clinical trials, immunotherapy involves boosting the patient’s immune system with drugs to help it fight cancer. Your immune system recognizes when cells do not belong in the body, and this is true with cancerous growths. However, cancer cells often create their own protective measures against the immune system. Mesothelioma cells in particular have many of these “checkpoint” proteins that will essentially turn your white blood cells off when they’re in attack mode.
Immunotherapy drugs can block the formation or operation of these proteins so your immune system can destroy the dangerous cells.
Still an emerging area of treatment, gene therapy delivers new DNA to cancerous cells to induce a desired response. Using viruses, scientists have successfully delivered DNA to cancerous cells that:
- Boost the performance of the immune system or help it better target the cancer
- Cause or increase sensitivity to a drug or other treatment type
- Bolster the body’s anti-tumor response and/or replace destroyed genes whose functions involve tumor suppression
- Induce rapid cell death in tumors
Mesothelioma gene therapy is often used in conjunction with chemotherapy. Changing the genetic profile of a cell can make it less likely to survive the effects of chemotherapy drugs. Genetic and immunogenetic therapies are not widely available; they are usually used only in clinical trials.
Multi-Modality Treatment for Mesothelioma
By combining treatment methods, doctors are often able to improve a patient’s prognosis and/or reduce their symptoms. When surgery is used as a primary treatment and followed by radiation, chemotherapy, or gene therapy, the treatment is considered multi-modal.
For patients with early-stage mesothelioma, trimodal treatment involving extrapleural pneumectomy, chemotherapy, and radiation treatment may expand a patient’s life expectancy by months. However, multi-modality treatment can also be more dangerous for the patient. Before the patient is permitted to undergo this type of aggressive disease management, they must first have an MRI of both sides of the chest so their doctor can evaluate how much of the thoracic cavity between the lungs and the diaphragm have been affected. Their lung function should also be tested and an echocardiogram is administered to assess how much of the thoracic cavity between the lungs has been invaded by the tumor and how well the ventricles of the heart are functioning
Multi-modality treatment techniques are still a source of debate within the scientific community. Studies have shown mixed results, and because mesothelioma is a rarer cancer, it may take longer to gather sufficient data. Additionally, as scientists test new gene- and immunotherapies, the landscape of multi-modality treatments is always shifting.
Treatments for Mental Wellbeing
While the above therapies focus on the toll cancer may take on your body, patients also are likely to need mental health support during this time as well. After a diagnosis, it’s normal to struggle with anxiety and depression. Holistic and alternative treatment methods can help you take care of yourself, so stress or depressed moods do not make your life any harder.
Mesothelioma Treatment FAQs
Do I Need to See a Specialist for Mesothelioma Treatment?
Every cancer patient will be referred to an oncologist, a doctor who specializes in cancer treatment, but that doesn’t mean the doctor has dealt with mesothelioma before. Some larger hospitals have dedicated mesothelioma specialists who are likely to know more about the disease and its treatment methods. You should talk to your oncologist to learn whether they have worked with mesothelioma patients before. If you do not feel they have enough knowledge to provide the help you need, you may want to reach out to a mesothelioma specialist to help plan your treatment.
How Do I Find a Good Mesothelioma Doctor?
If you decide you want a mesothelioma specialist in your corner, your oncologist and other treating physicians may be able to provide a referral. There are medical facilities in the country that specialize in mesothelioma treatments and are among the top options for patients with the cancer. Though you can contact one of these clinics directly, we recommend discussing your concerns with your personal physicians first.
Can Surgery Remove Mesothelioma?
Surgery to remove mesothelioma is invasive and very painful and is only a viable treatment option for early-stage patients. Your doctor can help you determine whether you are a good candidate for treatment.
What Is Metastasis?
Metastasis is the spread of cancer from one organ to another. While most mesotheliomas originate in the pleura, cancerous cells can make their way into the bloodstream and affect any organ, from the lungs to the liver to the brain.
Does Chemotherapy Help Mesothelioma Patients?
Chemotherapy is an option for mesothelioma, and there is more than one drug that has been found effective in fighting the cancer. Though mesothelioma cannot be cured via chemotherapy, the treatment may extend a patient’s life.
Is Radiation Treatment an Option for Mesothelioma?
Though radiation treatment may be difficult because mesothelioma does not always form compact tumors, improvement in medical technologies has helped doctors increase the effectiveness of this treatment method.
Should I Try to Join a Clinical Trial for Experimental Treatments?
Deciding to join a trial of an experimental treatment is a personal decision. While any therapy being tested on humans has already undergone studies to look for major red flags, experimental treatments can be dangerous and could cause serious side effects. If you choose to enroll in a clinical trial, you must be prepared for the chance the treatment will not work. Or, you might be one of the first people to receive a helpful new therapy.
One of the positives of joining clinical trials is knowing you are helping mesothelioma research progress. We suggest you consult with your family, religious/spiritual leaders, physicians, and lawyers before making this decision.
Call Shrader & Associates, L.L.P. at (844) 256-8685 to speak with one of our experienced mesothelioma lawyers. We’ve helped patients recover nearly a billion in damages.