Those diagnosed with mesothelioma often worry about the treatment options. Your doctor will work with you to determine the best means of treating it, but you can learn about the potential options. Here's a look at the most common forms of treating mesothelioma: surgery and chemo or radiation. We'll also discuss additional treatment options that may be available to some patients.
If you are diagnosed with mesothelioma, surgery is one of the most standard treatment options. It can help accomplish one of two goals:
1) Eliminate the disease by removing the cancer.
2) Help decrease the signs and symptoms of the illness.
There are several different types of surgery. The best surgery for you will most likely be based on the stage and/or location of your mesothelioma. And as with any treatment option, it should be discussed in-depth with your doctor.
Surgery to try and cure the patient of cancer by removing it, which is known as an extrapleural pneumonectomy or EPP, is only a viable option if the cancer is detected in its earliest stages, or when the cancer is localized. Mesothelioma is a rapidly spreading form of cancer, thus making this surgery option very rare. This procedure is normally done on patients suffering from pleural mesothelioma. It involves removing the chest wall lining, part of the diaphragm, the sac surrounding the heart (pericardium), nearby lymph nodes, and the entire lung where the tumor is present. The diaphragm and pericardium can be reconstructed with man-made materials.
Numerous other surgeries are available to decrease symptoms or the spread of mesothelioma. One of the simplest procedures is the removal of fluid. A hollow needle is inserted to drain the fluid buildup. The problem with this procedure is that fluid can build up again. However, a similar procedure can help remedy this issue. Pleurodesis involves inserting a tube to help drain the fluid, and then medicine is injected to prevent future fluid build-up. Shunt placement is another draining option that allows the fluid to move from one part of the body to another to be absorbed.
More invasive surgeries to decrease symptoms are pleurectomy/decortication (P/D). This operation removes the pleura lining of the chest wall or lungs. The lungs and diaphragm in this procedure are not removed. Another surgery, called debulking, is a procedure whereas much of cancer as possible is eliminated. This normally involves removing less tissue than a P/D. Debulking can also help doctors direct radiation treatment.
Other specific surgeries may be performed if you have peritoneal, pericardial, or testicular mesothelioma.
Surgery, many times, is only a part of a comprehensive treatment plan. All surgery options should be discussed in-depth with your doctor before any decisions are made.
Chemotherapy and Radiation Therapy Treat Mesothelioma
Chemotherapy and radiation therapy can be a part of the treatment plan for your mesothelioma. These treatments are often used in conjunction with surgery.
Chemotherapy is when anti-cancer drugs are used to kill cancer cells or prevent their continued growth. This treatment is given in cycles. A cycle generally lasts three to four weeks and is followed by a rest and recovery period. Chemo cycles can be given at two different times. The first is referred to as neoadjuvant which is given before surgery in an attempt to shrink cancer and lower the risk of it spreading. The second is called adjuvant therapy and is performed after surgery in order to kill cancer cells left behind. This treatment can delay or prevent cancer from returning.
These chemo treatments can be given one of two ways. One option is to have it injected into a vein. The drugs then travel through the bloodstream to reach and destroy cancer. The other option, depending on where the cancer is localized, is intrapleural (directly in the chest) or intraperitoneally (directly in the abdomen). With this treatment option, the chemo goes directly to the cancer site. This delivery method allows doctors to increase the dose of chemo and tends to cause fewer side effects on the rest of the body.
Radiation therapy is used less in treating mesothelioma, but still can be a useful treatment option. It uses high energy x-rays to kill cancer cells. It is mainly used after surgery to kill remaining cancer cells. This therapy can be administered in one of two ways. The most common is via an external source, where an x-ray machine outside the body delivers the radiation. It is a painless procedure and is normally performed five days a week for several weeks. The second delivery method, known as brachytherapy, is when the radiation source is placed inside the body. This method is seldom used for mesothelioma patients.
Even though radiation is not always the standard treatment for mesothelioma, newer techniques allow mesothelioma patients to be treated more accurately which may increase the success rates, as well as decrease unpleasant side-effects.
As with any treatment method, it should be discussed in-depth with your doctor to evaluate which treatment would work best based on your condition and overall health.
Chemo for Mesothelioma
Chemotherapy is often given in two distinct ways as a part of treating mesothelioma, which can include either direct injection into the veins or via a targeted method. In systemic treatment, the chemotherapy drugs are released into the bloodstream to target cancerous cells wherever they may lie. Intrapleural chemotherapy involves placing the drugs directly into the chest cavity, while intraperitoneal involves placing these drugs into the abdomen; both methods require the use of a small catheter.
There may be many questions regarding the side effects often associated with chemotherapy, including hair loss and nausea. As with any form of medication, it’s important to speak with your pharmacist, doctors, and nurses about potential side effects. By working with your healthcare provider, they can prescribe medications to ease side effects. It’s also essential to rely on your loved ones and friends to provide the emotional support you may need during this time. It may also be helpful to seek out local support groups or speak to a counselor about your concerns.
Managing the Side Effects of Chemo
You may feel overwhelmed by the fatigue, nausea, and daily coping involved with living with mesothelioma, as well as the side effects of chemotherapy. It may be helpful to keep a log of questions that may occur so that you don’t forget to ask your doctor or nurse about them. It is also important to remember to eat a well-balanced diet and include moderate exercise as your doctor recommends. It’s also essential to get plenty of rest as your energy levels may decrease.
It’s important to understand the changes your body may experience, and how those changes may impact your normal routine. Taking naps earlier in the day, planning shopping trips when you are feeling stronger, or participating in lighter forms of exercise such as yoga and swimming may help to decrease fatigue.
Remember, you are not alone in this process, and seeking out support and guidance will help during this time. Your loved ones may also be coping with the changes that are occurring, and it’s important for them to develop a strong support network.
Additional & Alternative Treatment Options
Additional mesothelioma treatment options can include:
- Decreasing fluid buildup
- Removing tissue around the lungs or abdomen
- Debulking, which removes as much of the cancer as possible
- Removing a lung and surrounding tissue
Alternative Therapy Options
There are several different therapies that your treatment team might recommend or try out, some of which might be in clinical trial phases (see below). These include:
- Immunotherapy: Immunotherapy treatment for mesothelioma uses certain aspects of a patient’s immune system to fight the disease either by:
- Stimulating the immune system to work harder in attacking cancer cells
- Providing the immune system with other components, such as man-made immune system proteins
- Targeted Therapy: Using drugs to attack specific abnormalities within cancer cells.
- Biological Therapy: Using the body’s immune system to fight cancer.
- Gene Therapy: Altering genes inside cancer cells in order to stop the spread of the disease.
- Photodynamic Therapy: A photosensitizing agent or photosensitizer is given intravenously and absorbed into the body. The drug is then activated, producing a kind of oxygen that destroys the surrounding cancer cells with relatively mild side effects. This treatment option is being studied further while awaiting FDA approval.
Because new methods for mesothelioma treatment are tested before they reach the market, patients may opt to participate in a clinical trial for new treatments. These may include medications, therapies, surgeries, or a combination of treatment types.
Holistic and Alternative Treatments
Alternative and holistic treatment options for mesothelioma have not proven to be helpful in treating asbestos-causing cancer, but complementary treatments have helped patients with some symptoms. Methods that have been shown to aid the symptoms of mesothelioma include acupuncture and acupressure, herbal medicines, yoga, and mental health counseling. Mesothelioma patients should consult their doctor before attempting any alternative treatment options.
Chemotherapy and surgery are the most common forms of mesothelioma treatments, but they are not the only options available. Your doctor can help you determine which treatment—or combination of treatments—will have the best chance of success based on your case. Clinical trials are often offered to mesothelioma patients and may be an option for you. Holistic treatments will not successfully treat mesothelioma, but some might be complementary to your treatment plan.