Start Treatment for Mesothelioma as Soon as Possible After Diagnosis
There are multiple ways mesothelioma can be treated. They are more effective if used in combination, but whether any particular one can be used depends on the type of mesothelioma and how far advanced it is.
Surgery
Surgery can be an effective form of treatment while the cancer is in an early stage of progression.
Patients with early-stage pleural mesothelioma may be good candidates for extrapleural pneumonectomy (EPP). In this surgical procedure, patients forfeit one of their two lungs and the pleural lining surrounding it. The lung marked for removal is the one on which mesothelioma tumors are growing (which means this procedure must be performed before the cancer has spread to the second lung).
A less radical surgery for pleural mesothelioma is a pleurectomy/decortication (P/D). Here, only the cancerous pleura is removed, and the lung that was wrapped within it remains intact. The advantage here is the patient is left with both lungs—this makes breathing easier and for the most part allows normal activities of daily living to continue.
Debulking is a surgical procedure for the treatment of peritoneal mesothelioma. This entails cutting out tumor tissues on the peritoneum and nearby sections of the intestines. The objective is to remove as much of the cancer as can be safely accessed by the surgeon’s instruments.
Another type of peritoneal mesothelioma surgery is an omentectomy. In this procedure, surgeons remove the omentum, a layer of tissues that cover the liver and stomach.
For pericardial mesothelioma patients, it’s possible to remove the entirety of the lining around the heart. This is known as a pericardectomy. Performing this procedure on a pericardium turning cancerous limits the dangerous buildup of pressure to which the heart would otherwise be subjected.
Chemotherapy
Unlike surgery, chemotherapy is a mesothelioma treatment that can be administered at any stage of the cancer’s progression. It’s usually considered the first-line treatment for patents whose mesothelioma has advanced too far for surgery.
Chemotherapy works by putting into the patient’s bloodstream certain chemical agents that kill mesothelioma cells.
The agents are introduced to the bloodstream through an infusion pump that drips them at a carefully controlled rate into a vein. It normally takes several hours for a single dose of the agent or agents to be administered.
A patient typically receives one or more such dosages over the span of up to three days, then is given a rest period of about three weeks before receiving additional dosages.
When chemotherapy is given in conjunction with surgery, for instance, the treating physician hopes to eliminate more mesothelioma cells than can be knocked out with the knife alone. Typically, chemotherapy is given before surgery to reduce the amount of cutting that will be necessary. It’s also given after surgery to eradicate mesothelioma cells that escaped the scalpel.
For the treatment of peritoneal mesothelioma, doctors have developed a chemotherapy technique that is administered in the middle of surgery. It is called intraperitoneal chemotherapy. Once the tumor is removed, surgeons flood the abdominal cavity with a chemotherapy agent that kills remaining mesothelioma cells. The agent is flushed out before the surgery site is closed.
A variant of intraperitoneal chemotherapy is heated intraoperative chemotherapy. Before administering the chemotherapy, the chemicals agents are warmed and kept that way throughout the procedure. The developers of this technique discovered that heated chemotherapy agents have greater potency that those delivered at their normal cool temperature.
Radiation therapy
Mesothelioma cells can be destroyed by targeting them with high-energy x-rays produced by a linear accelerator.
Before this form of treatment can begin, diagnostic imaging tools such as PET, PET-CT, or MRI scanners are used to identify the exact borders of the tumor. The idea is that the radiation will be delivered to only the cancer cells and not the healthy cells adjacent to them—and in order to do that, doctors must know where the line between the healthy cells and the mesothelioma cells is located.
Radiation therapy is usually performed at a cancer care center outfitted with the necessary equipment. Patients are often first given a radiosensitizing drug that makes it easier to kill cancer cells (meaning, doctors can accomplish their objectives with less radiation).
Radiation is administered over a period of about 10 to 30 minutes every day for four to six weeks. Chemotherapy is customarily given before the first dose of radiation and then again after the final dose to maximize the effectiveness of treatment.
Immunotherapy
Immunotherapy, however, aims to disrupt cancer’s ability to send those molecular signals and so enable the immune system to detect and respond to the presence of cancer cells.
There are a variety of mesothelioma immunotherapy drugs currently available. The most widely used include:
- PD-1 inhibitors
- CTLA-4 inhibitors
- Immune checkpoint inhibitors
- Cancer vaccines (these do not immunize against cancer; instead, they trigger an immune system response to cancer)
Experimental and complimentary therapies
Researchers have developed a variety of still-to-be-proven treatments for mesothelioma.
Photodynamic therapy (PDT) is one such experimental treatment. A drug that only cancer cells like to feast upon is injected into the patient’s bloodstream to make those cells sensitive to light. They die off when exposed to high-intensity light delivered via an endoscope.
In addition to experimental therapies for mesothelioma, there also exist those intended to help patients bear up better against the cancer.
Among the mesothelioma complementary therapies available are these:
- Nutrition
- Exercise
- Herbal medicines
- Emotional support
- Transcutaneous Electrical Nerve Stimulation (TENS)
- Therapeutic and lymphatic massage
Mesothelioma treatment effectiveness depends on a number of variables. Early diagnosis of the disease is one such variable. Another is the skill of the doctors, nurses, and medical support teams involved in administering treatment. Even the quality and track-record of the facility where treatment is provided plays a role.
Learn more about these factors by downloading this free guide.