The treatment of mesothelioma depends on the stage of the disease. Options include surgery, chemotherapy, and radiation. Participation in a clinical trial may also be an option for some mesothelioma patients. Mesothelioma treatments may be curative, where the goal is to cure the cancer, or palliative for the relief of symptoms.
Stage I and II mesotheliomas are potentially resectable, meaning that the tumors may be removed via surgery. Whether or not surgery is an option will depend on several factors, including:
People with resectable pleural mesothelioma may undergo pleurectomy/decortication (P/D) or extrapleural pneumonectomy (EPP). EPP is not well tolerated by all patients, and it is more likely to lead to complications. However, it is also more likely to result in the removal of all cancer.
Early-stage peritoneal mesothelioma might also be resectable. Long remissions have been seen in some people who undergo a combination of surgery with heated intraperitoneal chemotherapy (HIPEC). Surgery might also benefit some people with more advanced peritoneal mesothelioma. However, those benefits will likely only last a short time.
Palliative surgery to relieve symptoms is a treatment option for some mesothelioma patients. For example, thoracentesis/paracentesis or pleurodesis might be helpful for patients who have fluid buildup in the chest or abdomen.
Radiation treatment to kill cancer cells and shrink tumors is an option for all stages of mesothelioma. Depending on the stage of cancer, this mesothelioma treatment can relieve pain and even improve life expectancy.
Radiation for patients with pleural mesothelioma might include external beam radiation, which uses high-energy rays targeting malignant tumors. High beam radiation is usually fast and painless, and can be done on an outpatient basis. Intraoperative radiation can also be used for pleural mesothelioma as part of the surgical procedure where a radiologist applies the beams to the affected areas in order to stop the spread of cancer cells during the operation. This type of radiation is often used in conjunction with EPP.
Radiation is not as effective in people with peritoneal mesothelioma, as it can be far too toxic to the small intestines, liver, kidneys and other organs within the abdominal cavity. However, doctors may opt to use targeted radiation during surgery to prevent seeding of cancer cells during the procedure.
Chemotherapy can be utilized in all stages and types of mesothelioma in order to:
As a mesothelioma treatment, chemo is usually used in conjunction with other therapies, including surgery. In such a case, chemo drugs may be administered before (neoadjuvant), during (intraoperative), or after (adjuvant) a procedure. The drugs may be given intravenously, via a port or orally. Treatment time varies by case, and is on average 1-3 times per week during a multi-week cycle.
Chemo options for mesothelioma might include:
Mesothelioma patient response rates to single agent chemotherapy have typically been very low. However, recent studies suggest that patients respond well to combination chemotherapy involving two or more agents, such as cisplatin and pemetrexed.
Over 50% of all mesothelioma patients take part in at least one clinical trial. Emerging mesothelioma treatments include gene therapy to repair cancerous cells; immunotherapy to stimulate the immune system to attack the cancer; and photodynamic therapy, which attempts to kill cancer cells by exposing them to oxygen that is activated by a light source. Photodynamic therapy is often used in conjunction with pleurectomies.
You can find out more about mesothelioma clinical trials at any of these links:
The attorneys at Bernstein Liebhard LLP may be able to assist you in obtaining compensation for the costs associated with your mesothelioma treatment, as well as other damages related to your cancer. To learn more, please contact our office by calling (888) 994-5118.
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