How Is Mesothelioma Treated?
TRADITIONAL TREATMENTS
In traditional treatments,
surgical resection, radiation therapy, and chemotherapy are commonly used to
treat mesothelioma. Surgical resection involves the removal of cancerous tissue.
Radiation therapy is focused on high-dose targeted delivery of x-rays or other
forms of radiation to a tumor site in order to destroy cancer cells, often with
fewer side effects than chemo. Chemotherapy uses medication designed to attack
rapidly dividing cells and can include single or combination drugs that may be
taken orally or injected into a vein by a doctor. While traditional
mesothelioma treatments can help relieve symptoms and improve the quality of life
for some patients, they do not guarantee long-term survival rates.
Surgery
The most common mesothelioma
treatment is surgery, which aims to remove as much of the tumor as possible.
Often, doctors are able to completely remove a tumor. If there is any sign that
cancer cells may have spread beyond a tumor or organ, however, surgery isn't an
option; instead, radiation therapy and chemotherapy will be used instead.
Surgery can also help ease symptoms by removing other tumors or improving
ventilation for patients with breathing difficulties. Common symptoms of
mesothelioma include shortness of breath and abdominal swelling due to fluid
build-up around organs in your abdomen.
Chemotherapy
While surgery and radiation are
usually a part of mesothelioma treatment, chemo is a newer option for many
patients. Chemo works by putting chemicals in your bloodstream that reach every
part of your body. The drugs can shrink tumors and slow down or stop cancer
growth. They also help with certain side effects caused by mesothelioma
treatment like nausea, fatigue, pain, and lack of appetite. Chemo is used most
often to treat pleural mesothelioma but can be used to treat peritoneal
mesothelioma too. Your doctor will decide if chemotherapy is right for you
based on your type of cancer and how it has affected you so far. For example,
some people don’t respond well to chemotherapy because their cancer is already
very advanced when they start treatment. Other people may not want chemotherapy
because of its side effects. If you do have chemotherapy, you may need
treatments over several months (called an induction phase) before moving on to
another phase (maintenance). For more information about chemotherapy as a
treatment for mesothelioma, see our page on Chemotherapy and Mesothelioma
Treatment.
Radiation Therapy
Many people wonder how radiation
therapy is used in treating mesothelioma, and whether it can be used as a
primary or only treatment. Radiation therapy involves high-energy rays (usually
gamma rays) that are targeted at cancer cells. These rays break up tumor cells,
shrinking or eliminating them altogether. The treatment itself is painless, but
some side effects may occur during and after radiation sessions, including fatigue,
weight loss, skin rashes, and nausea. During treatment, patients must avoid
exposure to people who have weakened immune systems (such as individuals with
HIV), pregnant women, young children, and others who are at risk for infection
from contagious diseases. Patients undergoing radiation should also refrain
from using make-up on their face and head. Radiation treatments usually last
between 30 minutes and one hour per day, five days per week for three weeks.
Treatment time varies depending on factors such as age, size of the tumor, and other
medical conditions. Radiation therapy may be given alone or combined with
chemotherapy drugs or surgery to treat mesothelioma. When radiation is combined
with chemotherapy, doctors call it chemoradiation.
Multimodal Therapy
When mesothelioma is diagnosed
early, some doctors may recommend a multimodal treatment plan. This typically
involves surgery to remove as much of the tumor as possible followed by
chemotherapy and radiation therapy. These treatments are generally given in a
combination known as multimodal therapy, which takes into account individual
patient circumstances and cancer type when designing a treatment regimen that's
most likely to provide successful results. Surgery: Surgical removal of tumors
is often one of—if not the—first approaches in battling mesothelioma because it
can remove cancerous cells from surrounding tissue before they spread or grow.
Unfortunately, due to its location within body cavities, it’s very difficult
for surgeons to get rid of tumors entirely through open surgery.
Tumor Treating Fields
In addition to surgery,
chemotherapy, and radiation therapy, doctors may recommend Tumor Treating
Fields (TTFields) for cancer patients. TTFields are delivered through
electrodes that adhere to your chest. The treatment is a non-invasive type of
radiation that can be used as an adjunct to your mesothelioma treatment plan.
It is FDA approved for use in combination with chemotherapy or alone if you are
undergoing palliative care and not responding well to standard treatments. At-home systems make it possible for you to deliver them yourself throughout each
day. This allows you to continue normal activities like bathing, dressing and
eating while receiving treatment. Studies have shown that TTFields help reduces
tumor size in up to 80 percent of patients who have not responded well to other
types of chemotherapy. These fields also help relieve pain caused by cancerous
tumors pressing on nerves near vital organs such as your heart or lungs. They
do so by stopping the growth of new blood vessels around tumors, which stops them
from growing larger and reduces their ability to spread further into
surrounding tissue.
Immunotherapy
One of the newest developments in
mesothelioma treatment is immunotherapy, which harnesses your own immune system
to fight cancer. Immunotherapy has shown tremendous promise for a range of
cancers, including breast cancer and some advanced melanomas. Now scientists
are investigating whether immunotherapy may be effective against mesothelioma
as well. And although more research is needed to understand how immunotherapy
can be used to fight mesothelioma, there are already promising early evidence
suggesting that combination treatments may yield positive results. In one
recent study, researchers found that giving combination chemotherapy followed
by immunotherapy improved survival rates among patients with mesothelioma. In
another study, researchers observed that some patients who received combination
chemotherapy and radiation therapy lived an average of 24 months longer than
those who received radiation therapy alone. The take-home message: Combination
therapies appear to offer significant benefits over single-modality treatments
when it comes to fighting mesothelioma.
Treatments by Mesothelioma Type
There are two types of
mesothelioma. Malignant pleural mesothelioma, which is considered more
aggressive, is often treated with a combination of surgery and chemotherapy.
Peritoneal mesothelioma is typically treated with surgery, followed by
radiation therapy and chemotherapy. Supportive treatments for mesothelioma
symptoms may include anti-nausea medications; diuretics; medication to lower
blood pressure or boost heart function; pain relievers; and nutritional
supplements or tube feeding through a central line. Because chemotherapy can
cause severe side effects like nausea, mouth sores, low blood counts, nerve
damage, and reduced appetite, your doctors will likely give you supportive care
during treatment to help manage symptoms. Some people also use complementary
therapies to relieve their symptoms. These may include acupuncture, meditation,
massage therapy, and others. For information on complementary therapies that
have been studied in cancer patients, visit our Complementary/Integrative
Therapies page. To learn about clinical trials that are studying new ways to
treat mesothelioma, visit our Clinical Trials section.
Pleural Mesothelioma Treatments
The most common treatment for
mesothelioma involves a combination of surgery, chemotherapy, and radiation
therapy. It’s also important to note that not all mesothelioma patients require
or want aggressive treatments such as surgery and/or radiation therapy. In some
cases, these procedures can make symptoms worse because they increase pressure
on affected lung tissue. For example, patients with pleural mesothelioma might
undergo surgery in order to reduce discomfort and improve breathing – but it's
very important that doctors don't accidentally remove too much healthy lung
tissue during a procedure. This is why it's so important to work closely with
your doctor when deciding which treatment options are right for you.
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