If you've been diagnosed with mesothelioma, you have several treatment options. Talk with your doctor about these to get full information about the best options for your situation.
The most common conventional treatments are surgery, chemotherapy, and radiation therapy. Treatment is usually ‘multi-modal,' meaning that a patient will receive more than one type of treatment. For patients who are good candidates for surgery, a surgical procedure to remove tumors, followed by chemotherapy or radiation therapy to kill any remaining cancer cells is a common course of treatment.
Surgical treatments are of three categories: diagnostic, curative, and palliative.
Diagnostic surgeries involve a biopsy to remove a sample of cells or fluid from a tumor site. This sample is tested in a laboratory to aid in diagnosis.
Curative surgeries attempt to cure disease by removing all tumors. For example, a person with pleural mesothelioma may undergo surgery to remove part or all of one lung. Curative surgery is usually followed by chemotherapy or radiation therapy.
Palliative surgeries are designed to relieve a person's symptoms rather than try to cure them. People with advanced-stage cancers are usually limited to palliative treatments, as they are often not in good enough general health to cope with the stress of curative surgery.
Chemotherapy agents are drugs that are toxic to cancer cells. However, they are usually non-specific—often they kill any cells which are dividing rapidly, which means healthy hair follicles and immune cells are killed during chemotherapy treatments. For this reason, people who undergo chemotherapy often experience side effects such as hair loss and lowered immunity to infectious diseases. Common chemotherapy drugs for mesothelioma include Alimta, Cisplatin, and Carboplatin.
People with peritoneal mesothelioma can sometimes receive a chemotherapy treatment directly into the abdominal cavity. This is called intraperitoneal chemotherapy. The advantage to the patient is improved drug efficacy, and reduced side effects, because the drug is not administered systemically.
People with mesothelioma may receive radiation therapy after surgery, or as a palliative treatment without surgery. This treatment applies ionizing radiation, which can kill cancer cells, shrink tumors and slow down the spread of the disease.
There are two types of radiation therapy: external beam radiation therapy is the most well-known type, where tumors are exposed to a beam of radiation from an external source. This treatment often has painful side effects, as healthy tissue surrounding a tumor is affected by the radiation. Brachytherapy requires implanting tiny radioactive rods inside a tumor. These deliver a high dose of radiation to a tumor without extensive damage to surrounding tissue.
Experimental and Alternative Treatments
Depending on your specific situation—the type of mesothelioma you have, and the stage the disease is at—you may be eligible for a clinical trial in which you might receive an experimental treatment such as photodynamic therapy, gene therapy, or immunotherapy, or an experimental chemotherapy drug. Talk to your doctor about clinical trials, or use the National Institute of Cancer searchable database at www.cancer.gov/clinicaltrials/search to find out about specific trials.
Photodynamic therapy is usually used to treat skin cancers, but has shown initial success in treating some people with pleural mesothelioma. In a photodynamic treatment a patient receives an intravenous dose of a drug that is rapidly absorbed and held by cancer cells. Two or three days later, the patient is exposed to light of a special wavelength that is toxic to cells that have absorbed the drug. This treatment shows promise in particular because it is highly specific and kills only cancer cells.
Normally the immune system doesn't recognize cancer cells as being harmful because they originate in the body. Immunotherapy involves ‘tricking' the immune system into recognizing cancer cells as harmful bodies that need to be killed.
One type of immunotherapy uses a sample of cancer cells taken from a patient that has been altered in a laboratory, then injected back into the patient. If the treatment is successful, the re-injected cells act as a vaccine that activates an immune response against all tumor cells in the body.
Gene therapy for treating mesothelioma targets cancer cells with genetic material to make them more vulnerable to chemotherapy drugs. In this type of therapy a patient is treated with a non-infectious virus that has been genetically altered so that it produces a protein inside the cells it enters. After the treatment, cancer cells become infected with the virus and start to produce the protein. Following this, the patient is treated with a chemotherapeutic drug that is toxic only to cancer cells that are producing the protein.
Alternative and Complementary Treatment
Some mesothelioma treatments, such as TENS therapy, acupuncture, and massage therapy, are considered alternative or complementary treatments. Many people who try these types of treatments experience relief from pain and other symptoms, but it should be noted that alternative and complementary treatments aren't curative, and can't stop the cancer advancing or spreading in the body.
Making Treatment Choices
If you've been diagnosed with mesothelioma, your doctor will provide you with treatment information and recommend what they feel is the best course of treatment.
Choosing what treatments to undergo is a very personal decision, however, even though it's one you'll make in conjunction with your doctor. The final say is always yours—you have the right to refuse a treatment you don't want, or to ask for information about a treatment you may have heard of from a source other than your doctor.