Treatment Options for Mesothelioma
There is not just one type of treatment to relieve mesothelioma patients of symptoms and to remove the cancer. Patients have several options, such as: radiation, chemotherapy, surgery, and palliative (reduce symptom severity) procedures.
Depending on the stage of mesothelioma you are diagnosed in, your overall health, the type of mesothelioma you have, and many other factors, your treatment may differ significantly from other mesothelioma patients. Your doctor will present you with your treatment options, in which you may have more if you are in better health, and from there, you can make the important decision. We can help you become more acquainted with your options here.
Radiation
Radiation is one of your treatment options and has been in practice for a long time. Over the years, the use of radiation has changed slightly but is still very effective. This form of treatment kills cancer cells already present and also prevents the growth of new cells by using ionizing radiation. Radiation helps patients find relief from pain associated with the mesothelioma, shortness of breath and coughing. Most of the time, radiation is used alongside another type of treatment such as surgery or palliative procedures to combat the cancer from as many angles as possible. Sometimes treatment that is beneficial and helps one problem may also cause another problem such as the following side effects:
- Skin irritation
- Pain near the treatment site
- Digestive issues
- Difficulty swallowing
Two Types of Radiation
Two types of radiation used to treat mesothelioma are External Beam Radiation and Brachytherapy. External beam radiation uses an external source of radiation emitted directly to the tumor source killing cancer cells. It also has the negative side effect of killing healthy cells in the body. Brachytherapy implants a seed of radiation into the patient's body on or near the tumor essentially killing the cancer cells. The benefit of taking part in brachytherapy is that it causes little damage to other healthy cells in the body. The implantation may be either temporary or permanent depending on the needs of the patient.
Chemotherapy
Developed in the 1940's, chemotherapy uses chemicals to treat the patient and is administered by pill or IV. This form of treatment aims to kill cancer cells and affects healthy cells as well, which is why it is well-known for its strong side effects.
Common side effects of chemotherapy:
- Nausea
- Vomiting
- Fatigue
- Alopecia (hair loss)
- Fever
- Chills
- Diarrhea
- Mouth sores
- Weakness
- Difficulty sleeping
- Flu-like symptoms
- Loss of appetite
- Skin rashes
- Low blood count
Intrapleural chemotherapy is used for pleural mesothelioma patients whereby the chemicals are injected directly into the pleura, not affecting healthy cells in the body as significantly.
Commonly used types of chemotherapy
Alimta/Cisplatin – This combination IV chemotherapy is usually administered when surgery is no longer an option. Alimta prevents cancer cells from growing and targets against three specific enzymes vital for cancer cell production. Treatment lasts for three weeks and runs every 21 days. Cisplatin is administered for two hours beginning thirty minutes after Alimta treatment ends.
Gemzar – This antimetabolite IV medication prevents cancer cells from growing. Doctors recommend not taking Gemzar while taking part in radiation treatments.
Mitomycin/Mutamycin – This is an antitumor antibiotic IV type of chemotherapy. It is a vesicant drug, which means it is a chemical causing extensive tissue damage and blistering and must be administered by a well-trained physician and/or nurse to avoid leaking from the veins during treatment.
Surgery
The main purpose for surgery for a mesothelioma patient is to relieve symptoms
and pain. Depending on several factors such as the stage of cancer you
are in, your overall health, the type of mesothelioma you have and others,
your doctor will be able to determine if you are a candidate for surgery.
Surgery may make living with mesothelioma easier on you physically and
may extend your survival time. Three types of surgical procedures
performed:
- Diagnostic surgery is non-invasive and used to confirm a mesothelioma cancer diagnosis
- Curative surgery is performed to remove as much cancer as possible,
but is not actually a cure. A thoracotomy, the general term for lung surgery
performed on patients with pleural mesothelioma includes three specific
types: wedge resection, lobectomy, and pneumonectomy.
- Wedge resection- leaves as much healthy tissue possible, while removing the tumor.
- Lobectomy- Removal of one or more of the five lobes of the lungs.
- Pneumonectomy- Patients with cancer only in one lung are candidates for this type of lung removal surgery, which is only performed on patients in Stage I or II.
- Extrapleural Pneumonectomy- Very risky and only performed in rare situations, involves removal of theentire lung, as well as the areas surrounding it.
- Palliative surgery is performed to find a relief for symptoms and pain of mesothelioma patients and involves removing cancerous tissue.
Palliative Procedures
Procedures are generally performed to relieve symptoms and pain for the patient. There are several procedures your doctor may perform throughout your treatment and each one has a specific purpose. You may need to have more than one type of procedure and may also need chemotherapy and/or radiation. Procedures typically performed on mesothelioma patients:
- Thoracoscopy- Used to help diagnose pleural mesothelioma, an incision is made in the chest and a long, narrow tube is inserted into the pleural spaces in the lungs to view the pleura. Your doctor will then removesuspected cancer cells for testing.
- Thoracentesis- Helps diagnose mesothelioma and is also a palliative treatment to relieve patients of pain and symptoms resulting from fluid buildup in the lungs. A long, hollow needle is inserted into the pleural spaces in the lungs to remove fluid to be tested. To help the doctor know where to remove fluid, a chest x-ray may be performed beforehand.
- Pleurodesis- Involves inserting talc into the pleural space to cause inflammation and to stop fluid from collecting for up to a few years.
- Pleurocentesis/Paracentesis- Outpatient procedure that involves withdrawing fluid from the pleural space with a long thin needle to relieve pain symptoms for the patient.