Treatments for Mesotheileoma – Surgery and Chemotherapy
There are a number of treatment options for mesotheileoma, though not all may be available to every patient diagnosed with the rare cancer caused by asbestos. The traditional treatments for cancer include surgery, chemotherapy and radiation therapy. These may be prescribed by themselves or in conjunction with each other, depending on the decisions made by the doctor and patient together. It is important to thoroughly discuss all of your options for mesotheileoma treatment with your doctor before making a decision. However, it is also important to make those decisions in a timely manner in order to take full advantage of the range of treatment options available.
Surgery
If the mesotheileoma is diagnosed early enough, some doctors may attempt a resection to remove the area of the lung where the cancerous cells are found. This is referred to as a resection, and the hope is that the surgery will remove all the cancerous cells and stop the spread of cancer. In later stages, there are other surgical treatments that can ease the symptoms of mesotheileoma, extend life and make the patient more comfortable. These surgical options are called “palliative” because they do not cure the cancer, but are meant to improve the patient’s quality of life. These surgical treatments for mesotheileoma include:
- Thoracentesis, a procedure that involves inserting a hollow needle into the chest cavity and withdrawing the excess fluid that has collected there. It is successful in relieving chest pain and shortness of breath in about 90% of cases. The procedure is relatively low risk, and may be combined with injecting talc or an antibiotic into the chest cavity to slow or prevent the accumulation of excess fluids. A similar procedure can be performed to drain fluids from the peritoneal area and from the pericardium. The most common complication of this procedure is that the cancer cells may spread through the needle path.
- Pleurectomy can be performed even in cases where the mesotheileoma is far advanced. It involves the removal of the pleura, the outer lining of the lung, where the majority of the cancerous cells are located. While it does not cure the cancer, it can relieve many of the symptoms of mesotheileoma and reduce the pain caused by the cancer.
- Pneumonectomy is a far more extensive surgery that removes the diaphragm, pleura, pericardium and lung on the side where the mesotheileoma is found. This major surgery is very rarely done and can only be attempted if the patient is in overall good health with no other complications. The aim is to remove all of the cancer if possible.
Chemotherapy
There are a number of anti-cancer drugs that have proven to have some effect against mesotheileoma, and research has uncovered some promising new avenues for drug therapy. Drugs used for treating cancer may be given orally or intravenously. In some cases, doctors will prescribe drugs that can be taken at home in conjunction with chemotherapy sessions delivered at a hospital or treatment center. Often, chemotherapy is prescribed together with surgery and/or radiation therapy for best effect.
The drugs most commonly prescribed to treat mesotheileoma are cisplatin and alimta, which are often given together to increase the effectiveness of both. Other drugs that are often prescribed to treat mesotheileoma are Adriamycin (doxorubicin), which has the best track record in fighting mesotheileoma and is usually prescribed alone. Drug combinations which your doctor may try include methotrexate and vincristine, vinblastine and mitomycin, cisplatin and doxorubicin; and doxorubicin, cyclophosphamide (or ifosfamide) and cisplatin. There are other drugs undergoing clinical trials to test their safety and effectiveness in treating mesotheileoma.
While drugs used in chemotherapy are effective against cancerous cells, they do not usually discriminate and often kill healthy cells as well. Chemotherapy has many unpleasant side effects, some of which can be relieved through other drugs and through alternative therapies.
Radiation Therapy
A third type of treatment for mesotheileoma is radiation, the use of X-rays to kill cancerous cells. There are two types of radiation therapy that are used to treat mesotheileoma. The first is external radiation, which focuses high intensity X-rays on the cancerous cells from outside the body. The second is internal, with radioactive materials placed inside the body at the cancer site to irradiate and kill the cancerous cells. Recent advances in medical technology make it possible to target the cancerous cells more specifically than was ever possible before. In addition, some drugs can weaken the cancerous cells and make them more vulnerable to the radiation therapy.
Radiation therapy is sometimes prescribed as the major treatment for mesotheileoma in patients who are too ill to withstand surgery. It may also be prescribed in addition to surgery to remove pockets of cancerous cells that were not removed by the surgery.
