Mesothelioma Treatment Overview
If you’ve recently been diagnosed with mesothelioma, the next step is learning about your treatment options.
Treatment Options for Mesothelioma
There are three main types of conventional treatment for mesothelioma—surgery, chemotherapy, and radiation therapy. There are also several experimental treatments, including gene therapy, immunotherapy, and photodynamic therapy, as well as experimental chemotherapy drugs. These types of treatments are generally available only for people in clinical trials.
In most cases, a person with mesothelioma won’t receive just one type of treatment. Mesothelioma treatment is multi-modal, meaning most patients receive treatment of different types at the same time. One of the most common treatments is surgery to remove tumors, followed by chemotherapy to kill any remaining cancer cells.
Most people who are diagnosed with mesothelioma will undergo several different types
What Types of Surgery are Available?
Surgical options include diagnostic, curative, and palliative surgeries.
Diagnostic surgeries are also called biopsies. These are usually simple and quick procedures, in which a small amount of cells or fluid is removed. The sample is tested for the presence of proteins and molecules that help determine what type of cancer (or other disease) a person has.
Curative surgeries for pleural mesothelioma include removal of part or all of one lung, a section of lung lining, or simple of a localized tumor mass. These surgeries are carried out to try and cure the cancer or prolong life. Curative surgery is usually followed up with chemotherapy or radiation therapy.
Palliative surgeries aren’t able to cure a patient—they are carried out to relieve pain and discomfort and improve quality of life.
For more information, please see “Mesothelioma Treatment – Surgery.”
Chemotherapy and Radiation Therapy
Chemotherapy drugs are usually administered intravenously, to apply the drugs to the patient’s entire body. These drugs are generally toxic to rapidly-dividing cells—which includes not only cancer cells, but also healthy hair follicles and immune cells. This non-specificity of chemotherapy drugs is responsible for side effects such as hair loss and reduced immune system function. Chemotherapy drugs used to treat mesothelioma include Alimta, Cisplatin, and Carboplatin.
Some people with peritoneal mesothelioma can be treated with chemotherapy drugs that are applied directly into the abdominal cavity, often following surgery. This direct application improves the efficacy of the drug, and also reduces its toxic side effects.
Please see “Mesothelioma Treatment – Chemotherapy” for further information.
Radiation therapy uses ionizing radiation to kill cancer cells and shrink tumors. People with mesothelioma may receive this treatment after surgery, or as a stand-alone palliative to reduce the discomfort caused by larger tumors.
There are two types of radiation therapy: external beam radiation therapy is the standard type of radiation therapy where a beam of radiation is applied to tumors. This type of therapy can produce painful side effects as the treatment can also harm surrounding healthy tissue.
In a newer type of radiation therapy called brachytherapy, tiny radioactive rods are implanted within a tumor. These deliver a concentrated dose of radiation to a tumor and do little damage to surrounding tissue, resulting in very few side effects.
What Types of Experimental Treatments are Available?
The following types of experimental treatments are sometimes available for people in clinical trials. Entering a clinical trial isn’t for everyone—it’s something to discuss with your doctor, to find out if there’s a trial you are eligible for. Web sites such as the National Institute of Cancer at http://www.cancer.gov/clinicaltrials/search/ have a searchable database where information about trials can be found.
Photodynamic therapy is an experimental treatment for pleural mesothelioma which uses light energy to kill cancer cells. In a photodynamic therapy treatment, a patient is treated with a drug that makes cancer cells sensitive to a special kind of light. A few days after treatment the patient is exposed to the light, and cancer cells that have absorbed the drug are killed. This is a highly specific treatment, as the drug is one that is absorbed only by cancer cells—healthy tissues don’t absorb the drug, and aren’t affected.
Gene therapy targets cancer cells and makes them more vulnerable to chemotherapy drugs by implanting them with new genetic material. The main type of gene therapy under development for mesothelioma treatment forces cancer cells to produce substances that make them vulnerable to chemotherapy.
This involves treating a patient with a non-infectious virus that has been genetically altered to make it produce a special protein. Cancer cells that become infected with the virus begin producing the protein. When the patient is treated with a special chemotherapeutic drug, cancer cells that produce the protein are killed.
Immunotherapy uses a patient’s own immune system to kill cancer cells. Normally the immune system does not kill cancer cells, but the right kind of immunotherapy treatment can ‘trick’ the immune system into recognizing cancer cells as harmful.
In one type of immunotherapy, cancer cells are removed from a patient and treated in a laboratory, then injected back into the patient. The laboratory treatment turns the cells into a vaccine—when treatment is successful, the vaccine activates the immune system and forces it to recognize that cancer cells are harmful.
Can I Use Alternative or Holistic Treatments?
Not all mesothelioma treatments could be considered conventional. Often, people find that alternative treatments such as acupuncture and massage therapy can provide effective relief from pain and discomfit, without the stress that chemotherapy or radiation therapy can sometimes cause. However, it’s very important to note that these types of treatment are palliative, and cannot cure mesothelioma.
Can I Choose my Own Treatment?
If you are diagnosed with mesothelioma, your doctor will choose treatments based on the type of cancer involved, how far advanced the disease is, and your overall physical health. If you’ve been diagnosed with early stage cancer, for example, your doctor may recommend surgery and chemotherapy as your best treatment option.
Don’t forget, however, that you have a say in your treatment, and that you always have the right to refuse a treatment you don’t want, or ask for more information about a treatment that your doctor might not have mentioned.
Sources
http://www.cancer.org/downloads/PUB/DOCS/SECTION28/89.pdf
http://en.wikipedia.org/wiki/Immunotherapy
http://www.ornl.gov/sci/techresources/Human_Genome/medicine/genetherapy.shtml
http://en.wikipedia.org/wiki/Photodynamic_therapy
http://en.wikipedia.org/wiki/Radiation_therapy
http://en.wikipedia.org/wiki/Mesothelioma#Heated_Intraoperative_Intraperitoneal_Chemotherapy
