Mesothelioma Treatment Options
There are 3 Mesothelioma Treatment Options for all patients with malignant mesothelioma.
- surgery (taking out cancer)
- radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells)
- chemotherapy (using drugs to fight cancer)
Surgery is a common treatment for malignant mesothelioma. The doctor may remove part of the lining of the chest or abdomen and some of the tissue around it. Depending on how far cancer has spread, a lung also may be removed in an operation called a pneumonectomy. Sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed.
Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy).
If the fluid has collected in the chest or abdomen, the doctor may drain the fluid out of the body by putting a needle into the chest or abdomen and using gentle suction to remove the fluid. If the fluid is removed from the chest, this is called thoracentesis. If the fluid is removed from the abdomen, this is called paracentesis. The doctor may also put drugs through a tube into the chest to prevent more fluid from accumulating.
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells throughout the body. In mesothelioma, chemotherapy may be put directly into the chest (intrapleural chemotherapy).
Intraoperative photodynamic therapy is a new type of treatment that uses special drugs and light to kill cancer cells during surgery. A drug that makes cancer cells more sensitive to light is injected into a vein several days before surgery. During surgery to remove as much of cancer as possible, a special light is used to shine on the pleura. This treatment is being studied for early stages of mesothelioma in the chest.
Treatment by stage
Treatment depends on where the cancer is, how far it has spread, and the patient's age and general health. Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Not all patients are cured with standard therapy and some standard treatments may have more side effects that are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in many parts of the country for many patients with malignant mesothelioma.
Drugs / Medications
ALIMTA [ (pemetrexed) is now available on expanded access basis. ALIMTA will be available on an expanded access use for people with malignant pleural mesothelioma, cancer usually associated with exposure to asbestos. As of July 9, 2002, the Food and Drug Administration agreed to place ALIMTA in an expanded access program, which gives patients access to an agent that isn't yet commercially available, although the sponsor is actively pursuing marketing approval. Eli Lilly is pursuing approval of ALIMTA in combination with cisplatin for the treatment of malignant pleural mesothelioma, a disease that causes tumors to grow in the linings of the lung, or pleura. Patients live an average of six to nine months following diagnosis. The company said results of a Phase III trial showed that patients treated with ALIMTA and cisplatin combined lived longer and had less pain and shortness of breath, than patients treated with cisplatin alone. In the trial, the most common side effect of cisplatin and ALIMTA was a decrease in infection-fighting white blood cells. Under the expanded access program, ALIMTA will be given free of charge to patients who meet medical eligibility requirements.
L-NDDP (carboplatin). The intrapleural administration is intended to exceed the usefulness of other platinum drugs like Cisplatin that are limited by toxicity and drug resistance.
Endostatin. Has been shown to inhibit a tumor's ability to grow blood vessels without destroying normal healthy cells. Works with angiostatin. Lovastatin. A cholesterol drug was shown to potentially inhibit the growth of cancer cells.
Intrapleural interferon gamma. The anti-cancer drug, Interferon Gamma is directly administered into the affected area.
Photodynamic therapy. Light energy is used to destroy cancer cells. Immunotherapy. Focuses on strengthening the immune system to assist the body in fighting the disease.
Gene Therapy. Focuses on pinpointing and correcting the genetic defect that first allowed the tumor to develop.