Mesothelioma is considered an incurable cancer, but it can be treated. In fact, a number of successful treatments are available that can slow the condition's progression and even eliminate it to some degree. Treatment can also alleviate symptoms, which often include pain and difficulty breathing.
Doctors have no clearly defined treatment programs specific to mesothelioma, as they usually follow a plan designed for standard cancers. This process typically includes surgery, chemotherapy, and radiation or a combination of these strategies. Which option is used depends on a number of factors, such as the stage and location of the cancer, its type, the age and general health of the patient, and his or her wishes.
Once these elements are determined, the doctor and patient can begin discussing treatment options. Because of the disease's typically low survival rate, one of the top priorities in choosing treatment is the patient's wishes. Some people are willing to try anything to prolong their lives, including putting up with the debilitating side effects of aggressive treatments. Other people prefer less-invasive treatments that allow them to be comfortable.
The purpose of any cancer treatment is to destroy the malignant cells and protect the healthy ones. There are basically three ways to do this.
Surgery – This strategy can be performed either to try to cure the cancer or to relieve pain and improve the quality of life. As a cure, surgery is not usually a viable option because mesothelioma is often discovered late. In addition, a typical mesothelioma tumor encases the mesothelium like a rind and is close to the lungs and heart, making surgical removal risky.
Alternatively, palliative surgery can reduce pain and other symptoms. One of the most common symptoms of mesothelioma is pleural effusion, in which excess pleural fluid builds up in the space between the lungs and the inner chest wall. Two alleviate this buildup, a procedure called a pleurodesis can be performed. A pleurodesis fuses together the two layers of the mesothelium so the fluid cannot accumulate. Another procedure, called a thoracentesis, uses a needle to remove the fluid.
Chemotherapy – This technique uses drugs to lessen symptoms as well as shrink or slow the cancer. Patients may receive chemotherapy agents either as an injection, in pill form, or intravenously. Other drugs are also given to help ease the treatment's side effects, which frequently include nausea and vomiting.
Doctors often combine two chemotherapy drugs to get the best possible results. This combination may be different for each patient. The first and only drug approved for mesothelioma, Alimta, is often combined with cisplatin or carboplatin, but other combinations may be used as well.
Radiation – Many times, a patient's health is not strong enough for surgery or chemotherapy. Radiation has fewer side effects so is often preferred.
The favored type of radiation for mesothelioma is external beam radiation. The therapy is usually generated by a machine outside the body and is directed at the affected areas. Radiation can also be administered internally through a seed, capsule, or filament that carries radioactive material. This allows the radiation to more precisely target the cancerous cells, killing fewer healthy cells.
Unfortunately, radiation usually has little effect on mesothelioma tumors. Accordingly, radiation makes breathing and swallowing easier and lessens pain and bleeding.
In most cases, doctors will use several of these methods with the goal of improving life expectancy. Surgery can be preceded or followed by chemotherapy or radiation, or all three treatments can be used. This allows the patient to get the most from his or her treatment while hopefully experiencing few side effects. Researchers are still looking for the perfect combination of treatments that afford the best prognosis.
In addition to traditional treatments, doctors may suggest that patients take part in clinical studies. Patients can find out about them from their doctors and volunteer to participate. By taking part, patients may find something that works for them and be part of a medical breakthrough. It should be noted, though, that experimental treatments developed in these clinical trials have shown some promise but are not quite ready for widespread use. These options include photodynamic therapy, immunotherapy, intensity modulated radiation therapy, and gene therapy.
Instead of these treatments, some people turn to alternative therapies, either as a standalone method or to complement the traditional approaches. Herbs, vitamins, nutritional supplements, acupuncture, meditation, hypnosis, massage therapy, and TENS therapy are some examples of alternative or complementary treatments that may produce relaxation and other health benefits.
Regardless of what method is used, there is no guarantee that mesothelioma will not recur. Consequently, patients should follow up with their doctor regularly.