Treatment options for a mesothelioma patient can depend on a number of factors, but a primary one is the location of the main tumor. There are four main types of mesothelioma, and the types are designated by where the cancer develops. Each type has a standard set of treatment protocols .
The four general types of mesothelioma are pleural,peritoneal, pericardial, and testicular. Pleural mesothelioma, by far the most common type, develops in the lining of the lungs. Peritoneal mesothelioma develops in the lining of the abdomen. Pericardial and testicular mesothelioma, the rarest types of this disease, develop in the lining of the heart and in the lining of the testicle, respectively.
Find out more about what treatment options are available for your diagnosis. An experienced doctor near you can provide specialized care for your specific condition. Find a mesothelioma doctor and get top treatment by using the Mesothelioma Center's free Doctor Match Program.
Common Treatments
Treatments for mesothelioma in many cases mirror treatments for other cancers: surgery to remove tumors, chemotherapy and radiation therapy. Surgery is not always an option for mesothelioma patients, and these options are vastly different for each type of mesothelioma. Other treatment options like chemotherapy, radiation therapy and alternative therapy tend to overlap.
For any type of mesothelioma, many doctors recommend a multimodal approach. Multimodal therapy is a combination of surgery, chemotherapy and/or radiation therapy and is meant to attack the cancer in as many ways as possible. Many doctors believe multimodal treatment enjoys more success than any solo treatment.
Pleural Mesothelioma Treatment
Pleural mesothelioma is by far the most common form of mesothelioma cancer, making up about 75 percent of all mesothelioma cases. For pleural mesothelioma patients, many doctors recommend a multimodal treatment approach which almost always includes surgery . Even if chemotherapy and radiation treatments aren't used, surgery is closely looked at as a first option for treatment, particularly if the cancer is caught in an early stage.The most common procedures are extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D). Doctors recommend EPP only if the cancer is relatively localized, meaning it has not spread to other parts of the body.
EPP and P/D Surgeries
An EPP removes an entire lung and some surrounding tissue. It can prolong lifespan but it also can radically affect quality of life. By removing the lung, doctors hope to completely remove tumor growth, thereby extending life expectancy. In contrast , P/D spares the lung, removing only the cancerous lining of the lung and any surrounding cancer tissue. This can be a better option for some patients, especially those in the earliest stages of mesothelioma.
Chemotherapy and Radiation Therapy
Often, patients begin a chemotherapy regimen shortly after surgery. In these instances, chemotherapeutic drugs are used to kill any cancer cells left behind by surgery. Radiation therapy may also be used after other treatments to prevent local recurrence. In some cases, doctors may also recommend following up other treatments with radiation therapy. Radiotherapy is not used as a first-line treatment for a few reasons. The proximity of the tumors to vital organs can heighten potential damaging effects of radiation therapy on healthy tissues. Radiotherapy may damage the lung, liver, spinal cord, heart or esophagus. Doctors have also noted that radiation therapy may not reach the entire tumor. If the tumor is widespread, dosage restrictions can limit positive effects of the therapy. Radiation therapy is most successfully used to slow or prevent cancer recurrences after other treatments.
Alternative Treatments and Therapies
Largely because pleural mesothelioma is the most common type of this disease, it is the subject of the majority of alternative treatments.
Clinical trials for immunotherapy, photodynamic therapy and gene therapy are possibilities for patients when considering a treatment plan. These options are being tested in pleural and peritoneal mesothelioma patients, and early studies found that they can significantly improve prognosis.
Patients can also incorporate respiratory therapies to help ease chest pain, fatigue and breathing problems. Minor dietary changes can have similar effects. Pleural mesothelioma patients are encouraged to incorporate slippery elm bark into their diets. This nutritional supplement is proven to ease respiratory problems.
Learn more about pleural mesothelioma treatment
Peritoneal Mesothelioma Treatment
Peritoneal mesothelioma is the second-most common type of mesothelioma, accounting for nearly a quarter of all cases. This type of mesothelioma develops in the lining of the abdominal cavity, called the peritoneum.As with pleural mesothelioma, the main treatment options for peritoneal mesothelioma are surgery and chemotherapy.
A peritonectomy is an aggressive surgery in which doctors remove cancerous parts of the lining of the abdomen. (The procedure is called cytoreduction when it involves more than one part of the abdomen.)By itself, a peritonectomy relieves symptoms like abdominal pain.
Peritonectomyis often paired with chemotherapy, which may be administered before, during or after surgery. In combination with surgery, a chemotherapy regimen is used to shrink the tumor and extend life expectancy. Radiation therapy may be used for a similar purpose but is not standard. If radiation therapy is used on peritoneal mesothelioma, the highly destructive radiation would be aimed at the cancer and at nearby vital organs. This is considered too dangerous and usually is not tried.
Patients seeking more treatment options should consider making some dietary changes. Peritoneal mesothelioma patients can include ginger in their diets. Ginger is a recommended herb known to relieve stomach pain.
At least two recent clinical trials concluded related to alternative treatments for peritoneal mesothelioma. One studied diagnostic procedures related to oxygen levels in the blood and improving photodynamic therapy. A second looked at changes to a patient's DNA with the goal of helping doctors identify cancer biomarkers.
Learn more about peritoneal mesothelioma treatment
Pericardial Mesothelioma Treatment
Pericardial mesothelioma is a rare form of mesothelioma, accounting for only about 200 documented cases. This type of mesothelioma develops in the lining of the heart sac and easily causes complications.If the cancer has not spread beyond the general area of origin, patients can opt for surgery to reduce heart complications and to stop the cancer from spreading. This can lead to a longer life span. In most cases, however, this type of surgery is not an option because the cancer has already spread. Patients in a progressed stage can have surgery to reduce symptoms.
Primary surgeries for pericardial mesothelioma are pericardiocentesis and pericardiectomy, both of which are performed to relieve symptoms but not to extend a patient's life span. Pericardiocentesis drains fluid from the pericardial sac, which relieves pressure around the heart, pain and fatigue. The procedure is not ideal because it does not prevent fluid from building up again. Pericardiectomy is a more involved procedure and removes the lining of the heart sac. It similarly relieves pain and other symptoms. Unlike pericardiocentesis, it prevents further fluid buildup and prevents the recurrence of the same heart conditions.
Although some studies suggest chemotherapy and radiation therapy as helpful, most of the medical evidence shows that pericardial mesothelioma cases are resistant to them. Researchers continue studying the usefulness of both procedures for pericardial mesothelioma patients.
There are no known alternative therapies being studied for pericardial mesothelioma.
Learn more about pericardial mesothelioma treatment
Testicular Mesothelioma Treatment
Testicular mesothelioma is the rarest type of mesothelioma, and fewer than 100 cases have ever been reported. This type of mesothelioma develops in the lining that covers the testicle. Treatment is limited to surgery, because other treatments were found ineffective. Chemotherapy, radiation therapy and immunotherapy have not proved they can shrink or control testicular mesothelioma tumors and are not used regularly. However, radiation therapy can help prevent local recurrence and therefore may be used after surgery.
Surgery may be used to extend life span or only to improve quality of life. Doctors can consider a variety of surgeries, depending on the case. The simplest procedure is aspiration, in which a needle is used to drain built-up fluid. This reduces pain but does not prevent further fluid buildup. A more permanent alternative is hydrocelectomy, which removes fluid and prevents further buildup.
If patients are eligible for more serious surgeries, they may undergo one or more to remove cancer growth and improve life expectancy. These surgeries are usually performed in a series. One is performed to remove the entire cancerous testicle. Another procedure removes the cancerous half of the scrotum. If doctors deem it necessary, a final surgery removes lymph nodes from the cancerous side of the body. This is important because it prevents the lymph nodes from carrying the cancer throughout the body.
There are no known clinical trials for alternative therapies for testicular mesothelioma.
Clinical Trials
There is an easy way to keep up with emerging treatments and therapies for mesothelioma p atients. For help finding one near you, complete the form on the Clinical Trials page. Joining a clinical trial can add months or even years to a patient's life if the new treatment method is effective. Clinical trials are ongoing throughout the country.
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