Comprehensive Guide to Treatment of Mesothelioma
Mesothelioma is a rare and aggressive cancer that primarily affects the lining of the lungs, abdomen, and heart. Exposure to asbestos, a naturally occurring mineral widely used in construction, insulation, and other industries, is the main cause of this cancer.
The treatment of mesothelioma is complex and depends on various factors such as the stage of the disease, the patient’s overall health, and the specific type of mesothelioma. This comprehensive guide will provide an overview of the various treatment options for mesothelioma, along with insights into the latest research and clinical trials.
Diagnosis of Mesothelioma
Biopsy
The diagnosis of mesothelioma is made by performing a biopsy. A biopsy involves the removal of a small tissue sample for laboratory analysis. The biopsy procedure is selected based on the affected area of the body. There are two options for biopsy:
- Needle biopsy: A thin needle is inserted through the skin on the chest or abdomen to remove fluid or a piece of tissue.
- Surgical biopsy: A tissue or fluid sample is collected during an operation. The surgeon might make a small incision and insert a tube with a video camera to see inside the chest or abdomen. Special tools can be passed through the tube to collect a tissue sample.
Determining the extent of the cancer
After mesothelioma is confirmed, additional tests may be recommended to determine the extent of the cancer. These tests may include CT scans of the chest and abdomen, MRI, and PET. The information from these tests is used to assign a stage to the cancer. The stages of pleural mesothelioma range from I to IV and are indicated using Roman numerals. A lower numeral indicates that the cancer is more likely to be localized to the area around the lungs, while a higher numeral means that the cancer has spread to other areas of the body.
Treatment Options for Mesothelioma
Surgery
Surgery is one of the primary treatment options for early-stage mesothelioma. It may cure the cancer in some cases. Most of the time, it isn’t possible to remove all of the cancer, but surgery may help reduce the signs and symptoms caused by mesothelioma spreading in the body.
Surgical options may include:
- Surgery to decrease fluid buildup. This is done when pleural mesothelioma causes fluid to build up in the chest, causing difficulty breathing. Surgeons insert a tube or catheter into the chest to drain the fluid. Doctors may also inject medicine into the chest to prevent fluid from returning (pleurodesis).
- Surgery to remove the tissue around the lungs. Surgeons may remove the tissue lining the ribs and the lungs (pleurectomy). This procedure won’t cure mesothelioma but may relieve signs and symptoms.
- Surgery to remove a lung and the surrounding tissue. Removing the affected lung and the tissue that surrounds it may relieve the signs and symptoms of pleural mesothelioma. If radiation therapy to the chest is planned after surgery, this procedure also allows doctors to use higher doses since they won’t need to worry about protecting the lung from damaging radiation.
- Surgery for peritoneal mesothelioma. Peritoneal mesothelioma is sometimes treated with surgery to remove as much of the cancer as possible. Chemotherapy may be used before or after surgery.
Chemotherapy
Chemotherapy uses chemicals to kill cancer cells. Systemic chemotherapy travels throughout the body and may shrink or slow the growth of mesothelioma that can’t be removed using surgery. Chemotherapy may also be used before surgery (neoadjuvant chemotherapy) to make an operation easier or after surgery (adjuvant chemotherapy) to reduce the chance that cancer will return.
In the case of peritoneal mesothelioma, chemotherapy drugs may also be heated and administered directly into the abdominal cavity (intraperitoneal chemotherapy).
Radiation Therapy
Radiation therapy focuses high-energy beams from sources such as X-rays and protons on a specific spot or spots on the body. Radiation may be used after surgery to kill any remaining cancer cells. It may also help reduce the signs and symptoms of advanced cancer in situations where surgery isn’t an option.
Targeted Therapy
Targeted therapy uses drugs that attack specific vulnerabilities in cancer cells. These drugs aren’t commonly used for treating mesothelioma, but doctors might recommend targeted therapy based on the results of tumour DNA testing.
Immunotherapy
Immunotherapy uses the immune system to fight cancer. The body’s disease-fighting immune system may not attack cancer because the cancer cells produce proteins that blind the immune system cells. Immunotherapy works by interfering with that process. This treatment might be an option if other treatments aren’t working.
Clinical Trials
Clinical trials are studies of new mesothelioma treatment methods. People with mesothelioma may opt for a clinical trial for a chance to try new types of treatment. However, a cure isn’t guaranteed. Patients should carefully consider their treatment options and talk to their doctor about what clinical trials are open to them. Participation in a clinical trial may help doctors better understand how to treat mesothelioma in the future.
Clinical trials are currently investigating a number of new approaches to mesothelioma treatment, including new targeted therapy drugs and new approaches to immunotherapy.
Treatment for Other Types of Mesothelioma
Pericardial mesothelioma and mesothelioma of the tunica vaginalis are very rare. Early-stage cancer may be removed through surgery. Doctors have yet to determine the best way to treat later-stage cancers, though. Doctors may recommend other treatments to improve patients’ quality of life.
Preparing for Treatment and Life Afterwards (Prehabilitation)
Prior to treatment, patients can take steps to improve their physical and mental health. Prehabilitation, also known as prehab, can help individuals feel more in control and prepared for their hospital stay.
Treatment Options for Pleural Mesothelioma
Common treatment options for pleural mesothelioma are chemotherapy, radiotherapy, and surgery. The treatment plan is determined by the cancer stage.
Treatment Options for Peritoneal Mesothelioma
Chemotherapy and surgery are two treatment options available for peritoneal mesothelioma. However, due to the advanced stage of diagnosis, the treatment may be difficult.
Follow-Up and Survivorship Care
The Dana-Farber Cancer Institute’s Adult Survivorship Programme offers follow-up services to adult-onset cancer survivors. The programme provides clinical care and services, including research focused on finding solutions to issues faced by survivors after cancer treatment. The programme is a member of the LIVESTRONG Survivorship Centre of Excellence Network.
Conclusion
The treatment of mesothelioma is a complex process that requires a personalized approach. Patients with mesothelioma can achieve better outcomes and a better quality of life with the right care and support. It is essential to work closely with your healthcare team to develop a treatment plan that meets your needs and preferences.