Treatment of Malignant Mesothelioma
There are generally three options for treatment of malignant mesothelioma: surgery, radiation therapy, and chemotherapy. One or a combination of them may be tried. The decision depends upon the extent of the disease and the overall health of the patient. An elderly person who has many other medical conditions and in whom the cancer is far advanced will not be as good a candidate for surgery as a young, otherwise healthy person with a small tumor. Even the younger, healthier person, however, will probably need additional treatment besides surgery.
In the most extensive surgery, the doctor will remove the tumor and the area surrounding it, including the entire lung, the pleura, the sac around the heart, and muscle in the diaphragm area. In some cases, the surgeon will perform a “pleurectomy,” or removal of the pleura only and not of the lung and other areas. A pleurectomy may not remove the entire tumor and may be done to alleviate pain rather than to eradicate the cancer. The survival rate for surgery for both operations is good. Surgery is often followed with other therapies.
In radiation therapy, high energy x-rays or other forms of energy are directed at the tumor in order to shrink it or to control its growth through killing the cells. Mesothelioma is susceptible to radiation, but because the tumors are often wide-spread by the time the disease is diagnosed, using radiation on the entire tumor would often result in the death of many healthy cells. Consequently, radiation is usually used in combination with chemotherapy or surgery or both. It is sometimes used alone in order to reduce the size of the tumor and alleviate pain when the disease is very far progressed. A course of radiation will typically last about five weeks, with treatment daily.
Chemotherapy is the attempt to kill the tumor with drugs. Often a combination of drugs is used in order to attack the cells at various stages of growth and duplication. Drugs are usually given through a needle into a vein, although there has been some experimentation with inserting drugs directly into the chest. Because drugs cannot be specifically targeted at the cancerous cells, they affect other, healthy cells as well. Chemotherapy is usually given in cycles so that the body has time to recover from the drugs before beginning the next round. For people who are very ill, the side effects of chemotherapy can be extremely difficult. However, new drugs are frequently being tested, and patients can apply for participation in clinical studies of these drugs.
There have been some studies in gene therapy as a treatment for malignant mesothelioma. Gene therapy involves replacing the damaged DNA of the cancerous cells with healthy DNA. However, the studies on it have so far only been experimental, and it is not a standard form of treatment for malignant mesothelioma. Patients who want to receive gene therapy are only able to do so as part of an experimental group.
Other forms of experimental treatment for mesothelioma involve trying to stimulate the immune system with proteins or antibodies. These studies are also only in the experimental stage.
back to Malignant Mesothelioma