Mesothelioma Treatment

Mesothelioma can be hard to treat, whether the cancer is resectable or not. It’s very important that you understand the goal of treatment before it starts – whether it is to try to cure the cancer or to help relieve symptoms – as well as the possible benefits and risks. This can help you make an informed decision when looking at your treatment options.

Despite years of research since the disease was first identified, it’s still difficult to identify the best approach to treating the disease, says David Rice, MD, a cardiothoracic surgeon and nationally known mesothelioma expert who practices at the University of Texas MD Anderson Cancer Center in Houston, TX.
The very rareness of the cancer—only about 3,000 people a year are diagnosed in the United States—makes it difficult to run the kind of research studies needed to compare treatments and determine the ideal therapy at each stage of the disease. “There isn’t a lot of evidence-based science in this disease,” Dr. Rice admits. So when his patients ask him what the best treatment is for the disease, he tells them what we tell you in this section, adding that “we don’t have a reliable cure for this disease.”
Thus, a major goal of treatment is to reduce pain and suffering and prolong a patient’s life as long as possible while providing them with the highest quality of life possible.

Choosing the right mesothelioma doctor is an important first step in planning for treatment.

There are a number of mesothelioma experts, like Dr. Rice, practicing in specialized clinics throughout the country. Each of these cancer specialists has an acute knowledge of the behavior and pathology of Malignant Pleural Mesothelioma and its treatment. It is likely that if you are diagnosed with mesothelioma, you will be referred by your personal physician to a larger scale comprehensive cancer center.
The most important consideration in mesothelioma treatment is the cancer stage and type, said Dr. Rice. Treatment decisions also depend on whether the cancer is localized to the chest or has spread to the chest wall, diaphragm, or lymph nodes, your age and overall health, and the center where you’re being treated. Learn more about finding a doctor here.
 

Conventional treatments for mesothelioma involve surgery, chemotherapy, and radiation therapy.

As with most solid tumors, doctors turn to surgery, radiation and chemotherapy to manage mesothelioma. When exploring the various treatment options available with your doctor it is important to be informed about the risk and benefits of each one before making a final decision.

The stage (extent) of a mesothelioma is an important factor in determining treatment options. But other factors, such as whether the doctor feels the cancer is resectable (all visible cancer can be removed by surgery), as well as a person’s general health and preferences, also play a role.

Types of Mesothelioma

There are three main types of mesothelioma, and each affects a different area of the body.  The three types of this deadly cancer are:

• Pleural Mesothelioma
• Peritoneal Mesothelioma
• Benign Mesothelioma

Pleural Mesothelioma

Pleural mesothelioma is the most common type of malignant mesothelioma (accounting for an approximate 75% of all documented cases of the disease) and affects the section of the mesothelium called the pleura. Although the most common type of malignant mesothelioma, the disease is still somewhat of a rarity. As a result, pleural mesothelioma is often confused with other types of diseases, such as lung cancer and viral pneumonia. Lung cancer can be caused by Asbestos (asbestos lung cancer), though it differs from pleural mesothelioma in that it is a malignancy of the lung tissue itself, as opposed to pleural mesothelioma which is a malignancy of the tissue casing of the lungs. Viral pneumonia shares certain symptomatic similarities with pleural mesothelioma and is often misdiagnosed as such.
The most common presenting symptom of pleural malignant mesothelioma is chronic chest pain. A buildup of fluid inside the pleural space can cause severe and chronic chest pains; this is called pleural effusion. Steps can be taken to drain the fluid and relieve the pain (with the possibility of recurrence) or surgery can be performed to close the pleural space (with virtually no possibility of recurrence). Some of the other notable symptoms associated with pleural mesothelioma include:

• Shortness of breath
• Chronic coughing
• Weight loss
• Fever

Raw asbestos fibers

Pericardial Mesothelioma

Pericardial mesothelioma is much less common than malignant mesothelioma of the pleura or peritoneal. Peritoneal mesothelioma is the second most common type of malignant mesothelioma (accounting for an approximate 10% to 20% of all documented cases of the disease) and affects the section of the mesothelium called the peritoneum (the mesothelial lining of the abdomen). Peritoneal mesothelioma is most often caused by the ingestion of carcinogenic asbestos fibers. Inhaled Asbestos fibers can become lodged in mucous lining the mouth and esophagus. Once swallowed, it travels through the digestive system where it can potentially become lodged and develop into a tumor.
 In fact there are only about 150 cases ever reported in the medical literature. It affects the section of the mesothelium called the pericardium (the mesothelial lining of the heart). People in the fourth to seventh decades of life are most likely to have this cancer, and there is a 2:1 male to female ratio. Currently, surgical excision (removal) of the pericardium is the treatment for pericardial mesothelioma, primarily to lessen symptoms of constriction around the heart.

Symptoms that are associated with pericardial mesothelioma include:

• Chest pain
• Fluid buildup around the heart
• A mass in the space between the lungs
• Abnormal or difficult breathing (dyspnea)
• Chronic coughing
• Irregular heartbeat (palpitations)

 

Malignant Versus Benign

The aforementioned types of mesothelioma are malignant forms, and are thusly the most dangerous. Malignant mesothelioma is often the product of asbestos inhalation from individuals who have worked or resided in areas not up to current health and safety standards. Since the disease has a high latency period, often times it is not diagnosed until it has progressed far beyond any rectifiable measure.
As the name suggests, benign mesothelioma is a form of non-malignant mesothelioma that is easily treatable. While benign tumors can at times be cancerous, unlike malignant mesothelioma, the tumors do not spread, making it easier to isolate and remove.

Mesothelioma of the Tunica Vaginalis Testis

Mesothelioma of the tunica vaginalis testis is the least common type of malignant mesothelioma (amounting to less than 100 of all documented cases of the disease) and affects the section of the mesothelium called the tunica vaginalis testis (the mesothelial lining around the testes). Most patients are in their 50s or older, but about ten percent of the patients are younger than 25 years. Patients generally present with a hydrocele (an accumulation of serous fluid in a sac-like cavity (as the scrotum)) or hernia. Treatment is usually a high inguinal orchiectomy (surgical excision of the entire affected testis through an incision in the lower abdomen - called also orchidectomy). Prognosis is somewhat better than for pleural mesothelioma.
Symptoms that are associated with this cancer include:

• Hydrocele (a fluid filled sac attached to a testicle)
• Suspected hernia