Mesothelioma can be treated by surgery (removing the cancer cells), radiation therapy (using high-dose X-rays to kill cancer cells), and chemotherapy (using high-dose anti-cancer medication to kill the cancer cells).
The two main surgical procedure options for patients with mesothelioma are: a pleurectomy, in which the surgeon removes part of the lining of the chest or abdomen and some of the tissue around it; and an extrapleural pneumonectomy, in which the entire lung, along with its pleural lining, and the diaphragm (the breathing muscle located below the lungs) are all removed. No study has ever compared the efficacy of these two procedures against one other.
If the cancer has spread too far to be operable, surgery may still be performed to relieve symptoms. This kind of surgery is called palliative because it is not meant as a cure. For instance, fluid in the chest can be relieved by placing a needle in the chest cavity. A similar procedure can be used to remove fluid in the abdomen and heart. Fluid can also be removed in a pleuroscopy, in which the surgeon looks into the pleural cavity through a small hole or holes, and empties the fluid under direct vision. (This procedure also allows directed sampling, or biopsies, of the cancer when a diagnosis is still being sought.) Often, this procedure is completed with a chemical pleurodesis, in which a pleural irritant-most commonly talcum powder-is left in the pleural cavity to minimize the risk of the fluid coming back.
Radiation Radiation therapy can be performed externally or internally. External radiation uses a machine outside the body. Internal radiation, also called brachytherapy, involves the insertion of radioisotopes (materials that produce radiation) through thin plastic tubes directly into the place where cancer cells are found.
Chemotherapy Chemotherapy may be taken in pill form, or given intravenously, or-in clinical trials-put directly into the chest. This last method is called intrapleural chemotherapy.
Follow-Up After Treatment
As part of the Survivorship Program at SCCA, a clinic has been developed for general medical oncology survivors treated with conventional therapy. This clinic is the Medical Oncology Survivorship Team (MOST). For more information about the MOST program, click here.
The Cancer Profiler
For more information about a type and stage of cancer, please try the The Cancer Profiler, a free decision support tool brought to you by the Seattle Cancer Care Alliance (SCCA) and NexCura, Inc. The Cancer Profiler enables cancer patients and their physicians to make better informed treatment decisions using information from evidence-based, peer-reviewed medical literature.