As with any cancer, treating mesothelioma depends on:
• location of the cancer
• progression of the disease
• age of the patient
• state of health of the patient
It is the oncologist who specializes in the disease who will decide on the line of treatment. The disease is difficult to treat, and in most cases the prognosis is poor.
10 Options in Treating Mesothelioma
1. If diagnosed in the early stages, surgery may be the recommendation to remove all cancerous tissues. Surgery means thoracoscopy, VATS or video-assisted thoracic procedure, mediastinoscopy (used for staging), or laparoscopy. Doctors often advise palliative options like chest tube drainage and pleurodesis, thoracoscopy and pleurodesis, pleuroperitoneal shunt, or pleurectomy. These options treat the symptoms of mesothelioma rather than the disease.
2. Radiation is prescribed aggressively for mesothelioma patients. Often this is given in combination with surgery or to control symptoms, palliatively. Research on using radiation therapy using implants or UV light therapy is in progress as traditional radiation therapy damages surrounding healthy tissue.
3. Chemotherapy is an option, and around 12-20% of patients respond to the drugs. Anti-cancer drugs destroy cancer cells and prevent their spread. In mesothelioma, chemotherapy is not considered to be curative. The aim is to avoid the spread of the disease; shrink the tumor before surgery, known as neoadjuvant therapy; to annihilate any remains of the tumor in the body post-surgery; and to relieve pain and other discomforts, palliative chemotherapy. Experts recommend prescribing premetrexed along with cisplatin. These drugs have shown positive results, and this is now standard care for mesothelioma not treatable by surgery.
4. Biological therapy using interleukin 2.
5. Immunotherapy stimulates the body’s immune system to fight the disease. Biological response modifiers, BRMs, are used in treatment. These enhance the functions of the immune system; regulate metabolic reactions that promote the growth of cancers; alter cancer cell division; block or reverse processes that lead to the formation of cancers, and prevent the spread of disease.
6. Gene therapy attempts to correct the gene sequence that causes cancer. There are of two kinds: replacement gene therapy, and knockout gene therapy.
7. Administration of lovastatin, a cholesterol-lowering drug.
8. Photodynamic treatment where a photosensitive medication is activated using a laser during the surgical removal of cancerous tissues.
9. Draining of fluid in the chest or abdominal cavity followed by the introduction of medications into the cavity to prevent fluid accumulation, done for patients who have uncontrolled fluid accumulation and intense discomfort stemming from it.
10. Combination therapy or Trimodal therapy which means surgery accompanied by radiation and chemotherapy.
There is often a utilization of complementary medicines. Termed to be holistic, this kind of treatment focuses on a patient’s physical, mental, emotional, and spiritual well being.
In the case of treating mesothelioma, which is uncurable, one can opt for clinical trials. New treatments are in progress in several research laboratories and centers. The oncologist or physician would recommend the best advice on the line of treatment.