Mesotheilioma Treatment Options: Chemotherapy & Surgery
Treatment for mesotheilioma typically involves a combination of surgery and chemotherapy, but the exact treatment regime used depends on the type of mesotheilioma involved, and the stage the cancer is at.
In general, treatment involves some type of surgery to remove as much cancerous tissue as possible, followed up by chemotherapy to kill any cancer cells which remain. In some cases, however, the patient may not be in good enough overall health to withstand the physical strain of surgery. In such cases chemotherapy is typically used as a stand-alone treatment. Another consideration is whether it is pleural, peritoneal, or pericardial mesotheilioma involved, as most surgical options currently available are for pleural or peritoneal mesotheilioma.
Mesotheilioma Surgery
- Paracentesis is a palliative procedure carried out to relieve symptoms caused by fluid build-up in the abdominal cavity of a person with peritoneal mesotheilioma (which puts pressure on internal organs). During the procedure, fluid is removed via a long, hollow needle. The procedure may also be used for diagnostic purposes; in this case the fluid sample is sent to a laboratory for testing.
- Thoracentesis is similar to paracentesis, with fluid being removed from the lungs of people with pleural mesotheilioma. Thoracentesis can be used as a diagnostic procedure or a palliative treatment.
- Pleurodesis is used to treat the build-up of fluid in the lungs which is a common symptom of pleural mesotheilioma. Lung membranes are drained of fluid, and an inflammatory substance is then applied to the membranes. This makes the membranes swell, leaving less space between them, preventing fluid build-up.
- Pneumonectomy is a pleural mesotheilioma treatment involving the removal of one entire lung. To be a suitable candidate for surgery, the patient must be in good general health, as the surgery can be physically stressful, and the patient will rely on a respirator for several days afterwards.
- Thoracotomy is a pleural mesotheilioma treatment involving the removal of sections of diseased lung tissue. The objective is to remove all diseased lung tissue while leaving healthy tissue intact.
Mesotheilioma Chemotherapy
Many chemotherapy drugs available for cancer treatment, but mesotheilioma is a special case, because it is resistant to many chemotherapy agents. Currently around half a dozen different drugs are used for mesotheilioma treatment.
Most produce side effects such as nausea, hair loss, loss of appetite, and susceptibility to infection. Unfortunately, these drugs can only increase survival time for mesotheilioma patients – there are no chemotherapy drugs which can cure the disease.
- Alimta is usually used in conjunction with Cisplatin to treat pleural mesotheilioma, often to treat people who aren’t good candidates for surgery. Treatment is usually administered every three weeks, and people receiving the Alimta/Cisplatin treatments must take vitamin B, folic acid, and folate supplements.
- Carboplatin is a Cisplatin derivative with reduced side effects, usually used following surgery. Although Carboplatin has reduced side effects in comparison to its parent drug, it can have toxic complications in people with kidney or liver problems. Carboplatin is usually administered every four weeks.
- Gemcitabine is used to treat pancreatic, breast, and bladder cancer as well as pleural mesotheilioma, but isn’t suitable for people with kidney or liver problems. Generally administered following surgery, once a week for up to seven weeks.
- Navelbine is unusual in that it is not synthetic, as most chemotherapy drugs are. Navelbine is derived from the Periwinkle plant, and has been shown to produce positive results in people with mesotheilioma, with overall fewer side effects than most other chemotherapy drugs.
- Onconase is another non-synthetic agent derived from eggs of the Leopard Frog. This drug has showed promise in the treatment of mesotheilioma but is still undergoing clinical trials (and therefore is not generally available).
Heated Chemotherapy is used for the treatment peritoneal mesotheilioma. In this treatment a heated solution of a chemotherapy drug is infused throughout the peritoneum. The heat treatment allows deeper penetration of the drug into affected tissue, and the targeted therapy means there are fewer side effects than are usually experienced with intravenous administration. Heated chemotherapy is usually carried out following surgery, but may also be used as a stand-alone treatment.
