Mesothelioma Treatment Options

Many factors affect the treatment options available for mesothelioma, including:

• The stage of the cancer - Staging is based on the size of the tumor, whether the cancer has spread to the lymph nodes, and whether the cancer has spread to other parts of the body.
• The size of the tumor.
• Whether the tumor can be removed completely by surgery.
• The amount of fluid in the chest or abdomen.
• The patient's age and general health, including lung and heart health.
• The type of mesothelioma cancer cells and how they look under a microscope.
• Whether the cancer has just been diagnosed or is a reoccurrence.

A treatment plan is devised depending upon the mesothelioma type, aggressiveness, primary location, and degree of local (rarely, distant) spread. The treatment of pleural mesothelioma is difficult. Treatment with surgery, radiation therapy, or chemotherapy used alone or in combination may be proposed, depending upon the potential benefits and risks of each modality. Surgery is rarely used alone but sometimes suffices when only a small pleural patch of mesothelioma is detected, thus allowing visually complete removal of the tumor. More often, mesotheliomas of the left or right pleural cavity cannot be completely removed without taking the entire lung (pneumonectomy) on the same side as well. In such cases, radiation therapy and/or chemotherapy is given postoperatively to help eradicate any residual mesothelioma that may have escaped the surgeon.

The treatment of peritoneal mesotheliomas is even more problematic. Until recently no consistent treatment was available. Now, at a few institutions, peritoneal mesotheliomas have been managed in the experimental setting with combined modality treatment consisting of extensive (usually not complete) debulking surgery, followed by intraperitoneal and systemic chemotherapy followed in turn by whole abdominal radiation therapy.

Because mesotheliomas now represent less than 1 per cent of cancers and and are infrequently seen in the practice of most community oncologists, finding the correct treatment can be very difficult. Proper management of mesotheliomas often requires evaluation at larger tertiary hospitals or Comprehensive Cancer Centers by specialists in medical, surgical, and radiation oncology with experience in all aspects of the clinical care of mesothelioma patients, including the newest experimental treatments.