| Treatment for Mesothelioma | |
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The treatment information in this document is not official policy of the Society and is not intended as medical advice to replace the expertise and judgment of your cancer care team. It is intended to help you and your family make informed decisions, together with your doctor.
Your doctor may have reasons for suggesting a treatment plan different from these general treatment options. Don't hesitate to ask him or her questions about your treatment options.
If you have mesothelioma, you doctor will suggest one or more ways to treat the cancer. This is an important decision and you should take time to think about all of your choices.
You may want to get a second opinion. A second opinion can give you more information and help you feel more secure about the treatment choice you make. Also, some insurance companies require a second opinion before they will agree to pay for certain treatments.
Because this is such a rare cancer, it has been hard for doctors to compare the value of different treatments. Since many doctors have little or no experience treating this disease, you may be referred to a specialist at a large medical center. Treatment options include surgery, chemotherapy and radiation therapy. One problem with treating mesothelioma is that it does not grow as a single mass. Instead it tends to spread along surfaces, nerves, and blood vessels. This makes it hard for one or more types of treatment to get rid of all of the disease .
Surgery
Surgery for some types of mesothelioma might be done to try to bring about a cure or to relieve symptoms. Surgery to relieve symptoms (called palliative surgery) is often done in cases where the tumor has already spread, or when the patient is too ill to withstand more involved surgery.
To attempt a cure, extensive surgery might be needed. This might be done if the patient is in good health (other than the cancer) and if it seems as if the tumor is confined to one place. While surgery is not likely to cure the cancer, it might extend the patient's life.
Unfortunately, the cancer has often spread to other places before it is found. So the role of surgery in treating this cancer is open to debate. If your doctor recommends surgery, you can ask for more details about the operation and what the goal is.
In many cases, methods other than surgery are used to relieve symptoms. Fluid in the chest can be removed by placing a needle into the chest cavity and drawing the fluid out. Sometimes talc or drugs that cause scarring are injected into the chest to keep the fluid from coming back. A similar method can be used to remove fluid around the abdomen or heart. While these methods can relieve symptoms, they are not meant to cure the cancer.
Chemotherapy
Chemotherapy refers to the use of drugs to kill cancer cells. The drugs can be swallowed in pill form or they can be injected by needle into a vein or muscle. Once the drugs enter the bloodstream, they spread throughout the body. In treating mesothelioma, these drugs may also be given directly into the chest (or abdominal) cavity at the site of the tumor. More than one drug may be used to make the treatment more effective.
Depending on the type and stage of the cancer, chemotherapy may be given as the main treatment or along with surgery. Chemotherapy for this disease is given to relieve symptoms, not to cure the cancer.
Chemotherapy can have some side effects. These side effects will depend on the type of drugs given, the amount taken, and how long treatment lasts. Side effects could include the following:
- nausea and vomiting
- loss of appetite
- hair loss
- mouth sores
- an increased risk of infection
- bleeding or bruising after minor cuts
- tiredness
- shortness of breath
Most side effects go away once treatment is over. Anyone who has problems with side effects should talk with their doctor or nurse, as there are often ways to help.
Radiation Therapy
Radiation therapy is treatment with high energy rays (such as x-rays) to kill or shrink cancer cells. The radiation may come from outside the body (external radiation) or from radioactive materials placed directly in the tumor (internal or implant radiation). External radiation is the preferred type for mesothelioma. It is given in the same way as the type of x-ray used to find a broken bone, although it takes longer. Treatments are usually given daily (5 days a week) for 3 to 5 weeks.
As a rule, radiation treatment doesn't help much for mesothelioma, and the need to treat a large part of the lung leads to problems with lung damage. But radiation can be used along with surgery to kill small areas of cancer that cannot be seen and removed during surgery. It can also be used as a way to ease symptoms such as shortness of breath, pain, bleeding, or trouble with swallowing. If fluid builds up in the chest, radioactive drugs can be put into the space after the fluid is drawn out. This might help keep the fluid from coming back.
There can be side effects from radiation. Most of these will go away after a short while. The skin in the area treated may look sunburned and then become darker. You may also feel tired. Be sure to talk with your doctor about any side effects. Often there are medicines or other methods that will help.| Clinical Trials | |
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Studies of promising new treatments are known as clinical trials. A clinical trial is done only when there is some reason to believe that the new treatment may be of value to the patient. Clinical trials are needed in order to find new and better ways to treat cancer. Treatments used in clinical trials are often found to have real benefits. The main questions the researchers want to answer are:
- Is this treatment helpful?
- Does it work better than the one we're now using?
- What side effects does it cause?
- Do the benefits outweigh the side effects?
- Which patients are most likely to find this treatment helpful?
Clinical trials are carried out in steps called phases. Each phase is designed to answer certain questions
Phase I clinical trials look at the best way to give a new treatment and how much of it can be given safely. The main purpose of a phase I study is to test the safety of the new drug.
Phase II clinical trials are designed to see if the drug works. Patients are given the highest dose that doesn't cause serious side effects and then watched closely to see if there is an effect on the cancer.
Phase III clinical trials compare the new treatment with standard treatment. Large numbers of patients are divided into two groups. The control group receives standard treatment and the other group receives the new treatment. Everyone is closely watched to see which treatment is more effective. The study is stopped if the side effects are too severe or if one group has much better results than the other.
If you are in a clinical trial, you will have a team of experts watching your progress very carefully. However, there are some risks. No one knows in advance if the treatment will work or exactly what side effects will occur. That is what the study is designed to find out. Keep in mind, though, that even standard treatments have side effects.
Taking part in a clinical trial is completely up to you. Even after joining a clinical trial, you are free to drop out of the study at any time, for any reason. Taking part in the study will not prevent you from getting other medical care you may need.
The American Cancer Society offers a service to patients and their families that will help match them with a clinical trial. We will ask you about your cancer, where you live, and whether you can travel or not. Then our computer will give you a list of clinical trials that might meet your needs.
To use this service, please call our toll-free number (1-800-303-5691) or log on to our Web site at http://clinicaltrials.cancer.org.
The National Cancer Institute has current information about NCI-sponsored clinical trials. You can call the NCI at 1-800-4-CANCER or visit their Web site at www.cancer.gov/clinicaltrials.| Complementary and Alternative Therapies | |
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