Malignant Mesothelioma
What are the treatments for the disease?
A mesothelioma is very hard to cure. It often responds poorly to treatment. For some people, the disease is so aggressive and widespread that there is no effective treatment. Treatment can involve surgery, radiation therapy,
chemotherapy, or a combination of these. To ease symptoms, the following may be used:
intravenous glucose
narcotic pain medicine
removal of pleural or peritoneal fluid
In its advanced stage, this cancer is not considered curable. In this case, treatment involves making the person comfortable. Surgery may be able to cure the disease in Stage I and, in some cases, in Stage II.
Before performing surgery, the healthcare provider must determine if the tumors are operable. The person must also have adequate heart and lung function. Surgery can involve removal of the pleura and pleural-based tumor. Some people may need to have the lung on that side of the body removed as well.
Individuals with peritoneal mesothelioma can sometimes benefit from surgery. Operations can remove fluid buildup, bowel obstruction, or other problems. They may also relieve pain linked with these conditions. If the cancer has invaded the chest wall, heart, lymph nodes, or diaphragm, surgery probably will not help. People in whom the cancer has spread to distant sites will also not be helped by surgery.
Different forms of radiation therapy can be used. These include:
colloidal radioactive chemicals placed into the pleural cavity or peritoneum
a combination of colloidal radioactive chemicals and radiation implants
radiation implants in the pleural cavity or peritoneum
radiation of the chest wall
Medicines used for chemotherapy include doxorubicin, dacarbazine (DTIC), mitomycin, and cisplatin. The therapy is primarily to ease discomfort. This type of chemotherapy can be combined with radiation. It can also be given directly into the pleural or peritoneal space.
What are the side effects of the treatments?
Surgery can be fatal due to the extensive nature of the operation needed. Other possible side effects include:
accumulation of pus, called empyema
allergic reaction to anesthesia
bronchopleural fistulas, which are abnormal openings between the airways and the lining of the lungs
chronic lung failure
infection
loss of lung function
serious bleeding during surgery with need for blood replacement
vocal cord paralysis
Radiation frequently damages the lung. Significant injury to other normal tissues including the heart and liver is possible.
Single-agent or multiple-drug chemotherapy can be toxic. Use of combination agents is likely to cause:
bone marrow suppression, in which the bone marrow is not able to produce normal types and amounts of blood cells
diarrhea
hair loss
increased risk of infection
mouth sores
What happens after treatment for the disease?
After treatment, the individual will be monitored for lung, heart, and other organ function. Some people who have had a lung removed may need to continue using oxygen.
How is the disease monitored?
Monitoring includes physical exams, blood tests, chest X-rays, and CT scans. There is no specific blood test that accurately predicts recurrence. Mesothelioma can come back several months to a few years later. A second tumor, independent of the first, has been known to occur as well. Any new or worsening symptoms should be reported to the healthcare provider.
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