The very first and important step for mesothelioma treatment plan is to choose the right doctor. You can find some mesothelioma doctors throughout the country that practicing in specialized clinics and hospitals.
Some other important issues regarding mesothelioma treatment plan are to determine the cancer stage, cell type, and the main affected tissue. For instance, if you’re suspected to have pleural mesothelioma cancer, the treatments will depend on cancer's location; whether it is localized to the chest or has spread to another part such as the diaphragm, lymph nodes, and chest wall. Your age and overall health will also determine the further treatment.
Surgery, chemotherapy, and radiation therapy are the conventional treatments for mesothelioma. But before making a final decision, it is important to be informed about the benefits and risks of each treatment.
SurgeryThere are still many debates about which surgery is more efficient and effective, although some studies have proved that most long-terms survivors are patients who had undergone surgery.
There are two main surgeries for pleural mesothelioma cancer:
The tumor will be removed from around the lung as much as possible. Decortication or pleurectomy has a higher chance of failure that is resulting in the recurrence of tumor in chest cavity 50-80% of the time. The difficulty of removing the tumor without removing the lung is the primary reason for the high recurrence. However, with advanced radiotherapy techniques, the result may change.
• Extrapleural Pneumonectomy
The lung itself will be removed. Studies found that pneumonectomy in 80-85% of patients will prevent tumor recurrence if it is followed by radiation.
However, there is a 55% chance of complication and a 3% risk of death due to a long and intensive operation. Thus, this kind of surgery will only be performed if the patient has a good prognosis; for instance, the patient’s cancer has not spread outside the chest.
The best-suited patients for pneumonectomy are the younger ones; with no evidence of lymph node, has an epithelial form of the disease, and healthy enough to take on the procedure.
Unfortunately, in both of the surgeries, there is no significant difference in survival rates. Most of the time, the reason is that cancer has spread to other organs by the time it is diagnosed.
In the end, there is a big question whether the surgery is more effective because the patients offered are mostly young and in earlier stage disease.
ChemotherapyChemotherapy or systemic therapy is using infusion-based or oral medications to kill cancer cells in the patient’s body. It can be done both before and after surgery, including people who do not undergo surgery. Though not curing, chemotherapy has a survival benefit. It is also used to improve the quality of life and reduce pain in the palliative setting.
There are few drugs that commonly used in chemotherapy. Your doctor may recommend starting with only one drug if you can't manage combination drugs for therapy. The doctor will infuse the medication directly into the chest cavity (called pleural chemotherapy), or into the abdomen (called intraperitoneal chemotherapy). You can also get a “second-line” chemotherapy (the second course).
RadiationThis treatment can be a crucial part of mesothelioma treatment. It is a challenging problem to provide this kind of intensive and high-dose therapy to shrink the tumor because the cancer is near the lungs and heart.
However, there is a newer option called Intensity-modulated Radiotherapy (IMRT) which is more accurate to avoid healthy tissue and target cancer cells only. If it is performed by experienced doctors, the result may be better.
Palliative CarePalliative care stage is at the point where the management of the disease is no longer trying to cure, but to keep the patient feel comfortable as long as possible.
Many patients enter a nursing home program that provides a designated hospice facility or in the patient’s home by a designated care provider or hospice nurse. The primary goal is to maximize the patient’s comfort. Medication will be provided to help with difficulty breathing, pain, and other symptoms that may happen. So is spiritual and emotional support.
Alternative TherapiesAlternative therapies may be helpful to ease side effects of chemotherapy or other traditional cancer treatment. Acupuncture, massage, and meditation are usually the alternative therapies that include in Complementary and Alternative Medicine (CAM). It may help the patients to have a better management of stress and anxiety towards the conventional treatment and the disease itself.
The most important thing in mesothelioma treatment is to discuss treatment goals with your doctor. You can choose whether to do everything you can to treat your cancer, even if that means you have to endure the side effects for a small improvement, or do treatments that make you comfortable so that you can live your remaining time as long as possible and as comfortable as possible.