Personalized treatments using multimodal therapies and advanced technologies are helping patients live longer with mesothelioma. All patients undergo a treatment plan tailored to their unique case to give you the best chance at improving your prognosis and extending your life.
Mesothelioma treatments are administered by specialists at cancer centers across the nation. If you’ve been diagnosed with mesothelioma, it’s critical to work with a specialist who can provide the latest and most effective treatments.
Here is what every mesothelioma patient should know about receiving treatment for mesothelioma:
Treatments are available for every mesothelioma stage
Standard treatments include a combination of surgery, chemotherapy and radiation
Effective treatment plans include multiple approaches and therapies
New treatment forms are being tested in clinical trials and are available to many patients
Aggressive treatments can extend life by months or years
More information on specialized treatments is available in the FREE Mesothelioma Justice Guide
While there is no known cure for mesothelioma, patients who undergo a specialized treatment plan immediately following diagnosis are given a much higher chance at life-extension.
On average, aggressive surgeries extend a patient’s life expectancy by one year, and in many cases have extended life by 5 years or more.
3 Types of Mesothelioma Treatments
There are 3 primary treatment types available to mesothelioma patients. Specialists may recommend all 3, depending on the unique case and how advanced the disease is. Having several treatment combinations gives patients further options to control and treat the disease.
The 3 primary treatment types are:
Surgery is the most effective way to control mesothelioma and prevent it from spreading.
During surgery, doctors cut open the chest or abdomen and physically remove all visible tumor masses and, in some cases, any surrounding tissues or partial organs. Doctors have developed different surgical procedures for each mesothelioma location. Some surgeries are considered more radical than others.
To stop cancer cells from multiplying and spreading to distant sites, doctors administer chemotherapy.
Chemotherapy involves anti-cancer drugs that circulate throughout the body, killing off cancer cells. Patients undergo multiple rounds of chemotherapy to improve its effectiveness. Depending on the treatment approach, chemotherapy may be given before, during or after surgery to increase the surgical success.
3. Radiation Therapy
Radiologists use machines to point high-energy rays directly at the tumor site. Powerful particles or waves scramble the DNA of the mesothelioma cells, preventing them from dividing and ultimately killing them off.
When the cells die off, the tumor shrinks, allowing doctors to control the disease spread. Doctors may administer radiation before or after surgery or as a stand-alone palliative (end-stage) treatment.
Deciding Which Treatments to Use and When
Doctors administer these three standard treatments to patients in different stages. When each treatment type is administered depends on the unique case. Doctors develop treatment approaches primarily based on the mesothelioma location.
Treatment Depends on Disease Location
Pleural and peritoneal mesotheliomas are treated as different diseases because they have separate prognoses and treatment requirements.
Pleural Mesothelioma Treatments
Patients with pleural mesothelioma have multiple treatment options that can improve prognosis. While there are many possible approaches doctors may take, in general, there are 2 main procedures. Each is a multimodal approach, meaning it uses more than one treatment type.
Each procedure is different in its treatment philosophy though both produce similar survival results. It’s up to the patient to decide which approach they believe in after receiving consultation from a trusted mesothelioma specialist.
Extrapleural Pneumonectomy with Chemotherapy and/or Radiation
The first pleural mesothelioma treatment procedure is the extrapleural pneumonectomy (EPP) surgery.
Considered a more aggressive surgery, the EPP involves removing the diseased lung and the entire pleura, as well as a portion of the diaphragm and pericardium (lung lining). The goal of this surgery is to limit mesothelioma cells from spreading (metastasis).
Preventing Mesothelioma Metastasis
By removing the surrounding pleural tissue, doctors get rid of areas that may have already been infiltrated by mesothelioma cells to prevent the risk of metastasis—when mesothelioma cells spread to distant sites.
Before surgery (neoadjuvant), patients may undergo chemotherapy to kill mesothelioma cells and improve the effectiveness of the surgery. Doctors may prescribe a combination of chemotherapy drugs, with cisplatin and pemetrexed being the most common formula.
During surgery, patients may also receive an intrapleural injection of chemotherapy directly into the chest through a catheter. Administering chemotherapy during surgery helps kill any remaining cancer cells that the surgeon couldn’t remove.
Post-surgery (adjuvant), all patients receive further rounds of chemotherapy. Doctors may also give intensity modulated radiation therapy (IMRT), which is computerized radiation that sends pre-measured doses directly to the tumor site to kill off remaining mesothelioma cells.
EPP Treatment Results
Aggressive surgeries like the EPP are only given to patients who are healthy enough to withstand the surgery and recovery. Multimodal treatment with EPP is an approach that gives patients a significant improvement in life expectancy.
Most studies show that patients can survive up to 2 years with this procedure while some studies have shown a survival of nearly 4 years.
Pleurectomy / Decortication with Chemotherapy and/or Radiation
The second pleural mesothelioma treatment approach involves the pleurectomy with decortication (P/D) surgery. P/D is a lung-sparing surgery where doctors only remove the diseased pleura (lung lining) and leave the lung.
Patients receive chemotherapy before the P/D to help shrink tumors. Shrinking tumors ahead of time makes it easier for surgeons to remove the pleura and as much of the mesothelioma as possible during surgery.
After the surgery, patients remain on chemotherapy for several more weeks to further ensure surgical success and prevent recurrence (when the mesothelioma comes back). Patients may also receive radiation therapy to support the surgery.
P/D Treatment Results
Reporting over the last 10 years has shown that the median survival time for patients who underwent the P/D procedure is 10-25 months.
Some studies have shown a high 5-year survival rate in stage 1 pleural mesothelioma patients. P/D also produces a lower short-term postoperative mortality rate. Fewer patients develop fatal complications during the 30 days after surgery compared to those who undergo EPP.
Peritoneal Mesothelioma Treatments
Specialists consider peritoneal mesothelioma the easiest disease location to treat. Patients can expect a personalized peritoneal mesothelioma treatment plan that addresses their unique case.
Treatment for peritoneal mesothelioma focuses on:
Stopping and controlling mesothelioma cells from spreading
Draining fluid buildup from the abdomen
The primary surgical procedure for treating peritoneal mesothelioma is called cytoreduction with HIPEC. It was developed by Dr. Paul Sugarbaker as a curative surgery, meaning the procedure’s goal is to remove all malignant (cancerous) tissue.
Surgeons perform cytoreduction with HIPEC in 2 parts:
Cytoreductive Surgery: Surgeons remove the entire diseased peritoneum (abdominal lining) and any tumors or diseased tissue surrounding the abdominal cavity. By removing as much malignant tissue as possible, doctors control and potentially stop the spread of the tumors from the abdominal cavity to distant sites.
Heated Intraperitoneal Chemotherapy (HIPEC): While the patient is undergoing cytoreductive surgery, the doctor administers chemotherapy directly into the abdominal cavity. The chemotherapy drugs are first heated and then allowed to circulate throughout the abdomen for up to 90 minutes to kill off any remaining, invisible mesothelioma cells.
All peritoneal mesothelioma patients receive neoadjuvant chemotherapy and radiation post operation. A combination of chemotherapy drugs administered after cytoreductive surgery helps to inhibit mesothelioma cell regrowth and stop the growth of certain proteins that promote tumor development.
Cytoreduction Survival Rates
Several studies, including one by the National Cancer Institute, have shown that the median life expectancy of patients after receiving cytoreduction with HIPEC is up to 7 years, though many patients have survived much longer.
For the right candidate, cytoreduction with HIPEC is a critical and lifesaving procedure that can lead to partial or full remission. For others, it helps to improve prognosis and life expectancy by several months or years.
New and Novel Treatments
Private organizations and foundations are currently funding important mesothelioma research. New and novel treatments are being tested in clinical trial settings, and many patients are good candidates for these potentially life-extending treatments.
Clinical trials are an excellent treatment option for patients with advanced mesothelioma or who have stopped responding to treatments or who have experienced recurrence (when the mesothelioma comes back).
Clinical trials take place in a safe and controlled environment that allows researchers to test the safety and effectiveness of treatment combinations while offering patients renewed hope at improving their quality of life.
Mesothelioma Treatment Goals
Before doctors recommend treatments, they consider multiple factors in each patient case, including:
The rate at which the mesothelioma is spreading
How far the mesothelioma has already spread
The treatment goals for stage 2 mesothelioma are different than those for stage 4 mesothelioma. While all treatments have to goal of improving quality of life and giving the patient the best chance at survival, localized cancer is much easier to control than advanced cancer.
Here are some of the possible mesothelioma treatment goals, depending on the diagnosis and unique patient case:
Remove as much of the tumor as possible (surgery)
Shrink tumors in size
Kill mesothelioma cells
Stop the mesothelioma from spreading to distant sites
Alleviate fluid buildup in the mesothelium linings
Manage pain and symptoms
Increase comfort and quality of life
Patients deemed good candidates, such as those who have stopped responding to other treatments, can also undergo clinical trial treatments. The goal in these cases is to administer new therapies to patients and possibly give them a revived chance at extending their life.
How to Get Mesothelioma Treatment
Patients diagnosed with mesothelioma are strongly advised to receive treatment from mesothelioma specialists. It’s important to seek treatment from a specialist who specializes in treating your exact location, stage and cell type.
Patients can undergo treatment at cancer centers across the country with in-house mesothelioma programs. At cancer centers, patients work with a full team of specialists who assess, plan and recommend a targeted treatment plan for your unique case.
Some of the nation’s top mesothelioma doctors providing personalized treatment plans include:
Dr. Avi Lebenthal: Pleural mesothelioma specialist at Brigham and Women’s Hospital, Boston MA
Dr. Paul Sugarbaker: Peritoneal mesothelioma specialist at Washington Cancer Institute, Washington DC
You can begin receiving treatment at any of the top cancer centers in the country by contacting a center near you and booking a consultation.
Or call our Justice Support Team today to learn how you can be matched with a top mesothelioma doctor.