Mesothelioma Help

Pleural mesothelioma treatment

Wednesday, January 9, 2008

Your choice of treatment for pleural mesothelioma will depend on a number of factors. These include

The stage of your cancer
Any other medical conditions you may have
Your general fitness

Unfortunately mesothelioma can be very difficult to treat. Nearly all treatment is aimed at controlling the disease for as long as possible and keeping symptoms under control. Mesothelioma can be treated with

Doctors and researchers are working to improve treatment all the time. You may be offered treatment as part of a clinical trial and not as a standard treatment. The results of the trials will be used to improve treatment in the future. There is information about taking part in a clinical trial in CancerHelp UK.

Mesothelioma treatment is designed to treat the immediate area of the pleural mesothelioma or the whole body. Whole body treatments are called systemic treatments. Localised treatments include surgery and radiotherapy. Systemic treatments act on cancer cells no matter where they may be in the body and include chemotherapy.

Chemotherapy

Chemotherapy uses anti-cancer drugs, which are usually injected into a vein. Depending on the type of chemotherapy drugs used, you may have treatment weekly, or every 2 to 3 weeks.

Chemotherapy for mesothelioma is given to slow down the cancer and to control symptoms. If you have had surgery, you may be given chemotherapy afterwards. This is called adjuvant chemotherapy. It is given to delay the return of the cancer as much as possible.

Chemotherapy can be used to control symptoms in more advanced mesothelioma. The treatment may also help to slow down the growth of the cancer. There is a clinical trial that is looking into giving chemotherapy in mesothelioma that cannot be operated on. The trial is comparing having chemotherapy to not having chemotherapy to see if chemotherapy can control symptoms and improve quality of life.

While they are open and recruiting patients, both these trials will be on our clinical trials database. To find mesothelioma trials, click on the blue clinical trials button to the left of your screen and choose 'Lung: mesothelioma' from the drop down menu.

Radiotherapy

Radiotherapy can be used to try to slow down the disease or to control symptoms. You may have radiotherapy after surgery for stage 1 mesothelioma to try to slow down the return of the cancer as much as possible. Radiotherapy given after surgery is sometimes called adjuvant radiotherapy.

Radiotherapy may also be used for stage 2, 3, or 4 mesothelioma. It is given to slow the cancer down, or to control symptoms. The length of your treatment will depend on the type and size of your cancer and on why you are being treated. Radiotherapy is sometimes given after fluid has been drained from around your lung. This is to try to stop new growths of mesothelioma developing on your chest wall.

Surgery

Surgery can be used to remove localised mesothelioma, or to take out as much as possible so that other treatments have a better chance of working. This is sometimes called de-bulking. There are 2 major operations that can be done

Pleurectomy

This means removing the pleura. The lung is left behind. The pleural space around it is sealed so that no further fluid can collect there. If you have stage 1 mesothelioma, it may be done to remove the cancer. If you have a more advanced stage, it will not cure you but can delay the progress of the disease, and help to relieve symptoms such as pain and fluid collection around the lung (pleural effusion). Removing as much of the cancer as possible may also help other treatments to work more effectively, for example, chemotherapy.

Extrapleural pneumonectomy (EPP)

This is extensive surgery, which is not suitable for everyone with mesothelioma. It can be done if you have mesothelioma that is up to TNM stage T3,N1. This means stage 1 mesothelioma as well as stage 2 mesothelioma and some stage 3 mesothelioma. It will not cure mesothelioma, but may slow down the progress of the disease and give people better quality of life for longer. Pneumonectomy means removing the lung. Extrapleural means that the pleura, diaphragm, covering of the heart (pericardium) are removed as well on the side affected by mesothelioma.

This operation is only possible if you are fit enough and have good heart and lung function. If your heart and lung function is already poor, the operation may do you more harm than good.

Supportive care (Palliative care)
Mesothelioma is often diagnosed when it is quite advanced. Some people with very advanced disease may be too ill to cope with chemotherapy, radiotherapy, or surgery. But they can still be given treatment to try to relieve symptoms such as pain, breathing problems and weight loss. Your care will be managed by a palliative care team. This is a team of doctors and nurses who are expert in controlling symptoms of advanced cancer. The team may also include a physiotherapist and a dietician.

If you are having trouble with fluid collecting around your lungs, you may be offered treatment to try to stop this from happening. Pleurectomy is one option. Another is thoracocentesis. This is often called a pleural tap.

fluid around the lung

The fluid that has collected in the pleural space is drained off। Often sterile talc or an antibiotic is put in to seal the space and stop the fluid collecting again. This is called pleurodesis.

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