Mesothelioma: Available Treatments

Treatment of malignant mesothelioma can be very difficult for a wide variety of reasons. First and foremost, mesothelioma can be difficult to correctly diagnose and may not show up in a patient for decades. This can create problems for treatment because with mesothelioma, as with all cancers, treatment is more difficult the longer the disease has been allowed to progress. In addition to the difficulties created by delayed treatment of mesothelioma, the disease often does not respond to traditional cancer treatments, further complicating treatment. Also, the organs that are involved in mesothelioma cannot be partially or wholly removed usually, which means that surgical options can be extremely limited. Lastly, the fact that the majority of mesothelioma patients are men of advanced age, usually over 50, means that some more radical treatment approaches cannot be used because of declining health due to old age.

Altogether, this can mean that even mesothelioma patients that have been recently diagnosed can be given a fairly negative prognosis from their doctos. Statistics are hard to come by, but British scientists suggest that 10% of newly diagnosed mesothelioma patients will live for at least three more years; Only 5% will live five years or longer. For patients in the first stage, 50% live for at least two more years. However doctors can be mistaken, and a diagnosis of mesothelioma is in no way always tantamount to a death sentence. In one famous case, scientist Stephen Jay Gould survived with peritoneal mesothelioma for almost twenty years. Eventually, he died from another kind of cancer.

There are four stages of malignant mesothelioma, which measure how far the disease has progressed. How a patient's mesothelioma is treated depends largely on which stage he or she is in when the disease is found.

* Stage I: Localized mesothelioma that exists only in the lungs, the diaphragm or the pericardial lining.

* Stage II: Advanced mesothelioma that has spread into the lymph nodes of the chest.

* Stage III: Advanced mesotheioma that has spread into the wall of the chest, the center of the chest, the lining of the heart and the diaphragm. Stage III malignant mesothelioma may or may not have spread to the lymph nodes.

* Stage IV: Advanced mesothelioma that has spread far from the chest and abdomen into other organs.

Surgery

Patients with Stage I or milder Stage II mesothelioma are generally offered one or more of the conventional cancer treatments: surgery, radiation and chemotherapy. For early-stage patients, surgery for mesothelioma aims to cure the disease by literally cutting the cancer out of the patient's body. The most common type of surgery for pleural mesothelioma is a pleurectomy/decortication, which is where doctors remove all or part of the tissues lining the lungs and chest cavity. If doctors find that they can't remove the cancer without removing the lung underneath those tissues, they may remove one lung as well; this is called a pneumonectomy. A more radical type of surgery for pleural mesothelioma is called an extrapleural pneunonectomy (EPP). In the case of an EPP, surgeons will remove parts of one lung, the pleura, the diaphragm, and the lining of the heart. These are quite dangerous and difficult types of surgery, which will not be recommended lightly by doctors or surgeons.

Patients with peritoneal mesothelioma -- the kind that affects the abdomen -- may be offered cytoredutive surgery. In this surgery, doctors are trying to remove all of the cancerous tissue they can find in the abdomen and gut. Doctors may also opt for a peritonectomy, in which the entire lining of the abdomen is removed. Again, this is not an easy surgery and may not be possible for everyone, but it has been successful in some patients. Patients with pericardial mesothelioma are not generally offered surgery.

Radiation and Chemotherapy

In addition to or instead of surgery, doctors may offer an early-stage mesothelioma patient chemotherapy, radiation or both. Radiation and chemotherapy are designed to kill the cancer cells without killing the patient. Unfortuantely, in order to kill the cancerous cells, these treatments often kill healthy cells as well. This is why cancer patients often lose their hair, have trouble eating and feel generally weak and sick during treatment. Doctors who prescribe chemotherapy or radiation may also suggest dietary supplements or other measures to control these symptoms.

Chemotherapy is any treatment where patients are given chemical medication specifically designed to attack the cancer cells as the undergo cell division. The drug is swallowed or injected into the bloodstream regularly over a period of weeks or months, in cycles that give a patient some recovery time in between treatments. A patient could stay at home, only requiring visits to a doctor's office for treatments; sometimes, they can even have the treatments at home. In some cases, doctors may choose to apply chemotherapy drugs directly to the cancerous tissue; this requires surgery, so patients must check into a hospital. There are many different kinds of chemotherapy drugs, and scientists are trying to develop better ones every day.

Radiation therapy seeks to kill the cancer cells with high-energy rays of radiation, such as x-rays, that stop them from growing. With external-beam radiation, patients will be subjected to directed rays of radiation directed as specific parts of the body affected by cancer. This treatment lasts about 30 minutes a day and is given in the exact same way each day over a period of weeks. In internal radiation therapy (brachytherapy), doctors put a container of radioactive material next to the cancerous tissue, using surgery or an existing body cavity. Some will be left in the body; others will be removed and replaced. Lastly, radiopharmaceuticals are sometimes used to administer radiation treatments, with the drugs being either injected, inserted into a body cavity or swallowed.