People with mesothelioma have three main treatment options: surgery, chemotherapy, and radiation therapy. Experimental treatments such as photodynamic therapy, gene therapy, and immunotherapy have shown promise in clinical trials. Other options include alternative and complementary treatments such as acupuncture and massage therapy, which are designed to alleviate pain and other symptoms rather than improve a patient’s prognosis.
Mesothelioma treatments are rarely used in isolation—a given patient does not usually receive only surgery, or only chemotherapy. Instead, treatment programs usually involve a combination of at least two different types of treatment. For example, a patient may undergo surgery to remove the bulk of a tumor, followed by either radiation therapy or chemotherapy to remove any remaining cancer cells. A treatment program of this type is a common option for mesothelioma patients who are strong enough to undergo surgery.
Curative versus Palliative Treatments
Mesothelioma is an aggressive cancer that is highly resistant to treatment. In addition, it is often diagnosed in a late stage of development. This means many patients are limited to palliative treatments. These are treatments designed to relieve symptoms rather than try to cure a patient.
Curative treatments, on the other hand, are those that are carried out in hopes of curing the patient. In terms of mesothelioma, curative treatments may be carried out, but because the cancer itself is very resistant to treatment, a true cure is extremely unlikely. Mesothelioma is almost 100 percent fatal.
Conventional Mesothelioma Treatments
There are three main conventional treatments for mesothelioma: surgery, chemotherapy, and radiation therapy.
Surgery: Surgical treatments for mesothelioma are diagnostic, curative, or palliative. Some types of surgery fall into more than one category. Diagnostic surgery involves removing a sample of tissue or fluid to test it for the presence of cancer cells. Curative surgeries remove either tumors or an organ to prevent further cancer spread. Palliative surgeries are designed to relieve pain and other symptoms.
Only curative surgery has the potential to remove all tumors, and curative surgery must usually be followed up by chemotherapy or radiation therapy. However, if curative surgery is to have any chance of being effective, mesothelioma must be diagnosed as early as possible.
For more information, please see “Surgery.”
Chemotherapy: Most forms of chemotherapy involve intravenous administration of drugs that kill rapidly dividing cells. However, cancer cells are not the only cell type in the body that divides rapidly. Hair cells and immunity cells do as well. This means people who receive chemotherapy often lose their hair, and become more vulnerable to infections. Only a small handful of chemotherapy drugs have any efficacy in treating mesothelioma. Patients with peritoneal mesothelioma sometimes have the option to undergo a relatively new form of chemotherapy called heated chemotherapy. This treatment is carried out following surgery.
For more information on this treatment option, please see “Chemotherapy.”
Radiation: A type of radiation called ‘ionizing radiation’ is used to kill cancer cells (to prevent or slow down the spread of cancer). Radiation therapy is usually used in conjunction with surgery. In some cases it may be used as a stand-alone treatment to relieve pain for people who are not good candidates for surgery. In both cases, radiation therapy usually provides only short-term symptomatic relief.
Mesothelioma patients may receive one of two types of radiation therapy—external beam radiation therapy (where tumors are bombarded with beams of radiation to kill cancer cells), and brachytherapy (where a tumor is implanted with tiny radioactive rods).
For more information about this type of treatment, please see “Radiation.”
New or Experimental Treatments
Photodynamic Therapy: Photodynamic therapy is most often used to treat skin cancers, as well as pleural mesothelioma and other types of lung cancer. This treatment is most effective in patients who have localized a condition (meaning it is not suitable for people with cancer that has metastasized).
This type of therapy uses light energy to kill cancer cells. During the treatment session the patient receives an intravenous injection of a drug that makes cancer cells sensitive to light of a special wavelength. The patient is exposed to the special light—which kills the cancer cells—between one and three days following the administration of the drug.
Gene Therapy: In terms of mesothelioma treatment, this uses genetic material to target cancer cells and make them more susceptible to chemotherapeutic drugs. In one type of therapy, called suicide gene therapy, a non-infection virus is genetically modified to produce a special protein. During treatment, a patient is treated with the virus, which enters cancer cells and makes them produce the protein. The patient is then treated with a chemotherapy drug that reacts with the protein to kill the cancer cell. This type of therapy has produced promising results for mesothelioma patients, but is only available through clinical trials.
Immunotherapy: These types of treatment use the patient’s own immune system to kill cancer cells. Normally the immune system is not able to kill cancer cells because they are modified versions of the body’s own normal cells. Immunotherapy treatments “trick” the immune system into recognizing the cancer cells as harmful, so the immune system can then attack the cancer. Immunotherapy strategies involve creating specialized vaccines made in the laboratory using a patient’s tumor cells. The vaccine is then given to the patient. If the treatment is successful, the patient’s immune system reacts to and destroys cancer cells. As with gene therapy, most immunotherapy treatments are considered experimental and are only available in clinical trials.