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The dream of anyone living with mesothelioma, or who loves someone with this terrible disease, is to have a cure, but curing any cancer has proven difficult. A mesothelioma cure does not exist, but new treatments have extended life expectancy and quality of life. Many specialists now focus on managing mesothelioma rather than curing it.
Can Mesothelioma Ever Be Cured?
There is no cure for mesothelioma, but that doesn’t mean no patients survive it. Mesothelioma survivors are few and far between, but they do exist. Some patients are still alive years after their diagnosis, but this is extremely rare.
Mesothelioma experts prefer to say that mesothelioma can be managed rather than cured. To say it can be cured is misleading. More so than many cancers, mesothelioma can return, even when a patient achieves remission.
Why Is Mesothelioma So Difficult to Cure?
Curing any type of cancer is challenging because, even years after remission, the cancer cells can return. Mesothelioma presents even more challenges than most cancer types:
- Mesothelioma is rare. Rare diseases don’t get as much research attention or funding as compared to more common conditions.
- Mesothelioma progresses differently. Compared to many other types of cancer, mesothelioma is more aggressive. It spreads more rapidly, making it difficult to treat. It also tends to develop as many small nodules around the lungs rather than one or two masses. This means that surgical cure is more challenging.
- Mesothelioma diagnoses are late-stage. Most people diagnosed with mesothelioma are already in the later stages. This limits treatment options and makes remission especially unlikely.
Potentially Curative Treatments Available Now
While there is no cure for mesothelioma, several treatment strategies give some patients the hope that they will go into remission. Remission means that no more cancer can be found in the body, but it does not mean that the tumor will not return.
For mesothelioma patients, those diagnosed in the early stages have the greatest hope of achieving remission with certain treatments:
- Surgery: Radical surgeries that aim to remove as much cancerous tissue as possible, as well as nearby healthy tissue to which the cancer may spread, are among the most hopeful strategies for curing early-stage mesothelioma. These include extrapleural pneumonectomy, which removes an entire lung, and pleurectomy/decortication, which removes part of a lung. These surgeries may be curative for a few patients but they come with serious risks.
- Multi-modal treatment: What boosts survival rates even higher for early-stage patients is combining surgery with other treatments, like chemotherapy or radiation, or even both. These other treatments help kill any remaining cells that the surgeon cannot see after the surgery removes the bulk of cancerous tissue.
Controlling vs. Curing Mesothelioma
For many illnesses, not just cancer, research is beginning to focus more on controlling the disease rather than finding a cure. Finding, detecting, and killing all cancer cells, especially in a cancer that spreads as aggressively as mesothelioma does, is a significant challenge.
Many treatment specialists and experts are trying to focus on helping patients control this cancer and live with a small tumor or several small tumors.
Controlling mesothelioma could help patients live much longer than they have in the past and do so with a greater quality of life. Treatment plans may focus on managing symptoms and on shrinking and managing tumors as well. Treatment success is when patients can live comfortably, with an extended life expectancy.
The Most Promising Emerging Treatments
The treatments most often used are imperfect, but they allow the hope of a cure and can significantly extend a patient’s life. They rarely cure a patient, and they may cause side effects or serious complications.
The surgery used to remove a lung, for instance, may cure a patient, but it also may lead to complications that kill the patient, so researchers continue to search for better treatments.
Some of the most promising lines of treatment research include:
- Gene therapy. By adding new genes to cancer cells, researchers have seen some success in helping improve the effectiveness of anti-cancer drugs. The main challenges include being able to get the new gene into the DNA of the cancer cells. The transfer rate is not high currently, but if researchers can get around this problem, gene therapy could potentially be curative.
- Immunotherapy. This has also has been used for some time and is starting to show promise in research labs. For mesothelioma, immunotherapy with cancer vaccines could stimulate the body’s immune system to attack cancer cells. Researchers are also developing drugs called biologics that boost the immune system’s function. Immunotherapy drugs are among the most exciting of new mesothelioma treatments and are the subjects of many clinical trials. One of the things researchers are studying is how to determine which patients will respond to specific immunotherapy drugs.
- Photodynamic therapy. This involves injecting a drug that travels throughout the body but accumulates the most heavily in cancer cells. After a few days, a tube with a light is inserted into the chest cavity to reach the tumor. The light activates the drug, which then kills cancer cells. Because the drug does not become active until exposed to light, this treatment causes fewer side effects than traditional chemotherapy. Chemotherapy uses active drugs that can kill healthy cells as well as cancer cells. The targeting of this treatment also means that oncologists can use higher doses.
- Tumor Treating Fields. TTFields is a newer treatment devised by a company called Novocure. The FDA first approved it to treat a deadly type of brain cancer in 2011, but many experts believed it could also help mesothelioma patients. The FDA subsequently approved it for mesothelioma in 2019. The system works by using electric fields of alternating frequencies to kill cancer cells. The therapy doesn’t require surgery, but it may be used along with chemotherapy.
Can Mesothelioma Be Cured if Caught Early?
Early diagnosis of mesothelioma is crucial in giving patients the hope of a cure through treatment and managing this cancer. If doctors can diagnose mesothelioma during stage I, a patient has a much better chance of being treated successfully.
Mesothelioma has always been difficult to diagnose. It develops over decades; it mimics symptoms of other illnesses, and it is a rare disease, so it is often misdiagnosed at least once before an accurate diagnosis is made.
For this reason, some researchers have focused on better ways of diagnosing mesothelioma early. One promising way of doing this is to detect biomarkers, which are molecules that are unique to mesothelioma.
Several markers have been found, and while they have improved diagnoses, none are foolproof ways of detecting the disease. They include proteins osteopontin and mesothelin.
One blood test, called Mesomark, can detect mesothelin concentrations that may be the closest way to diagnose the cancer unambiguously.
Clinical trials are crucial in the search for a cure or better treatments for managing mesothelioma. These studies test new drugs, surgical procedures, treatment strategies, and treatment combinations using human participants.
The new treatments are first tested in laboratories and animals and then in increasingly larger clinical trials to determine if they are effective and safe.
There are risks associated with participating in clinical trials, but they are often worth the possible benefits for patients with incurable cancer. These participants are also crucial in helping to advance new treatments. Developments could not be made without them taking the risk.
Clinical trials are currently testing gene therapies, new immunotherapies, targeted drugs, and other exciting new treatments for mesothelioma that could eventually lead to a cure. A couple of recent trials show promise:
- HPN536. Researchers at Memorial Sloan Kettering are looking into this investigational drug that targets the protein mesothelin. Mesothelin is found on the surfaces of some cancer cells, including mesothelioma cells. The current trial is working with patients with advanced cancers that have not responded to standard therapies.
- Cancer Vaccine. Also ongoing at Memorial Sloan Kettering is the study of a cancer vaccine called Galinpeimut used with immunotherapies. The vaccine targets a protein on the surface of mesothelioma cells. The study currently needs pleural mesothelioma patients.
- TAK-500. With trials in several locations, researchers are investigating TAK-500 in patients with advanced or metastatic cancers, including mesothelioma. Some patients are getting the new drug alone, while others also get an immunotherapy drug.
There is no cure for mesothelioma, but treatments continue to get better every year. Talk to your doctors about emerging treatments and the possibility of joining clinical trials.Get Your FREE Mesothelioma Packet
Page Medically Reviewed and Edited by Anne Courtney, AOCNP, DNP
Anne Courtney has a Doctor of Nursing Practice degree and is an Advanced Oncology Certified Nurse Practitioner. She has years of oncology experience working with patients with malignant mesothelioma, as well as other types of cancer. Dr. Courtney currently works at University of Texas LIVESTRONG Cancer Institutes.