Improvements in Mesothelioma Treatment
Mesothelioma is a difficult disease to manage and treat, and it has a poor prognosis.[1] In spite of the challenges, treatments have improved in recent decades. Specialists are now helping patients live longer lives in greater comfort.
Patients get the best treatment and more options by visiting treatment centers and mesothelioma specialists. These cancer centers provide compassionate and effective care as well as access to clinical trials.
Researchers at cancer centers improve the safety and effectiveness of surgery, the leading curative treatment for mesothelioma. They also work on experimental treatments like immunotherapy and gene therapy.
While there is still no cure, mesothelioma treatments are more effective, and patients are living longer than ever before.
Consult a Mesothelioma Specialist
It’s important to find a qualified specialist as soon as possible. Oncologists who focus on mesothelioma have studied this rare cancer and worked with patients like you.
Only mesothelioma specialists can provide access to the latest treatments. They also collaborate with other experts as part of a patient-focused team.
Mesothelioma specialists lead cutting-edge research for diagnosis and treatment, as well as clinical trials. They can offer some of the most innovative therapies available anywhere.
Mesothelioma Treatment Facilities
Specialists provide the best treatment and the most options for mesothelioma patients. They often work at specialty mesothelioma and cancer treatment facilities.
Mesothelioma treatment centers and departments have the staff, equipment, knowledge, and experience to provide the most up-to-date options for mesothelioma patients.
Making treatment decisions is difficult when facing such a devastating and life-threatening illness. Making the right choices becomes a little easier with an expert mesothelioma team guiding you.
What Are Available Treatment Options?
Your treatment plan for mesothelioma depends on several factors:[2]
- The type of mesothelioma
- The stage of your cancer
- Your age and overall health
- Your preferences and goals
The patient makes the final treatment decisions. A good medical team will provide information and guidance to help patients make the best choices for their needs and preferences.
One important issue is to determine how aggressive to be with treatment. Patients must weigh the benefits and risks of aggressive treatment.
Some prefer to focus on extending their lives at any cost. Others want to be comfortable in the time they have left and choose treatments that address symptom relief and quality of life.
Surgery
- The goal of surgery is to remove as much of the cancerous tissue as possible.[2]
- Surgery is often combined with chemotherapy or radiation to eliminate remaining cancer cells or to shrink tumors before surgery.
- Some patients choose aggressive surgical procedures to try to cure mesothelioma.
- Surgery is often used to extend a patient’s life and manage the disease rather than to provide a cure.
- Surgery also improves quality of life by providing relief from symptoms.
Chemotherapy
- Chemotherapy is a standard and common treatment for mesothelioma.
- Chemotherapy uses drugs to target and damage fast-growing cancer cells.[2]
- Patients receive chemotherapy drugs intravenously over multiple cycles.
- Chemotherapy typically causes several side effects.
- An innovative and promising new treatment for peritoneal mesothelioma involves washing the abdominal cavity with heated chemotherapy drugs after surgery.
Radiation Therapy
- Radiation therapy is a beam of high-energy particles that kills cancer cells.
- Radiation may be used before surgery to reduce tumor size or after surgery to destroy any remaining cells.
- Traditionally, radiation is administered from outside the body by aiming the beam at the area of tumor growth.
- New methods allow oncologists to deliver radiation internally for more targeted treatment and fewer side effects.
Multimodal Therapy
In general, treatment for mesothelioma involves a combination of therapies, also known as a multimodal approach. Each treatment can increase the effectiveness of the others.
A combination of surgery with chemotherapy or radiation therapy, or all three treatment types, is most effective for many patients.
Newer Treatments
Chemotherapy, surgery, and radiation therapy are standard cancer treatments, but researchers continue to develop novel treatments. Mesothelioma patients may benefit from:
- Immunotherapy
- Photodynamic therapy
- Cryotherapy
- Tumor Treating Fields
- Gene therapy
Experimental Treatments
Many mesothelioma patients have also found hope in experimental treatments. These are novel therapies tested in clinical trials for safety and efficacy.[3]
Discuss these options with your oncologist to find out if they are appropriate for your treatment.
What Are the Official Treatment Guidelines for Mesothelioma?
The National Comprehensive Cancer Network (NCCN) and other organizations provide guidelines for standard treatment approaches for different types of cancer.
The official guidelines for mesothelioma treatment include:[4]
- First-line chemotherapy should include pemetrexed and cisplatin or carboplatin.
- Certain patients benefit from the addition of bevacizumab to chemotherapy.
- Early-stage patients can benefit from extensive surgery—pleurectomy/decortication or extrapleural pneumonectomy.
- Cytoreductive surgery alone is not enough and should be used with chemotherapy or radiation, or both.
- Surgery is not recommended for stage IV patients.
- Radiation therapy can be used before or after extensive surgery or as palliative therapy.
These are only standard guidelines. Treatment teams made up of specialists use them to create individualized plans for each patient.
What Can I Expect with Mesothelioma Surgery?
Surgery gives most patients the best chance of extending survival time, but you must be a good candidate for it.
Consider these important factors when choosing surgery as part of a treatment plan:[5]
- If you have late-stage, metastatic cancer or are in poor health, aggressive surgery is probably not an option.
- Aggressive procedures to remove a lot of tissue can extend life but are also very risky.[6]
- Although surgery is an important part of treatment, it is rarely used alone. It is usually combined with radiation and chemotherapy.
- Some surgical procedures are used to provide symptom relief. This is called palliative surgery.[7]
Can I Benefit from Research and Clinical Trials?
- Approved Protocol
- Investigator Selection
- Approval Process
- Patient Recruitment & Participation
- Data Entered & Reviewed
- Statistical Analysis
- Presentation & Publication Report
- Data Field & Registration Obtained
In addition to standard treatments, you may be able to benefit from new therapies under study. These treatments are experimental and not yet approved. They are available to patients only through clinical trials.[8]
Physicians and researchers run clinical trials to determine if these new treatments are effective and safe.
Participation in a clinical trial provides patients with the unique opportunity to try a treatment that may have a better outcome than any other therapy currently approved.
Your team of specialists can connect you to relevant and appropriate clinical trials. Remember that the effectiveness of treatments being offered is still unproven. Experimental therapies can even be harmful, causing unexpected side effects.
What Are My Other Therapy Options?
Immunotherapy
Immunotherapy is an exciting area of research for treating all types of cancer, including mesothelioma.[9] Immunotherapies harness a patient’s immune system to attack and kill cancer cells.
Cancer cells use strong defenses against the immune system. Researchers are working on overcoming those defenses with novel treatments.
In 2020, the FDA approved the first immunotherapy treatment for unresectable pleural mesothelioma, a combination of Opdivo and Yervoy.[10]
Gene Therapy
Gene therapy is another new area of treatment research.[11] Gene therapies take advantage of a patient’s DNA and genes to fight disease.
Researchers manipulate the genome in patients with many types of cancer. Gene therapy shows promise for mesothelioma patients.
For mesothelioma, doctors use carefully manipulated cells with specific genes. They inject the patient with these cells to target and kill cancer cells. This is just one of several gene therapy strategies currently under investigation.
Photodynamic Therapy
Photodynamic therapy uses light energy to target and kill cancer cells.[11] A patient receives an infusion of drugs that kill cancer cells. They are only activated when stimulated by light.
Once the injected toxic drug has accumulated in cancer cells, doctors expose the tumor to light. This activates the drug to start acting on and killing the cells.
Clinical trials using photodynamic therapy are already proving that this strategy can extend life expectancies in mesothelioma patients.
Cryotherapy
Cryotherapy is an emerging treatment using cold temperatures to kill cancer cells. Although tested in other types of cancers, researchers continue to review the effectiveness of cryotherapy in mesothelioma patients.[12]
Cryotherapy may extend life expectancy. Right now, many patients receive the treatment as a type of palliative care. It is safe and low-risk, which makes it a good option for many patients.
Tumor Treating Fields System
NovoTTF-100L, or Tumor Treating Fields System, is the first new mesothelioma treatment approved by the FDA in fifteen years. Doctors use it in conjunction with traditional chemotherapy.[11]
The therapy uses electrical currents tuned to a specific frequency. This frequency disrupts the growth of cancer cells and slows tumor growth.
Tumor Treating Fields System is non-invasive and safe. Clinical trials proved that it could significantly extend life expectancy for patients with mesothelioma who cannot undergo surgery.
What Are My Options for Complementary and Alternative Medicine?
Many cancer patients turn to complementary and alternative medicine (CAM) in addition to traditional treatments.
Yoga, massage therapy, aromatherapy, acupuncture, and other CAM therapies provide important benefits for patients with mesothelioma.
CAM practitioners provide services to relieve cancer symptoms or side effects of treatments like chemotherapy. Many patients report CAM therapies bring relief from pain, nausea, vomiting, stress, anxiety, and other symptoms.
Practitioners provide CAM therapies along with standard cancer treatments. CAM is not a replacement for traditional medical treatment.[2]
Many cancer treatment centers include CAM practitioners on their multi-disciplinary teams. With your medical team’s guidance, try alternative treatments that interest you and provide relief.
The many options include:
- Nutrition
- Homeopathic medications
- Herbal and traditional Chinese medicines
- Energy therapies
- Massage therapy
- Acupuncture and acupressure
- Yoga
- Meditation
- Relaxation techniques
What Is Palliative Treatment?
The goal of palliative treatment is to improve the quality of life. It is not curative treatment and may or may not extend life expectancy.
While it has long been associated with terminal cancer, all patients can benefit from palliative therapies. These treatments provide several benefits:
- Decrease pain
- Minimize side effects of treatments
- Improve symptoms of cancer
- Provide patients with more independence
- Allow patients to live at home
- Improve mental and emotional state
How Does Treatment Affect Life Expectancy?
Research clearly indicates that treatment is a major factor in life expectancy for mesothelioma patients.[13] With some exceptions, patients who receive the most aggressive treatment for which they qualify live longer.
Exactly how treatment affects life expectancy depends on individual factors. On average, multimodal treatment extends life expectancy from 15 months to 23 months. Adding surgery to chemotherapy is particularly important to extending life.[14]
What Are My Options to Pay for Mesothelioma Treatment?
For a rare cancer like mesothelioma, costs rise quickly. Surgery can reach into the tens of thousands of dollars. Chemotherapy takes several weeks and multiple cycles to administer. A full course may cost $30,000 or more.
Radiation therapy is less expensive but still averages $2,000 per month. Alternative therapies may cost much less but are additional costs because they are not designed to replace any standard treatments.
Patients with limited or no health insurance may find themselves facing stressful decisions about treatment and costs. They also face additional financial burdens:
- Traveling for treatment
- Home medical care
- Providing for children
- Lost wages if going back to work is impossible
Several resources help patients struggling with finances during cancer treatment:
- Specialty treatment centers for mesothelioma and cancer often have aid for those who cannot afford to travel for their care.
- Clinical trials and grants may also be available.
- Veterans of the U.S. military may be eligible for special benefits.
- Victims of workplace asbestos exposure may receive compensation through a settlement or trust fund.
How to Make Difficult Treatment Choices
When it comes to a life-threatening disease like mesothelioma, making treatment choices is complicated. There are many factors to consider:
- Extending life expectancy
- Quality of life
- Treatment costs and insurance coverage
- Side effects of treatment
The best way to make difficult treatment choices is to listen to your expert treatment team, discuss with close loved ones, and make decisions based on your goals.
Some people want to extend their lives at any cost, while others prioritize quality over length of life. Know your goals, rely on experts, and take input from family.
Frequently Asked Questions
