Treatments & Clinical Trials in the United Kingdom

No matter in what country you reside, the treatment options for mesothelioma will largely depend on your individual case. However, there are drugs available in the United States that might not be available in the United Kingdom and vice versa. Some surgical procedures may be more readily used in one country than in the other. Currently, the United Kingdom and United States both offer many of the same options for meso sufferers.

Surgery

After a diagnosis of mesothelioma, in some cases doctors are able to perform a surgical procedure that removes as much as the tumor as possible. In many cases of mesothelioma, however, this is not an option because the disease is often diagnosed after it has reached its late stages and has metastasized.

When surgery is an option, surgical procedures might include a pleurectomy - the removal of the pleura, which is the lining of the lung. During this surgery, the lung is left intact. Doctors might also opt for an extrapleural pneumonectomy, a removal of the entire lung on the affected side. During this procedure, the surgeon will also remove the pleura, diaphragm, and the covering of the heart (pericardium) on the side affected by mesothelioma.

Chemotherapy

Often, chemotherapy is the first line of treatment recommended to a patient just diagnosed with mesothelioma, especially when surgery is not an option. There are numerous chemotherapy drugs used in the treatment of mesothelioma worldwide and most are approved for use in the United Kingdom.

Since 2007, the National Health System has agreed to finance the use of Alimta for the treatment of advanced mesothelioma. Once a bone of contention with the National Institute for Health and Clinical Excellence (NICE) because of its cost, Eli Lilly-manufactured Alimta is the only licensed drug specifically designed for the treatment of mesothelioma and, when used in conjunction with a platinum-based chemotherapy drug such as cisplatin, it has shown the most success in the treatment of the disease. Other drugs may be recommended as well.

The length and frequency of treatment with chemotherapy drugs will be dictated by a number of factors, including stage of the disease as well as its location in the body.

Radiation

Radiotherapy is often used in the treatment of mesothelioma in attempts to slow its spread or to relieve the highly debilitating symptoms of the disease. Radiation therapy does not offer a cure. As with chemotherapy, the length of treatment with radiation will depend on each individual case.

Palliative Treatment

The word "palliative" refers to treatments that help to keep the mesothelioma patient more comfortable during the remainder of their life span. Palliative treatment - also known as supportive care - can include both chemo and radiation but may also include procedures such as thoracentesis (a draining of the fluid of the lungs which allows for easier breathing) or pleurodesis - a surgery that introduces talc into the pleural area to stop the build-up of fluids.

Alternative treatments may also be a part of palliative care. These treatments may not be recommended by the oncologist but many cancer patients have found them to be quite helpful in easing pain and other symptoms. They include acupuncture, massage, meditation and hypnosis.

Clinical Trials in the UK

Clinical trials often involve testing a new drug or therapy or may merely involve the gathering of information about the disease and its trends and incidences. Two current studies are as follows:

One study now being conducted in the United Kingdom involves possible links between types of jobs and the risk of developing lung cancer and mesothelioma. It is open to both men and women who have already been diagnosed with mesothelioma. Men who qualify should be born after 1940 and women after 1925. This trial is not investigating a treatment, but rather gathering information via questionnaires and phone calls. No hospital visits will be required. The study will end at the close of 2015. For more information, contact Christine Rake, Study Administrator, Tel: 0800 0854 383. This is an HSE-sponsored study.

A second clinical trial is currently comparing two treatments for fluid which gathers around the lungs, a common symptom of those with mesothelioma. The two procedures are: pleurodesis - a surgical procedure that introduces a talc substance into the pleural area, which stops fluid from collecting; and pleurectomy - which involves the insertion of a tube called a chest drain, used to drain off the fluid between the lungs and chest wall. Surgery to remove the pleural membrane will follow the draining. This trial is currently in Phase III and will end in March 2009. For more information, contact Cancer Research UK, P.O. Box 123, 61 Lincoln's Inn Fields, London, WC2A 3PX, Tel: 020 7061 8355.

Not everyone qualifies for every clinical trial. Patients must meet a number of specific criteria. Most doctors specializing in mesothelioma are well aware of current clinical trials and can advise their patients on whether or not they qualify.