Palliative Mesothelioma Treatment
While the search for a mesothelioma cure continues, most mesothelioma patients undergo palliative treatment, which aims to manage pain and symptoms of the cancer. There are a number of palliative treatment options such as surgery, radiation therapy, chemotherapy and medications. Recommended treatments will depend on the stage and the type of mesothelioma diagnosed, among other factors like age and overall health.
The goal of palliative treatment is simple: relieve pain, reduce symptoms and improve overall quality of life. Palliative care is often for patients with terminal cancer and a poor prognosis. Patients with a late-stage diagnosis, either Stage 3 or Stage 4, will often choose this type of treatment because of the lack of curative treatment options. Although palliative mesothelioma treatment does not provide a cure, it has the potential to prolong life expectancy for pleural, peritoneal and pericardial mesothelioma patients.
If you have mesothelioma or are searching for information on behalf of a loved one, fill out the form on the right side of this page to receive a free informational packet that discusses everything you'll need to know about mesothelioma treatment.
Palliative Treatment for Pleural Mesothelioma
If aggressive surgery is not recommended for pleural mesothelioma patients, there are several palliative treatments that can help reduce symptoms and pain. Pleural mesothelioma symptoms generally include coughing, chest pain and shortness of breath. These symptoms result from tumors pressing against vital organs and pleural effusion, a condition marked by a buildup of fluid in the lungs.
Surgery:
Two palliative procedures that treat pleural effusion include a pleurodesis and a thoracentesis. Both procedures extract fluid through a tube and relieve pressure on the lungs in the process. A pleurodesis also eliminates the space where fluid can build up by using a talc-like substance to seal the space and is a more permanent fix to the problem, but some pain is felt during recovery.
After either one of these treatments, breathing should become easier and coughing should lessen. In one study, 92 percent of mesothelioma patients with pleural effusion experienced relief from shortness of breath following a pleurodesis that uses talc to seal the pleural space.
Chemotherapy:
Most often used in combination with or after surgery, chemotherapy is a palliative mesothelioma treatment option when used as a solo approach. However, chemotherapy does cause side effects like nausea, fatigue, vomiting, hair loss and lack of appetite. Such side effects are what some patients try to avoid when seeking palliative treatment and this may discourage them from trying chemotherapy.
For pleural mesothelioma, a combination of the medications pemetrexed (Alimta) and cisplatin is most often recommended. These chemotherapy drugs have demonstrated the ability to kill cancerous mesothelioma cells, relieve symptoms, improve quality of life and prolong survival in many patients.
Additionally, respiratory therapy can improve breathing and lung function in many mesothelioma patients.
Radiation Therapy:
This treatment is commonly utilized with surgery and chemotherapy to shrink tumors. When used alone, it can reduce tumor size to effectively relieve chest pain by relieving pressure on the lungs and chest. There are side effects associated with radiation therapy that some patients may wish to avoid when electing to receive palliative care, but sometimes the benefits can outweigh the side effects. Such side effects can include skin irritations, fatigue, pleural effusion and pulmonary toxicity if a high dosage is used.
Palliative Treatment for Peritoneal Mesothelioma
The majority of peritoneal mesothelioma patients are not candidates for curative surgery. Instead, doctors recommend a palliative treatment option that reduces symptoms, alleviates pain and improves overall quality of life while avoiding the rigorous recovery that follows surgery. The procedure is called a paracentesis, which removes fluid that has collected in the abdominal cavity, known as ascites. This treatment can relieve pain and reduce future complications concerning the bowels, kidneys and other parts of the digestive system caused by that fluid.
Another palliative treatment option that is considered standard care for peritoneal mesothelioma patients with debilitating ascites is cytoreductive surgery along with heated intraperitoneal (space in the abdominal cavity) chemotherapy. Although this procedure is more involved than most palliative options, it is still considered a palliative treatment. Cytoreductive surgery, or debulking surgery, is the surgical removal of part of the malignant tumor. This is performed when all of the tumor cannot be removed. After cytoreductive surgery, the efficacy of chemotherapy is significantly improved.
Although the implementation of chemotherapy following surgery has been successful, it's not always considered palliative because of the side effects. Another common treatment following mesothelioma surgery is radiation, but this is not the case for someone seeking palliative peritoneal mesothelioma treatment. This is because of the large volume of tissue that would require treatment when the peritoneal cavity is involved. The toxicities to the small bowel, liver, kidneys and other abdominal organs prevent radiation from being a palliative form of treatment.
Palliative Treatment for Pericardial Mesothelioma
Pericardial mesothelioma is a very rare type of the mesothelioma cancer, composing around 1 percent of all cases. Because of its rarity, there has been little research into developing treatments that can prolong life expectancy. Although surgery to remove cancerous tumors is an option in some cases, treatment for pericardial mesothelioma is almost strictly palliative, largely because of its proximity to the heart and the risk of complications.
The main palliative treatment option for pericardial mesothelioma patients is a pericardiocentesis. This procedure removes excess fluid in the pericardium, the sac that surrounds the heart. The purpose of a pericardiocentesis is to improve quality of life and reduce symptoms, which can consist of chest pain, coughing, difficulty breathing and an irregular heartbeat. Following a pericardiocentesis, the use of the chemotherapy medication cisplatin has been used with a low frequency of complications and may prolong life expectancy.
Pericardial mesothelioma is resistant to radiation as a single treatment approach and in combination with chemotherapy. The only effective chemotherapy drug for the palliative treatment of pericardial mesothelioma is gemcitabine, demonstrating as high as a 40 percent response rate. Other chemotherapy medications do not present a response and prognosis is not improved.
Alternative Palliative Care
Some mesothelioma patients may wish to avoid traditional treatment, even if it is considered palliative care. One of the most impactful decisions a cancer patient can make is electing to change their diet with the supervision of a dietician. There have been numerous cases where mesothelioma patients have extended their survival by eating the right foods and integrating supplements or healthy lifestyle changes. Such examples are Rhio O'connor and Paul Kraus, who used slippery elm bark, vitamin C and other holistic treatments to live longer than their expected survival. Any cancer patient should consult a nutritionist before making changes to their diet.
Patients can also benefit from a combination of common palliative care and alternative treatments, such as undergoing a pleurodesis and making nutritional changes. Since difficulty breathing is often a symptom of mesothelioma, patients may be able to improve their breathing patterns through respiratory therapy, meditation and yoga. If you'd like to understand more about palliative care for mesothelioma, call (800) 615-2270 to speak to one of our Patient Advocates.
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Last Modified Wednesday, May 16th, 2012 | Disclaimer | Privacy Policy |
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