Webinar Recap: Top Mesothelioma Specialists Discuss Customized Care

The Mesothelioma Center hosted a webinar designed to give people diagnosed with mesothelioma and their families clear, useful information about personalized treatment choices. Understanding these choices can help you take an active role in your care and feel more confident as you navigate next steps. 

Registered Nurse and Board Certified Patient Advocate Karen Selby led the discussion. Karen has supported people and families through mesothelioma for 15 years, offering trusted guidance and support. The panel included two leading experts: oncologist Dr. Hedy Lee Kindler and thoracic surgeon Dr. Jeffrey Velotta, both mesothelioma specialists.

Dr. Kindler is an internationally recognized expert in mesothelioma. She serves as associate vice chair for clinical research at University of Chicago Medicine. Dr. Kindler has authored more than 160 book chapters and articles and works as an associate editor of the medical journal Lung Cancer. Her leadership shapes effective treatment choices.

Dr. Velotta treats patients at Kaiser Permanente Oakland Medical Center in California. He also teaches as a clinical assistant surgical professor at the University of California San Francisco School of Medicine. His research moves mesothelioma care forward and expands treatment options.

During the webinar, the panel described how specialists use key details to create mesothelioma treatment plans tailored to each person. They talked about systemic therapies, the benefits of working with a team and the value of getting a second opinion. The experts also clarified common myths about mesothelioma care. These insights can help you make decisions that fit your needs.

If you or someone you love is facing mesothelioma cancer, this webinar connects you with expert knowledge and practical tips for discussing treatment with your care team and your family. You can request access to the full recording to learn more about how personalized care may work for you.

Key Factors for Creating a Mesothelioma Treatment Plan

When doctors create a mesothelioma treatment plan for you, they’ll carefully consider several important factors. Mesothelioma cell types play a major role. Epithelioid cells, for example, usually respond better to treatment and have a more favorable outlook. Your overall health, age and any other medical conditions also affect which treatments are safe for you and how well you might tolerate them.

How far the cancer has progressed, known as the mesothelioma stage, matters as well. Early stages may allow for aggressive options such as surgery combined with regional chemotherapy like HIPEC for peritoneal mesothelioma or HITHOC for pleural mesothelioma. Advanced stages often require systemic chemo or immunotherapy when surgery is no longer feasible.

List title: Factors When Considering a Mesothelioma Treatment Plan 

• Cell type: Epithelioid, sarcomatoid or biphasic mesothelioma cells influence treatment response and outlook.
• Mesothelioma stage: The extent of the cancer, or how far mesothelioma has spread, affects treatment options and likely outcomes.
• Type of mesothelioma: Treatment differs depending on whether your mesothelioma developed in the lining of the lungs (pleura) or the lining of the belly (peritoneum).
• Your goals, overall health and age: These shape treatment choices and tolerances, especially if you have other medical conditions.

Dr. Kindler and Dr. Velotta reminded participants all patients are unique individuals and treatment needs to be personalized. Mesothelioma treatment isn’t a one-size-fits-all situation. 

“When I see patients, whether they’re going to be a surgery candidate or not, we really try to hone in on what their stage is,” Dr. Velotta explained.  “That is helped by a nice CT scan with IV contrast. Like a good CT scan, not just kind of a low dose CT scan. That really does help.”

Systemic Therapies for Mesothelioma 

Dr. Kindler explains that with many treatment options available today, systemic therapies form the foundation of care for many people with mesothelioma. Systemic treatment means therapies that work throughout your body rather than targeting a single area. 

“Even if you have surgery, you usually need additional treatment such as chemotherapy or immunotherapy,” Dr. Kindler states. “Surgery is like peeling the white stuff off an orange. There is always a little bit of sticky stuff left at the edges, so you need systemic therapy to mop it up before or after. For patients who cannot have surgery, systemic treatment is still important to control the cancer.”

Your overall health plays a crucial role in choosing the best systemic therapy for mesothelioma. For example, immunotherapy may not be the best option if you have an autoimmune disease such as multiple sclerosis or rheumatoid arthritis because it can worsen symptoms. In these cases, chemo could be safer and more effective.

Dr. Velotta adds, “On the other hand, if your kidney function is poor or you have other medical issues, chemotherapy may not be right for you. The doctor must present the full range of treatment options and tailor the plan based on your goals, cell type and medical history.”

Surgical Treatment for Mesothelioma

Dr. Velotta explains when doctors create a treatment plan for you as a candidate for mesothelioma surgery, they focus first on what you want. This patient-centered approach puts your preferences and goals ahead of medical decisions.

He says, “So I look at: What do they want? Do they want to get treatment? Do they know what that entails?”

Next, he says he considers the location and type of mesothelioma. He adds, “Where is the cancer located? On one side? In other areas of the body? And what type of mesothelioma do you have?”

Dr. Velotta  emphasizes the importance of biopsy results. He adds that the pathology report contains critical information. He emphasizes, “This is really important with mesothelioma for surgeons. More and more we’ve learned epithelioid mesothelioma is more optimal for surgery. We really want to home in on what kind of mesothelioma you have.”

Dr. Velotta also stresses the importance of your physical condition. He asks if you can comfortably walk up a few flights of stairs, evaluates your lung function and checks if you need oxygen support. He also looks at weight loss. Extreme weight loss suggests you may not tolerate surgery well. 

He adds that some weight loss is to be expected. Dr. Velotta notes, “But if their weight is maintained, that helps me a lot in determining how they’ll tolerate an operation.”

The Importance of a Multidisciplinary Approach

Both Dr. Kindler  and Dr. Velotta stressed that surgery alone isn’t enough. Multidisciplinary care is key. This means you receive care from several medical specialists working together to ensure you get care tailored to your specific needs.

 Dr. Kindler explained, “At the University of Chicago, all of our patients are presented in our weekly mesothelioma multidisciplinary conference, which includes not merely me as the medical oncologist. But we also have symptom management specialists and palliative care specialists,”

“We have surgeons, we have radiologists who specialize in mesothelioma, and very importantly, the pathologist,” Dr. Kindler added. “Because it’s the pathologist who’s going to tell us not merely, is it epithelial, sarcomatoid or mixed, but what is the grade? How aggressive does it look?” 

She noted that cancer geneticists are critical members of the team. She explained, “We’re also looking at the molecular markers of the tumors.” She also said translational scientists are also key team members. Translational scientists help connect discoveries made in the lab with real treatments for people. They work to turn scientific findings into new ways to diagnose, treat or manage mesothelioma. They help move research from the lab to the clinic, making sure what scientists learn leads to better care as quickly and effectively as possible.

“Even after many years of being an experienced mesothelioma physician, I still rely upon my radiologist to show me some of the subtleties,” Dr. Kindler shared. I rely upon my pathologist to discuss some of the subtleties with the pathology.”

What Mesothelioma Patients Need to Know About Second Opinions

Dr. Kindler encourages you to ask for a second opinion so you can feel confident your treatment plan is right for you. Getting another expert’s perspective is easiest before starting mesothelioma treatment, since switching plans partway through usually isn’t possible.

She reassures you that it’s perfectly normal to seek another expert’s advice. She explained,, “Any doctor worth their salt isn’t going to object if an expert in a disease helps them guide the patient’s treatment. So you’re not going to offend your primary oncologist if you say, ‘Would it be okay if I got a second opinion?’ Because after all, it’s highly unlikely that they’re an expert in this disease. And even if they are, they’re not going to mind.”

Dr. Velotta agrees that talking to more than one specialist can help. A second opinion can confirm and clarify details of your diagnosis. You’ll also connect with mesothelioma doctors, which can open up new possibilities for your treatment.

Myths About Mesothelioma Treatment

The panel addressed several common myths about mesothelioma treatment. Some people think clinical trials are only for late-stage patients as a last option. Others believe surgery isn’t possible once you reach a certain age. 

Another myth says that treatment isn’t necessary because mesothelioma can’t be cured. Dr. Kindler explained that even though mesothelioma isn’t curable, treatment is still very important. 

She explained, “I like to think of this as a chronic disease, just like diabetes. When a patient’s diagnosed with new onset diabetes, they don’t say, ‘Oh my gosh, I’ve got terminal diabetes.’ They say, ‘Oh, I have to exercise and change my diet and take a pill. Now I need to take a few more pills. Now I need to take some shots and get my eyes checked and my kidneys checked.’ Well, the same thing with mesothelioma.”

Her point aligns with research and medical understanding. Without treatment, symptoms tend to worsen faster and survival time is shorter. Treatment helps you manage symptoms, which improves your quality of life.