Mesothelioma Treatment Options

Mesothelioma survivors are living longer thanks to advances in therapy and a shift toward personalized care at treatment centers nationwide. Hope for tomorrow is replacing the gloom and doom of the past.

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Dr. Jacques Fontaine sits down exclusively with Asbestos.com to talk about the treatment options available for mesothelioma patients.

Doctors offer three primary types of treatment to malignant mesothelioma patients: Surgery, chemotherapy and radiation. The types of treatment you receive depend on your diagnosis, the stage and type of your mesothelioma and your overall health.

If the cancer has not yet spread, a combination of radiation, surgery and chemotherapy likely will be offered to you. This combined approach to treatment is called multimodal therapy.

If the mesothelioma already has spread significantly, doctors typically recommend palliative treatments that can help alleviate pain, breathing problems and other cancer symptoms that lessen your quality of life. You are still likely to be offered radiation and chemotherapy, but probably not major surgery options.

Radiation therapy can soothe pain and correct breathing issues by shrinking tumors that press on your nerves, veins and airways. Chemotherapy also shrinks tumors, helping with chest pain and night sweats. Non-curative surgeries can remove tumors that cause troublesome symptoms, or drain fluid that builds up in the chest or abdomen.

You may also want to talk to your doctor about other treatment options beyond surgery, chemotherapy and radiation therapy. Experimental treatments exist, mostly in clinical trials, and sometimes they can make a huge difference.

Some patients also pursue alternative treatments like massage therapy, acupuncture or yoga. These can often be added to standard treatments like chemotherapy, so talk with your doctor about which therapies you'd like to explore.

What Are the Common Treatments for Mesothelioma?

Mesothelioma Surgery

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If your cancer is relatively contained in the lining around the lungs or the abdomen, you may be eligible for aggressive surgery. This option can be potentially curative. In addition to an aggressive surgery, you may be given some type of radiation and chemotherapy with the goal of killing the cancer cells that are left behind after surgery.

There also are less traumatic and more palliative surgeries available. Often these are used if you are not healthy enough to withstand the strain of a major surgery, or if the cancer already has spread. The goal of these surgeries is to relieve some of your symptoms and help you to feel better. You may also have chemotherapy and radiation before or after these surgeries.

Surgeries for Mesothelioma Include:

Learn more about mesothelioma surgery

Chemotherapy

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Chemotherapy is used in treating most types of cancer, including mesothelioma. Chemotherapy drugs, which are usually delivered by an IV into a vein in your arm, are designed to kill cancer cells.

The most common and most successful chemotherapy drugs for someone with mesothelioma are cisplatin and pemetrexed. A milder chemotherapy cocktail that uses pemetrexed with carboplatin often achieves the same results but with fewer side effects.

If you have peritoneal mesothelioma, your doctor may suggest a multimodal treatment called heated intraperitoneal chemotherapy (HIPEC). Also known as heated chemotherapy, this therapy is given immediately after surgery to help kill off the microscopic cancer cells that surgeons unavoidably miss. In one study involving more than 400 peritoneal patients, overall median survival after HIPEC extended beyond four years.

Because chemotherapy drugs affect cancer cells as well as healthy cells, you may feel worse after treatment. This is why some patients choose not to have chemotherapy. For many people, however, this feeling and other negative side effects wear off over time, and they experience notable improvements. A good specialist can help you understand your options.

The common chemotherapy drugs for mesothelioma are:

Learn more about chemotherapy

Radiation Therapy

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Radiation therapy is noninvasive and uses high-energy rays to target the cancer. It is typically paired with other treatment options to help shrink tumors or manage tumor growth. It doesn't have the strong side effects that chemotherapy does, and it often helps reduce the physical pain of mesothelioma.

However, because radiation can be toxic to various organs, and damages DNA while killing cancer cells, it is used sparingly and only with certain types of mesothelioma. Radiation also can be used in a palliative situation when surgery is no longer an option.

There are two main types of radiation:

Learn more about radiation therapy

Multimodal Therapy

Multimodal Icon

While each cancer treatment option may have benefits by itself, cancer specialists often opt for a more effective multimodal approach — a patient-tailored mix of surgery, chemotherapy and radiation. This strategy involves specialists in each field putting together a plan that is right for you.

Some people who try this multi-faceted approach are able to control mesothelioma. The key is involving specialists in each of the fields working together.

Learn more about multimodal therapy

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Free information for patients and caregivers to better understand their treatment options.

Get a Free Mesothelioma Guide

Free information for patients and caregivers to better understand their treatment options.

Who Are the Leading Mesothelioma Treatment Specialists?

The top specialists work at recognized mesothelioma centers. Some of the best known mesothelioma specialists, like Dr. David Sugarbaker, at Baylor College of Medicine, trained young surgeons who have moved on to other cities and treatment centers. Surgeons like Dr. Jacques Fontaine, at the Moffitt Cancer Center in Tampa or Dr. Alexander Farivar, at the Swedish Medical Center in Seattle, took Sugarbaker's expertise to others around the country.

Dr. David Sugarbaker

Dr. David Sugarbaker

Thoracic Surgery Baylor College of Medicine

Sugarbaker is a leading authority in mesothelioma treatment and current director of the Lung Institute at Baylor College of Medicine. He developed the highly successful extrapleural pneumonectomy surgery for pleural mesothelioma.

Contact Dr. Sugarbaker
Dr. Robert Cameron

Dr. Robert Cameron

Thoracic Surgery UCLA Medical Center

Cameron advises his patients against aggressive surgery and instead recommends a P/D, a lung-sparing mesothelioma surgery he pioneered. His approach removes tumors and treats the cancer as a chronic illness.

Contact Dr. Cameron
Dr. Rodney Landreneau

Dr. Rodney Landreneau

Thoracic Surgery Allegheny General Hospital

Landreneau left the highly regarded University of Pittsburgh Medical Center in 2013 after 20 years of service. He is now at Allegheny General Hospital, using his expertise in mesothelioma to treat patients from across the Northeast.

Contact Dr. Landreneau
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What is the Average Cost for Mesothelioma Treatment?

Mesothelioma treatment can be expensive if you don't have health insurance or financial resources, and cost is difficult to pinpoint because every diagnosis is unique.

The average cost of lung cancer surgery, which is comparable to mesothelioma surgery, is $39,891. Chemotherapy costs vary depending on the type of cancer, the drugs used and patient-specific factors, but can reach as high as $30,000 over an eight-week period.

Radiation therapy is estimated to cost about $2,000 per month, but the total expense depends on your health coverage and the number of treatments you receive.

If you can't afford to travel to a specialist, ask for assistance. Some facilities offer travel grants that include temporary housing. Some centers have resources to help with expenses. Others are willing to work with your local oncologist to come up with a treatment plan that best fits your needs.

Financial assistance expert Joe Lahav knows the intricacies of how to secure financial help for treatment, travel and other related expenses.

Get Help Paying for Mesothelioma Treatment

What Emerging Mesothelioma Treatments and Clinical Trials Are Available?

Some people with malignant mesothelioma have found unexpected success with clinical trials exploring the latest approaches to therapy. While there are no guarantees, this is where future cancer treatments are being developed. Being in a clinical trial may benefit you, but it also will benefit others in the future as scientists search for more effective therapies.

The future of mesothelioma treatment almost certainly involves therapies still being developed, so do not hesitate to ask your doctor about new treatments. There may be tremendous potential with immunotherapy, gene therapy and photodynamic therapy. All are being used in clinical trials and could become standard treatment at some point.

Surgery Icon

Immunotherapy

Immunotherapy helps you use your own immune system to fight off the cancer growth. Some types of immunotherapy are referred to as vaccination therapy. The therapy is only available in clinical trials right now, but some researchers believe it is the future of cancer treatment.

Learn about immunotherapy
Chemotherapy Icon

Gene Therapy

Gene therapy aims to treat or prevent cancer by injecting genetic material into the body. One form called suicide gene therapy targets cancer cells and causes them to die. This treatment is currently being tested on mesothelioma patients in clinical trials.

Learn about gene therapy
Radiation Icon

Photodynamic Therapy

Photodynamic therapy uses light energy to kill cancer cells. First, doctors inject a light-sensitive drug into the patient. After a few days, a special light is applied to the area, usually via laser, to activate the drug. This causes a reaction that kills cancer cells.

More photodynamic therapy

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What Complementary and Alternative Medicines Are Available?

Complementary and alternative medicine (CAM) options don't treat the disease itself, but concentrate on the patient mentally, emotionally and physically. They can be used alongside more traditional approaches to cancer treatment.

Treatments like massage, acupuncture, yoga, naturopathy and aromatherapy can be used to relieve the pain from mesothelioma, or reduce stress that comes from traditional treatment. Meditation also helps some patients. Patients in many states have access to medical marijuana, which can help control cancer pain.

CAM Treatments for Mesothelioma Include:

Where Are the Top Mesothelioma Treatment Centers?

Mesothelioma is not a disease that can be treated at any hospital. There are an estimated 3,000 cases annually diagnosed in the U.S., and many doctors around the country never treat it — or even see it. If you have mesothelioma and live near a cancer center that specializes in treating this disease, consider yourself fortunate. This will make your medical care easier for you. A number of treatment facilities are clustered in the Northeast, near New York, Boston and Philadelphia.

Brigham and Women's Hospital

Brigham and Women's Hospital

Brigham and Women's is home to the International Mesothelioma Program, the largest mesothelioma specialty center of its kind.

Ochsner Cancer Institute

Ochsner Cancer Institute

The Ochsner Cancer Institute — the most advanced cancer center on the Gulf Coast — offers a thriving clinical trial program for mesothelioma.

The H. Lee Moffitt Cancer Center

The H. Lee Moffitt Cancer Center

The Mesothelioma Research and Treatment Center at Moffitt boasts a talented team of physicians who specialize in mesothelioma.

UPMC Cancer Center

UPMC Cancer Center

The Mesothelioma Specialty Care program at UPMC offers cutting-edge treatments for mesothelioma, including heated chemotherapy for peritoneal cancer.

Fox Chase Cancer Center

Fox Chase Cancer Center

Fox Chase combines advanced mesothelioma therapies with expert research and clinical trials. The center is a nationally recognized leader in cancer care.

Mount Sinai Hospital

Mount Sinai Hospital

Mesothelioma experts at Mount Sinai offer personalized treatment plans that may include lung-sparing surgery, chemotherapy and radiation therapy.

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Free information for patients and caregivers to better understand their treatment options.

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Mesothelioma Treatment Timeline

Mesothelioma Treatment Timeline

The treatment timeline that a patient goes through varies depending on type. The following are steps one would see based on a mesothelioma diagnosis.

  • Step 1

    Diagnosis

    The doctor gives the person a diagnosis usually two to three months after symptoms appear.

  • Step 2

    Biopsy

    Doctor orders a biopsy and recommends a specialist to the person diagnosed. Biopsy confirmation can take up to 10 days.

  • Step 3

    Appointment with Specialist

    It usually takes a week for a surgeon or oncologist to meet with the person diagnosed after biopsy confirmation.

  • Step 4

    More Tests

    Surgeon or oncologist orders additional biopsies, X-rays, CT scans, MRIs, PET scans, stress tests and other tests to determine stage and surgery eligibility.

  • Step 5

    Treatment Plan

    If person is eligible for surgery, the surgeon will schedule the procedure, depending on their availability.

    If person is not eligible for surgery, they will schedule an appointment with an oncologist for other treatment options, including chemotherapy and radiation.

    • If treatment path is chemotherapy, then person receives chemotherapy within first few days.
    • Chemotherapy is delivered in three to four rounds every 21 days.
    • Follow-up CT scans are ordered to see progress.
    • More chemotherapy rounds may be ordered or oncologist may recommend a combination of treatments.

Need Help Finding a Doctor?

Getting you on the right treatment path is the key to living a better life, and it begins with finding you the best mesothelioma specialist. Medical Outreach Director Missy Edmunds makes your search easy.

Missy, who has a degree in psychology, enjoys the human experience — especially when it comes to connecting people. Her role at The Mesothelioma Center is to connect people with mesothelioma and their loved ones to services they need such as a doctor who understands their condition, and one who can craft a treatment plan that's best for them.

Missy Edmunds

Call Missy Now to Find Your Doctor (855) 404-4592

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Author

Karen Selby joined Asbestos.com in 2009. She is a registered nurse with a background in oncology and thoracic surgery and was the director of a tissue bank before becoming a Patient Advocate at The Mesothelioma Center. Karen has assisted surgeons with thoracic surgeries such as lung resections, lung transplants, pneumonectomies, pleurectomies and wedge resections.

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  5. Munkholm-Larsen, S., Cao, C. Q., and Yan, T. D. (2009). Malignant pleural mesothelioma. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2999110/?tool=pubmed
  6. Stahel, R.A., Weder, W., Lievens, Y., and Felip, E. (2010). Malignant pleural mesothelioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Retrieved from http://annonc.oxfordjournals.org/content/21/suppl_5/v126.long
  7. National Comprehensive Cancer Network. (2012). National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Malignant pleural mesothelioma. Version 2.2012.

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