Treatments for Mesothelioma and Asbestos Diseases

Personalized treatments using multimodal therapies and advanced technologies are helping patients live longer with mesothelioma. All patients undergo a treatment plan tailored to their unique case to give you the best chance at improving your prognosis and extending your life.

Treatment Overview

Mesothelioma treatments are administered by specialists at cancer centers across the nation. If you’ve been diagnosed with mesothelioma, it’s critical to work with a specialist who can provide the latest and most effective treatments.

Here is what every mesothelioma patient should know about receiving treatment for mesothelioma:

  • Treatments are available at every stage of mesothelioma
  • The primary treatment options for mesothelioma are surgery, chemotherapy and radiation
  • The most effective treatment plans include multiple approaches and therapies
  • New treatment forms are being tested in clinical trials and are available to many patients
  • Aggressive treatments can extend life by months or years

While there is no known cure for mesothelioma, patients who undergo a specialized treatment plan immediately following diagnosis are given a much higher chance at life-extension.

On average, aggressive surgeries extend a patient’s life expectancy by one year, and in many cases have extended life by 5 years or more.

3 Types of Mesothelioma Treatments

Several mesothelioma treatments exist. Not only are there multiple treatment types, but there are also several treatment combinations, giving patients further options to control and treat the disease.

There are 3 primary treatment types available to mesothelioma patients. Specialists may recommend all 3, depending on the unique case and how advanced the disease is.

The 3 primary treatment types are:

1. Surgery

Surgery is the most effective way to control mesothelioma and prevent it from spreading. During surgery, doctors cut open the chest or abdomen and physically remove all visible tumor masses and, in some cases, any surrounding tissues or partial organs. Doctors have developed different surgical procedures for different types of mesothelioma and some are considered more radical than others.

2. Chemotherapy

To stop cancer cells from multiplying and spreading to distant sites, doctors administer chemotherapy. As an anti-cancer drug, chemotherapy circulates throughout the patient’s body, killing off cancer cells in its path. Patients undergo multiple rounds of chemotherapy to improve its effectiveness. Depending on the treatment approach, chemotherapy may be given before, during or after surgery to increase the surgical success.

3. Radiation Therapy

Radiologists use machines to point high-energy rays directly at the tumor site. Powerful particles or waves scramble the DNA of the mesothelioma cells, preventing them from dividing and ultimately killing them off. When the cells die off, the tumor shrinks in size, allowing doctors to control the disease spread. Doctors may administer radiation before or after surgery or as a stand-alone palliative (end-stage) treatment.

Doctors administer these three standard treatments to patients in different stages. When each treatment type is administered depends on the unique case. Doctors develop treatment approaches primarily based on the mesothelioma location.

Pleural and peritoneal mesotheliomas are treated as a different disease because they have separate prognoses and treatment requirements.

Pleural Mesothelioma Treatments

Patients with pleural mesothelioma have multiple treatment options that can effectively extend their life expectancy. While there are many possible approaches doctors may take, in general, there are two main pleural mesothelioma treatment procedures. Each is a multimodal approach, meaning it uses more than one treatment type.

Each pleural mesothelioma procedure is different in its treatment philosophy though both produce similar life expectancy results. Ultimately, it’s up to the patient to decide which treatment approach they believe in after receiving consultation from a trusted mesothelioma specialist.

Extrapleural Pneumonectomy with Chemotherapy and/or Radiation

The first pleural mesothelioma treatment procedure is the extrapleural pneumonectomy (EPP) surgery.

Considered a more aggressive surgery, the EPP involves removing the diseased lung and the entire pleura, as well as a portion of the diaphragm and pericardium (lung lining). The goal of this surgery is to limit metastasis (spreading to distant sites).

By removing the surrounding tissue, doctors get rid of areas that may have already been infiltrated by mesothelioma cells to prevent the risk of metastasis. Before surgery (neoadjuvant), patients may undergo chemotherapy to kill mesothelioma cells and improve the effectiveness of the surgery.

Doctors may prescribe a combination of chemotherapy drugs, with cisplatin and pemetrexed being the most common formula.

During surgery, patients may also receive an intrapleural injection of chemotherapy directly into the chest through a catheter. Administering chemotherapy during surgery helps kill any remaining cancer cells that the surgeon couldn’t remove.

Post-surgery (adjuvant), all patients receive further rounds of chemotherapy. Doctors may also give intensity modulated radiation therapy (IMRT), which is computerized radiation that sends pre-measured doses directly to the tumor site to kill off remaining mesothelioma cells.

Aggressive surgeries like the EPP procedure are only given to patients who are healthy enough to withstand the surgery and recovery. Multimodal treatment with EPP is an approach that gives patients a significant improvement in life expectancy.

Most studies show that patients can survive up to 2 years with this procedure while some studies have shown a survival of nearly 4 years.

Pleurectomy / Decortication with Chemotherapy and/or Radiation

The second pleural mesothelioma treatment approach includes the pleurectomy with decortication (P/D) surgery.

P/D is a lung-sparing surgery where doctors only remove the diseased pleura (lung lining) and leave the lung. Some experts consider this procedure to be less risky than the EPP— it may give the patient a better quality of life by allowing them to keep their lung.

Patients receive chemotherapy treatment before undergoing the P/D surgery to kill mesothelioma cells and help shrink the tumors.

Reducing the tumor’s size makes it easier for surgeons to remove the pleura and as much of the mesothelioma as possible during surgery.

After the surgery, patients remain on chemotherapy for several more weeks to further ensure surgical success and prevent recurrence (when the mesothelioma comes back). Patients may also receive radiation therapy to support the surgery.

The median life expectancy of patients who receive the P/D procedure is around 29 months.

Some studies have shown a high 5-year survival rate in stage 1 pleural mesothelioma patients. P/D has also shown to have a lower short-term postoperative mortality rate. Fewer patients develop fatal complications during or within 30 days after surgery compared to patients who undergo EPP.

Peritoneal Mesothelioma Treatments

Specialists consider peritoneal mesothelioma the easiest disease location to treat. Patients can expect a personalized peritoneal mesothelioma treatment plan that will address their unique case by debulking tumors, stopping and controlling the spread of the disease or draining fluid buildup from the abdomen.

The primary surgical procedure for treating peritoneal mesothelioma is called cytoreduction with HIPEC. It was developed by Dr. Paul Sugarbaker as a curative surgery, meaning the procedure’s goal is to remove all malignant (cancerous) tissue.

Several studies, including one by the National Cancer Institute, have shown that the median life expectancy of patients after receiving cytoreduction with HIPEC is up to 7 years, though many patients have survived much longer.

Surgeons perform cytoreduction with HIPEC in two parts:

  1. Cytoreductive Surgery: Surgeons remove the entire diseased peritoneum (abdominal lining) and any tumors or diseased tissue surrounding the abdominal cavity. By removing as much malignant tissue as possible, doctors control and potentially stop the spread of the tumors from the abdominal cavity to distant sites.
  2. Heated Intraperitoneal Chemotherapy (HIPEC): While the patient is undergoing cytoreductive surgery, the doctor administers chemotherapy directly into the abdominal cavity. The chemotherapy drugs are first heated and then allowed to circulate throughout the abdomen for up to 90 minutes to kill off any remaining, invisible mesothelioma cells.

All peritoneal mesothelioma patients receive neoadjuvant chemotherapy and radiation post operation. A combination of chemotherapy drugs administered after cytoreductive surgery helps to inhibit mesothelioma cell regrowth and stop the growth of certain proteins that promote tumor development.

For the right candidate, cytoreduction with HIPEC is a critical and lifesaving procedure that can lead to partial or full remission. For others, it helps to improve prognosis and life expectancy by several months or years.

Overall, cytoreduction with HIPEC is a proven peritoneal mesothelioma treatment that can significantly improve a patient’s quality of life.

New and Novel Treatments

Private organizations and foundations are currently funding important mesothelioma treatment research. New and novel treatments are being tested in clinical trial settings. Many mesothelioma patients are good candidates for undergoing these potentially life-extending treatments.

Clinical trials are an excellent treatment option for patients with advanced mesothelioma or who have stopped responding to treatments. Other patients who were previously treated with standard mesothelioma treatments and who are experiencing recurrence (when the mesothelioma comes back) can also benefit from advanced treatments in clinical trials.

Testing new treatments in clinical trials is essential for the research community and its goal of finding a cure for mesothelioma. Clinical trials take place in a safe and controlled environment that allows researchers to test the safety and effectiveness of treatments and treatment combinations while offering patients renewed hope at improving their quality of life.

Mesothelioma Treatment Goals

Before doctors recommend treatments, they consider multiple factors in each patient case. Two of these factors are:

  1. The rate at which the mesothelioma is spreading and
  2. How far the mesothelioma has already spread.

The treatment goals for a patient with stage 2 mesothelioma are different than the treatment goals for a patient with stage 4 mesothelioma.

While all treatments aim to improve patient quality of life and give the patient the best chance at survival, early-stage cancer is much easier to control and stop than end-stage cancer.

Here are some of the possible mesothelioma treatment goals, depending on the treatment approach to an individual case:

  • Remove as much of the tumor as possible (surgery)
  • Shrink tumors in size
  • Kill mesothelioma cells
  • Stop the mesothelioma from spreading to distant sites
  • Alleviate fluid buildup in the mesothelium linings
  • Manage pain and symptoms
  • Increase comfort and quality of life

Patients who are deemed good candidates, such as those who have stopped responding to other treatments, can also undergo treatments in clinical trial settings. The goal in these cases is to administer new and novel therapies to patients and possibly give them a revived chance at extending their life.

Many patients who stopped responding to chemotherapy and radiation have undergone treatments in clinical trials and have extended their life by several months.

How to Get Mesothelioma Treatment

Patients diagnosed with mesothelioma receive treatment from mesothelioma specialists. Only experienced surgeons specializing in the treatment of mesothelioma and rare chest or abdominal cancers can effectively treat mesothelioma.

It’s important to seek treatment from a specialist who specializes in treating your exact location, stage and cell type.

Patients can undergo treatment at any of the specialized mesothelioma treatment programs at the various cancer centers across the country. Here, patients will work with a full team of treatment specialists who will assess, plan and recommend a targeted treatment plan for your unique case.

Some of the nation’s top mesothelioma doctors providing personalized treatment plans include:

  • Dr. Avi Lebenthal: Pleural mesothelioma specialist at Brigham and Women’s Hospital, Boston MA
  • Dr. Paul Sugarbaker: Peritoneal mesothelioma specialist at Washington Cancer Institute, Washington DC
  • Dr. David Sugarbaker: Pleural mesothelioma specialist at Baylor St. Luke’s Medical Center, Houston TX

You can begin receiving treatment at any of the top cancer centers in the country by contacting a center near you and booking a consultation.

Compensation for Mesothelioma Treatment

If you’ve been diagnosed with mesothelioma and are undergoing treatment, you may be eligible for compensation. Anyone who has developed mesothelioma as a result of their exposure in the workplace or their time served in the military is a victim of negligence on the part of the asbestos manufacturers.

Companies knowingly sold and distributed dangerous asbestos products and concealed any knowledge they had regarding health risks. As a result, many former industrial workers and veterans have developed mesothelioma and other asbestos-related diseases.

Veterans are eligible for medical benefits through the VA, whether you are an active duty member or a retired member. Both civilians and veterans may be eligible for legal compensation through asbestos claims and trust funds.

If you have a work history that exposed you to asbestos products, then it’s important to get the compensation you’re entitled to. Legal compensation can not only cover your treatment costs but any incidental expenses and damages as well.

The best way to get the full amount of compensation you’re entitled to be by working with a specialized mesothelioma lawyer. Contact The Mesothelioma Justice Network to speak to one our claims advocates today to get the compensation you need to ensure you get the best treatment options possible.

View Author and Sources
Sources
  1. Cancer Research UK, “Surgery for pleural mesothelioma” Retrieved from: http://www.cancerresearchuk.org/about-cancer/mesothelioma/treatment/surgery/pleural. Accessed on December 1, 2017.
  2. Canadian Cancer Society, “Treatments for Mesothelioma.” Retrieved from: http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/treatment/?region=on. Accessed on December 1, 2017.
  3. US National Library of Medicine, “A nuanced view of extrapleural pneumonectomy for malignant pleural mesothelioma.” Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5497104/. Accessed on December 1, 2017.
  4. The Annals of Thoracic Surgery, “Meta-Analysis of Survival After Pleurectomy Decortication Versus Extrapleural Pneumonectomy in Mesothelioma.” Retrieved from: http://www.annalsthoracicsurgery.org/article/S0003-4975(14)01926-2/fulltext. Accessed on December 1, 2017.
  5. American Cancer Society, “Treatments for Mesothelioma Based on the Extent of the Cancer.” Retrieved from: https://www.cancer.org/cancer/malignant-mesothelioma/treating/by-extent.html. Accessed on December 1, 2017.
  6. Cancer Research UK, “Treatment decisions for peritoneal mesothelioma.” Retrieved from: http://www.cancerresearchuk.org/about-cancer/mesothelioma/treatment/decisions-peritoneal. Accessed on December 1, 2017.

Last modified: May 8, 2018