Best Treatment for Mesothelioma Cancer (Complete)

Best Treatment for Mesothelioma Cancer (Complete)
Best Treatment for Mesothelioma Cancer (Complete)

There are treatment options available for patients with all stages of mesothelioma and include surgery, chemotherapy, radiation and new clinical options.

What Are My Treatment Options?

There are several treatment options for patients with mesothelioma, from surgery to chemotherapy. These treatment options are not typically considered a cure for mesothelioma patients, although patients have reached remission in certain cases. These cases are typically situations where the disease was caught in the earliest stages and treated aggressively by a specialist.

Surgical options are available for both curative and pain-relief purposes for all types of mesothelioma. Recovery from surgery can last several weeks.

Surgery is the primary curative treatment option for mesothelioma patients. It is used with chemotherapy and radiation, which can increase overall success rate.

Improving Survival and Reducing Pain

There are surgical options for patients with all stages of mesothelioma. In early stages of mesothelioma, surgery has helped improve survival times and some patients even reach remission. In later stages of mesothelioma, surgery provides comfort and relieves pain.

Curative Surgical Options

1. Extrapleural Pneumonectomy (EPP)

Usually used on stage 1 and 2 pleural mesothelioma patients, an EPP is the complete removal of the affected lung, pleura, and part of the diaphragm.

2. Pleurectomy/Decortication (P/D)

A P/D is the removal of the lung’s lining and any visible tumors. Stage 1 pleural mesothelioma patients commonly receive a pleurectomy to remove cancerous tumors.

3. Cytoreduction with HIPEC

A cytoreduction is the removal of the lining of the abdomen, called the peritoneum. This surgery is often combined with heated intraoperative chemotherapy (HIPEC).

There are different types of surgeons that specialize in various types of mesothelioma. Patients with pleural or pericardial mesothelioma are referred to a thoracic surgeon. Thoracic surgeons perform surgery on the heart, lungs, and other areas of the chest that are affected by cancer. Patients with peritoneal mesothelioma are referred to a gastrointestinal surgeon. These surgeons specifically handle cancers of the abdomen, like peritoneal mesothelioma.

Some of the surgical options available to mesothelioma patients require a lot of recovery time. Each specific surgery has its own recovery process. Patients should understand the details of mesothelioma surgery recovery before they decide to undergo a surgical treatment.

Surgery for Pleural Mesothelioma: EPP vs P/D

The two main methods of surgery for pleural mesothelioma are the extrapleural pneumonectomy (EPP) and the pleurectomy with decortication (P/D). Surgeons often prefer one or the other, even though both surgeries are usually personalized for the patient. The EPP vs P/D debate has to do with whether or not it is necessary to remove the patient’s lung to treat their pleural mesothelioma.

The EPP surgery was one of the first surgeries developed for pleural mesothelioma. This surgery involves removing the lung that has been affected by mesothelioma. Surgeons hope that they can remove more of the cancer by removing the whole lung.

Some surgeons worry about the patient’s quality of life with only one lung and prefer to not perform the EPP. The P/D surgery was developed as an alternative to the EPP. During the P/D surgery, surgeons remove the lining of the mesothelioma-affected lung, but not the entire lung.

Extrapleural Pneumonectomy (EPP)

The extrapleural pneumonectomy (EPP) was the first potentially curative surgery for pleural mesothelioma. It was developed by Dr. David Sugarbaker.

This surgery involves the removal of the entire affected lung, the lining of the lung (pleura), the lining of the heart (pericardium), and a section of the diaphragm. A patch made from Gore-Tex breathable fabric is inserted to stabilize the chest wall and fill the cavity.

The primary goal of an EPP is to remove all cancerous material and reroute all blood vessels to keep cancer cells from spreading. In many cases, this can also keep cancer from returning.

The EPP is a radical procedure and not generally suggested for later stage patients due to the risks that are associated with the surgery.

A study by Dr. Sugarbaker concluded that the average hospital recovery time after an EPP is 10 to 14 days. Patients take an additional six to eight weeks to recover outside the hospital. The extrapleural pneumonectomy has become safer than ever before.

1. Multimodal Treatment with EPP

Mesothelioma surgery is most successful when combined with other treatment options. Patients who were treated with surgery alone saw average survival times of approximately one year.

However, about 65 percent of all patients who underwent surgery combined with other treatments, like chemotherapy or radiation, lived at least two years past their initial surgery.

Patients are given chemotherapy and radiation to help prevent future mesothelioma growth. The combination of cisplatin and Alimta is the most common form of intravenous chemotherapy given.

After an EPP, patients are most likely to receive intensity-modulated radiation therapy to kill any remaining cancer cells in the chest cavity. Since the entire affected lung is removed, the patient usually takes part in post-surgery respiratory therapy.

2. Mortality Rates in EPPs

In 1976, a report by Dr. Eric Butchart stated that the mortality rate of an EPP was 31 percent. Mortality rates for patients undergoing an EPP have improved drastically over that last few decades and are now at approximately 7 percent.

However, in 2005, Dr. Sugarbaker and his colleagues stated the mortality rate, specifically at Brigham and Women’s Hospital, had improved to 3.4 percent. Dr. Sugarbaker and his team have advanced and nearly perfected the extrapleural pneumonectomy procedure.

The average survival time for patients who receive an EPP is 19 months. Fifteen percent of patients are still alive five years after their surgery. Complications that can stem from an extrapleural pneumonectomy include: hemorrhaging, increased heart rate, difficulty breathing, and fluid buildup in the remaining lung.

Pleurectomy with Decortication (P/D)

A pleurectomy with decortication (P/D) is a lung-sparing surgery innovated by Dr. Robert Cameron of UCLA Medical Center.

This procedure developed out of the belief that the extrapleural pneumonectomy was an outdated procedure. This has sparked a controversial treatment debate between the 2 procedures.

A P/D involves the removal of the pleura (mesothelium) surrounding the lung that is affected by mesothelioma. It is usually performed in patients with stage 1 or early stage 2 mesothelioma. These patients have cancer that has not spread beyond the site of origin, and this surgery may keep it from metastasizing.

A P/D also prevents pleural effusions in these early stage patients because liquid can no longer build up in the pleura if it is removed. Patients who receive this surgery tend to have a better quality of life after surgery.

1. Multimodal Treatment with P/D

Chemotherapy and radiation are often used before and after surgery to ensure that as many cancer cells are killed as possible. Similar to the extrapleural pneumonectomy, patients are commonly given the combination of cisplatin and Alimta after surgery. The combination of different modes of treatment improves survival rates considerably compared to surgery alone.

External beam radiation and intraoperative radiation therapy (IORT) are common forms of radiation that are used in patients receiving a pleurectomy with decortication. IORT is becoming more common because radiation can be introduced directly to cancerous cells.

2. Mortality Rates in P/Ds

Mortality rates for a P/D are much lower than those of an extrapleural pneumonectomy. Only 5 percent of patients who undergo a pleurectomy with decortication don’t survive the surgery. This surgery is usually performed in patients with stage 1 or early stage 2 pleural mesothelioma. The patient’s overall health may influence the lowered mortality rates.

Complications that may result after a pleurectomy include: pneumothorax (air leaking out of the lung), blood clots, difficulty breathing, and post-operative pain at port sites.

Surgery for Peritoneal Mesothelioma

Many factors play a role in determining the right treatment for a patient. These may include the extent of the disease, staging, type of additional treatment planned (radiation and chemotherapy) and the patients’ overall health. For many patients, the most effective treatment for peritoneal mesothelioma is cytoreduction surgery with HIPEC.

1. Cytoreduction

Cytoreduction involves the removal of the peritoneum (the lining of the abdomen) and any other visible tumors from the abdominal area. In some cases of mesothelioma, the growth of tumors begins in the peritoneum.

This surgery is performed in patients with all stages of malignant peritoneal mesothelioma. In the earlier stages it is used for curative treatment, while in the later stages it may be used for pain relief if patients can withstand the surgery.

Patients are placed under general anesthesia, and the surgery lasts for about 10 hours. During this time, a surgeon removes as much of the visible tumor as possible by removing the peritoneum. Recent studies have shown that patients who received a curative cytoreduction (stage 1 and 2) had a median survival time of 87.2 months.

2. Hyperthermic Intraoperative Chemotherapy (HIPEC)

A majority of cytoreduction patients also receive hyperthermic intraoperative chemotherapy (HIPEC) during the surgery. HIPEC is a heated chemotherapy bath in the abdominal cavity. Patients who received a cytoreduction with the HIPEC treatment (which included stages 3 and 4 mesothelioma) had an average survival time of 36 months. Of patients who received this form of chemotherapy, 85 percent reported decreased pain and discomfort.

Surgery for Pericardial Mesothelioma

1. Pericardiectomy

Pericardial mesothelioma is the rarest form of mesothelioma but is one of the most common types of pericardial tumors. The pericardiectomy includes the removal of the lining of the heart, which often constricts the heart during disease or inflammation.

Following the removal, Gore-tex patches are used to re-envelop the heart with an artificial pericardium. The pericardiectomy is typically performed on patients with pericarditis (inflammation of the pericardium). This surgery is rarely performed on patients with pericardial mesothelioma because of the health requirements. Patients are put under general anesthesia before the procedure and given pain medicine after.

Pericardial mesothelioma only accounts for 0.7 percent of all documented mesothelioma cases. It is usually only discovered in patients post-mortem. Patients who receive pericardiectomies remain in the hospital for one to two weeks although it may take 3 months or longer to fully recover from the surgery.

Palliative Process

Palliative surgeries are used in all stages of mesothelioma. They are used to relieve pain in patients by draining or preventing the buildup of fluid in the mesothelial cavities. This fluid causes pain in patients by making it hard for either the lungs, abdomen or heart to expand and contract normally. There are several palliative surgical options for these patients.

Mesothelioma Palliative Options
  1. Pleurodesis – Pleurodesis is a procedure that closes up the pleural space and limits fluid buildups. One of the most common symptoms of pleural mesothelioma is pleural effusion, a fluid buildup in the pleura surrounding the lungs.
  2. Thoracentesis – This procedure is also used to drain fluid buildup in the lungs. This procedure uses a needle to drain fluid, but does not close the pleural space.
  3. Paracentesis – This procedure uses a needle to drain fluid buildup in the abdomen. This fluid buildup is known as ascites.
  4. Pericardiocentesis – This procedure is used to drain fluid buildup from the sac that lines the heart (pericardium). Fluid is drained from the pericardium with a needle

Chemotherapy is an effective and viable form of treatment viable for patients with all 4 stages of malignant mesothelioma.
Chemotherapy is the standard treatment for patients with malignant mesothelioma. It’s often used to complement other treatment options like surgery or radiation therapy.

Treating Mesothelioma With Chemotherapy

Chemotherapy is a treatment option widely used among all cancer patients to improve life expectancy. Like all other non-surgical options, chemotherapy is not a curative treatment and is best used in conjunction with other treatments (surgery and radiation).

Benefits of Chemotherapy
  1. Improve Survival : Combined with surgical procedures such as the extrapleural pneumonectomy or cytoreduction, chemotherapy can significantly aid in recovery and survival rates.
  2. Patient Specialization : There are a variety of different medications and methods. This allows specialists the ability to manage each patient’s tolerance and comfort uniquely.
  3. Non-invasive : Chemotherapy treatment is often non-invasive, meaning surgery is not necessary for its success. Many mesothelioma patients are not eligible for surgery but are eligible for chemotherapy.
Chemotherapy Basics

The standard of treatment for most cases of mesothelioma is chemotherapy. Generally speaking, chemotherapy is designed to accomplish several goals, including:
  1. Killing mesothelioma cells
  2. Preventing cancerous cells from spreading
  3. Shrinking tumors
  4. Making other treatments, such as surgery, more effective
  5. Relieving symptoms, mainly pain, caused by tumors
Oncologists have to tailor chemotherapy on a patient by patient basis. This includes how long the chemotherapy is administered and how often it is given. As treatment begins, doctors may try different drugs to determine which are most effective for their patient.

Every patient responds to chemotherapy differently. A certain chemotherapy drug may add years to the life expectancy of one patient, while the same drug has little to no effect on another. The goal is to do the most damage to the cancer cells while protecting the patient’s health.

Medications and Combinations of Chemotherapy

There are few chemotherapy drugs for treating mesothelioma that have been approved by the Food and Drug Administration. However, there are also drugs being used that have shown success at treating mesothelioma that have not yet been approved. These drugs have also shown far better success when they are combined and delivered. Clinical trials are the best way to access novel chemotherapy drugs.

The combination of Alimta and cisplatin is the standard, and most common, chemotherapy treatment for mesothelioma. Other chemotherapy drugs include:
The outlook for future chemotherapy patients is steadily improving with the development of new trials conducted by mesothelioma specialists.

Multimodal Chemotherapy

Chemotherapy is most successful when used in combination with other treatments. Surgery and chemotherapy is the most common combination. Renowned pleural mesothelioma specialist Dr. Raja Flores recently conducted a study on intraoperative chemotherapy to evaluate the benefits of multimodal therapy.

The study shows that intraoperative chemotherapy after an extrapleural pneumonectomy can increase the average life span from 17 months to over 33 months.

Dr. Flores, based out of New York City’s Mount Sinai Hospital, is considered highly experienced with administering intraoperative chemotherapy. He is also one of the best surgeons in the field and performs both the extrapleural pneumonectomy and the pleurectomy with decortication. Get connected to specialists like him using our free Doctor Match program.

Chemotherapy Side Effects

Chemotherapy side effects are a major concern for patients considering the treatment. Drug prescriptions may be altered if the patient experiences adverse side effects.

Chemotherapy is administered in rounds based on how well the patient is handling the treatment. Side effects such as fatigue are normal, but chemotherapy rounds are stopped if serious side effects emerge. Common Side Effects : 
  • Hair loss
  • Nausea, vomiting, and constipation
  • Fatigue
  • Higher infection risk
  • Bruising and bleeding
  • Sore mouth
  • Delayed nausea and flu-like symptoms (often 2-5 days after treatment)
  • Peripheral neuropathy
  • Hearing loss
Patients receive treatment in the hospital, at cancer treatment centers, at outpatient facilities or at home. Doctors and nurses ensure the patient isn’t in any discomfort while receiving their chemotherapy and monitor patients for unusual side effects or complications.

Tips For Dealing With Side Effects

Notify your doctor – Be honest with medical staff about your side effects. Your doctor may be able to prescribe medicine for some of your symptoms, such as nausea medication. If the medical team that is caring for you are aware of your symptoms they can do their best to alleviate them.

Avoid infection – Chemotherapy can raise your risk of infection. Take care to avoid germs by staying away from people who are sick and contagious, washing your hands often, and being careful to cook foods thoroughly. It also may be helpful to rinse your mouth with baking soda or salt and water to flush bacteria from your mouth.

Prevent nausea – It may be difficult to eat during and after chemotherapy but you will need enough protein and calories to keep your weight up. Try eating smaller meals more frequently. Foods that may help include ginger and ginger flavored products, lemon drops, and cold foods. Avoid strong smelling foods and spicy foods.

What Causes Chemotherapy Side Effects?

Chemotherapy drugs work by targeting cells that divide quickly, such as cancer cells. Many side effects occur because chemo can affect other quickly dividing cells, such as bone marrow cells, which are important for creating blood cells. Many common side effects are caused by low blood cell counts, including white blood cells, red blood cells, and blood platelets. Chemo may also affect hair follicles and cells in the lining of the mouth and intestines.

Types and Methods Chemotherapy

There are chemotherapy types and methods that can be used in all stages of treatment for patients with mesothelioma. It is used for pain relief in patients with advanced mesothelioma and to prevent metastasis in early stage patients.

1. Treatment Types

Chemotherapy is commonly used on its own, but it is also used in conjunction with surgery to produce the results for the patient. There are different stages during a patient’s treatment when chemotherapy can be utilized in a multimodal approach.
  • Neoadjuvant Chemotherapy – Administered prior to surgery to reduce size of tumors. This can make surgery easier and more successful.
  • Intraoperative Chemotherapy – Administered during surgery. Doctors are able to apply higher dosages of chemotherapy directly to tumors with less side effects.
  • Adjuvant Chemotherapy – Administered after surgery to kill remaining cancer cells. Microscopic mesothelioma cells cannot be removed with surgery, so adjuvant therapy could kill these cells.
2. Delivery Methods

Patients who receive chemotherapy may be given the drug in a variety of ways. The method in which they receive the chemotherapy is based on the type of mesothelioma they have, the location of the cancer, and their overall health.
  • Intravenous Delivery – The most common delivery method. Delivery can be a simple injection or an IV drip. Delivery can take anywhere from minutes to hours.
  • Chemotherapy Port – Patients whose treatment is extended may be fitted with a port to make delivery more convenient. Chemotherapy is delivered quickly and easily through a port.
  • Oral Delivery – Oral medications for mesothelioma are only available in clinical trials. This is the most convenient method, usually taken daily but in small doses.
Process Chemotherapy
  • 1

    Initial Consultation
    If chemotherapy is part of a patient’s treatment plan, patients first consult with their oncologist. Oncologists specialize in using chemotherapy to treat a variety of cancers and treat each diagnosis uniquely. Patients have the opportunity to discuss their upcoming treatments and receive answers to any of their questions.

  • During the visit, patients are examined fully. Blood work is done so that doctors will have a baseline of the patient’s health. The oncologist may consult with a multimodal team (such as surgeons or radiation oncologists) to offer opinions. Initial consultations give the patient a solid understanding of their treatment plan.
  • 2

    Treatment Planning

    If a patient is receiving intravenous chemotherapy, they may need to have a device inserted before the chemotherapy can begin. This device may be a catheter, port, or pump. Chemotherapy drugs are delivered via this device.

    Patients should expect to feel slightly sick, especially after their first dose of chemotherapy. Patients should have a friend or family member drive them to and from their first appointment. Chemotherapy affects people in different ways and until patients are aware of how the drugs work with them, they should take caution.

    Doctors will prescribe drugs and vitamins to help prevent side effects including: vitamin B12, folic acid, corticosteroid, and antiemetic.
  • 3

    Receiving Treatment
    Most chemotherapy treatments are given in a comfortable setting and supervised by a chemotherapy nurse. Treatment time varies by case, and is on average administered every 3 weeks. Most patients receive 3-4 rounds. A common mesothelioma chemotherapy treatment includes 10 minutes of Alimta, 30 minutes to rest, and then 2 hours of cisplatin. During treatment, certain tests may be performed to ensure ideal effectiveness.
  • 4

    After TreatmentPatients will have follow up visits with their doctor beginning a few weeks after their chemotherapy treatment ends. The doctor will offer insights into the success of the treatment and discuss the patient’s future prognosis.They may also offer additional treatment suggestions. Continued follow ups help doctors to treat their patient accordingly if the cancer regresses, progresses, or stays the same. Visits may decrease in frequency if patients continue to receive successful tests and treatments.
Improving Chemotherapy

There are clinical trials being conducted to study chemotherapy and the effectiveness of different drugs on mesothelioma. Some studies are continuing to investigate traditional chemotherapy methods.

Some research is using chemotherapy to improve novel treatments. Doctors and scientists have found that even when chemotherapy doesn’t have a significant impact. For instance, chemotherapy may weaken cancer cells, making it easier for other drugs to kill mesothelioma cells. Chemotherapy may even be used to slow down the immune system for treatment to be more effective.

1. Three Drug Chemotherapy: Alimta, Cisplatin, Bevacizumab

The current standard of care for pleural mesothelioma is chemotherapy with Alimta and cisplatin. Researchers believe adding a third chemo drug may improve effectiveness. In a clinical trial, patients who received all three drugs had an average overall survival of 2.7 months longer than patients who received only Alimta and cisplatin. The 3 drug combination is now included in the National Comprehensive Cancer Network guidelines as a first-line treatment option for mesothelioma patients.

2. Making Immunotherapy More Effective

Several clinical trials are investigating immunotherapy treatments. Many of these trials also employ chemotherapy. Immunotherapies are meant to work with the patient’s immune system to attack mesothelioma cells. However, sometimes the patient’s immune system can attack the immunotherapy drug itself and prevent it from having an effect. One reason researchers will also prescribe chemotherapy is to suppress the immune system, keeping it from attacking the treatment.

3. How Can I Improve My Prognosis With Chemotherapy?

There are a multitude of chemotherapy drugs available to mesothelioma patients and even more combinations available. The best way for patients to access these drugs is through clinical trials. They often provide options that aren’t available to all patients yet. Let our patient advocates connect you with recruiting clinical trials and mesothelioma specialists through our free Doctor Match program.

Radiation therapy is an effective treatment option for patients with malignant mesothelioma. It works best in combination with other treatments such as surgery.

Radiation therapy can be used before and after surgery to help shrink tumors and kill remaining cancer cells in a specific area of the body.

Treatment for All Stages of Mesothelioma

Radiation therapy is effective in treating patients with all stages of malignant mesothelioma. It is best used to shrink or stunt the growth of cancerous tumors. In patients with early stage mesothelioma, radiation is often combined with curative surgical treatments. In the advanced stages, it is used to provide pain relief to patients. Benefits of Radiation Treatment :
  1. Improve Life Expectancy : Radiation treatment used in a multimodal setting before and after surgery has had the result of increasing life expectancies in some cases.
  2. Target Mesothelioma Tumors : Innovative radiation techniques can be used to directly target tumors, sparing healthy cells and tissue.
  3. Pain Relief : Radiation treatment is used for pain relief purposes in patients in all stages of mesothelioma by shrinking tumors. 

Specialist Care

Mesothelioma is a rare cancer, and most oncologists don’t have extensive experience treating it. It’s important to find a doctor who specializes in mesothelioma treatment. A patient’s doctor (or team of doctors) recommends a treatment plan for them, which may include radiation. If so, a radiologist or radiation oncologist consults with them.

Patients should seek out radiation oncologists who have experience treating mesothelioma. Patients having difficulty finding the right mesothelioma specialist can use our free Doctor Match program to connect them with a specialis. 

Radiation Basics 

Radiation therapy consists of noninvasive treatment sessions. During these sessions, high-energy beams such as gamma rays or X-rays are used to target malignant tumors.

Radiation oncologists prepare patients for their treatment by performing a simulation, which maps out the region and allows for doctors to ensure exact targeting. Treatment itself is painless and lasts only five to 10 minutes. The entire office visit only lasting around 30 minutes.

Patients simply come in to the office and lie still while the radiation targets the cancerous tumor. Side effects like nausea or general fatigue may occur following procedures, but this is normal. Radiation therapy is a key tool in the fight against mesothelioma and most patients believe the benefits outweigh the side effects.

Radiation Treatment Options

There are different types of radiation therapy that are used on mesothelioma patients. These options are considered after examining tumor size, metastasis, staging and general health. There are two general types of radiation therapy: external beam radiation and intraoperative radiation therapy.

External Beam Radiation

External beam radiation is effective for all stages of mesothelioma and is noninvasive. There is typically no preparation for external beam procedures. This method of radiation has significantly improved life expectancies in patients who combined this treatment with chemotherapy.

External beam radiation methods for mesothelioma include:
  • X-ray Radiation
  • CT Scan Radiation
  • 3D Conformal Radiation
  • Intensity-Modulated Radiation Therapy
Intraoperative Radiation Therapy (IORT)

IORT applies radiation directly to tumors during surgery. This allows doctors to avoid passing radiation through healthy tissue. IORT is used in early stage patients who are eligible for surgery. The use of IORT during surgery has contributed to increased survival times in many patients.

Surgery for Mesothelioma After Radiation Therapy (SMART)

SMART is a multimodal treatment procedure that uses Intensity Modulated Radiation Therapy (IMRT) prior to undergoing a radical extrapleural pneumonectomy (EPP).

This is a relatively new and somewhat unconventional procedure, as it administers large doses of radiation first. Multimodal treatments with surgery and radiation typically apply the radiation following surgery. With the SMART method, a higher level of radiation can be administered with less fear of harmful side effects to the patient, as the toxic area is then removed in surgery.

SMART is already providing promising results, with one study showing that 84 percent of patients who received the procedure survived three years or longer. In 2010, the 3-year survival rate for pleural mesothelioma patients was 10.8 percent.

The purpose of combining IMRT and the EPP is to kill mesothelioma cells surrounding tumors in the lung. This also makes surgery more successful, as it removes a larger percentage of the cancer.

Using the SMART procedure, patients are given IMRT over a period of 5 days prior to surgery. This procedure has shown better results than post-operative radiation in terms of survival and reduced side effects.

Radiation Therapy Process

Many patients ask about what they can expect when receiving radiation therapy. There are a series of general steps that often take place in the treatment process:

Consultation Visit

Patients speak with a radiation oncologist who determines the best type of radiation therapy to use. This specialist answers questions and helps determine a treatment plan. Patients are requested to bring all previous documentation with them. This includes X-rays, CT scans, MRIs, lab studies and other diagnostic tests. The physician performs a thorough examination and makes a recommendation for treatment.

Informed Consent

Prior to any procedure, patients have the right to understand their treatment plan, including any and all tests they’ve elected to undergo. Once patients confirm they understand their rights and the extent of treatment, they sign a consent form. However, patients may withdraw or amend their consent form at any time.

Imaging Simulation

Using a CT machine, also known as a simulator, a “map” of the location to be targeted with radiation is created. This only takes about an hour or so and is noninvasive. Simulation provides radiation specialists with the best imaging of the region they’ll be treating. It’s a critical step in the process of determining the best way to use radiation to affect the tumor.

Tattooing / Protective Coverings

In some cases, a soft ink is used to mark the spot of the treatment beams. The tattoo is nearly invisible to the naked eye, but plays an important role in ensuring the most accurate treatment. Also, depending on the location of the tumor, molds can be created to protect certain areas of the body (the face, for example), from errant radiation.

Treatment Day

Treatment begins after confirmation of treatment plans and configurations. The average length of time for the daily treatment is 15 to 30 minutes and is performed five days per week. In rare cases, patients may receive two treatments per day. Generally, these treatments go on for three to 10 weeks but may be altered by the doctor. The technicians take X-rays once every week to confirm that the treatment has targeted the right location. Patients take part in follow-up appointments as well.

Radiation Prognosis

It’s accepted in the mesothelioma medical community that radiation therapy alone doesn’t cure mesothelioma. However, epithelioid pleural mesothelioma patients who receive radiation therapy in conjunction with a curative surgery (such as EPP) have a 40 percent life expectancy improvement over surgery alone.

Patients have been shown to live an average of nearly three years after this multimodal treatment.

This is well above the average 16 months survival and continues to increase as further treatments are developed. Stage 1 and 2 patients who receive radiation in concert with a successful extrapleural pneumonectomy see a 30 percent decrease in risk of cancer recurrence.

Improving Radiation Treatments

Radiation is an effective component of a mesothelioma treatment plan, but it has its drawbacks. Organs and tissue may be damaged when the body experiences high levels of radiation. Radiosensitizers and radioprotectors may modify the reaction to radiation.

Researchers are learning more about certain chemicals that may help in regulating the cells that radiation may damage.


Radiosensitizers are intended to enhance the tumor killing process while minimizing damage to human tissue. Many of these radiosensitizers contain oxygen. As tumors grow, they become more deficient in oxygen (hypoxia), causing the cells around them to weaken.

When these cells weaken, they can no longer fight the tumor as efficiently. Radiosensitizers introduce more oxygen, which results in an increase in the effectiveness of radiation. Cisplatin is a widely used chemotherapy drug that also makes cancer cells weaker because it contains radiosensitizers.


Radioprotectors act as shields for healthy cells as radiation enters the body. Although these cells are not fully protected, the drug also helps to repair them. These protectants block oxygen from getting to the tumors, but not to the healthy cells. When tumors become more hypoxic (oxygen deficient), they cannot grow or spread as quickly.

Multimodal therapy is the use of a combination of several types of treatments to fight cancer. It has been shown to lead to the best possible life expectancy for mesothelioma patients.

Aggressive surgical treatments combined with chemotherapy and radiation have increased the life expectancy of many patients.

Top clinical trials for new treatments are currently recruiting for mesothelioma patients. Get access to new mesothelioma health options today.

Current Recruiting Clinical Trials

Since mesothelioma is such a rare cancer, new treatment options have been few and far between. As new treatments are developed, patients are given access to these investigational medications by participating in clinical trials. Learn more about how clinical trials work.

Clinical trials can offer patients treatment options that aren’t available to all patients. There is also potential to be part of a trial that can lead to recovery.

Clinical trials are an essential part of furthering mesothelioma research toward finding new treatments. Use the tool below to find a recruiting mesothelioma clinical trial that fits your needs

Source and for more info visite this link below: 
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