Pleural Mesothelioma Treatments
Malignant mesothelioma is an incurable condition. However, there are many treatment options which are aimed at relieving symptoms and prolonging life.
Initial treatments – thoracoscentesis (lung drainage) and pleurodesis
The initial and most helpful treatment is that which deals with symptoms. The majority of pleural mesotheliomas present with pleural effusion. Removing the fluid from around the lung can help relieve breathlessness. The fluid is drained by needle, or by inserting a small drainage tube. However, the fluid often re-accumulates and the chest physician or surgeon may perform a procedure called a pleurodesis. This is a procedure used to stick the lung surface to the chest wall by inserting sterile talc into the pleural space. This must be done be a surgeon using keyhole surgery, otherwise known as VATs (video assisted thoracic surgery).
Drugs to improve quality of life and reduce progression of mesothelioma
There are a number of drugs which have been or are currently being tested as treatment options for mesothelioma. The majority of the research and clinical trials for these drugs have been carried out in America. Listed below are some of the options available and a summary of the findings of the trials carried out on them in America.
In general there are 3 types of surgical procedures that may be performed on pleural mesothelioma patients. These include thoracoscopy, debulking pleurectomy/decortication and extra pleural pneumonectomy (EPP). A thoracoscopy is a scope used to look inside the chest and it is used to obtain a diagnosis of mesothelioma or treat shortness of breath by removing fluid in the pleural space (please see the diagnosis section for more information on thoracoscopy).
Is surgery a possibility?
Assessment of a patient’s overall state of health (their performance status) is essential in deciding whether a patient is fit enough for surgery. Assessment of the patients heart and lung function will be undertaken. If there are pre-existing heart problems and/or the lung function is poor radical surgery will not be an option. The patient also needs to have had few symptoms of mesothelioma, that is they need to be in a performance status of 0 to 1.
Chemotherapy is the treatment of cancer with specialised drugs that can destroy cancer cells. There are many types of chemotherapy drugs and each has a different way of attacking the cancer cells.
Palliative care and support is something that needs to be considered by all sufferers of mesothelioma.
There are a number of alternative treatments that can help relieve the symptoms caused by mesothelioma such as pain, anxiety and stress. Whilst these treatments will not cure the cancer they can relieve some of the symptoms related to or caused by the cancer.
Radiotherapy is a common type of cancer treatment. Radiotherapy is often used in combination with other treatments, such as chemotherapy and surgery, however radiotherapy can also be used alone to treat symptoms that are caused by the cancer. However radiotherapy alone will not cure cancer.
Cordotomy for Mesothelioma Related Pain
Cervical cordotomy is a nerve destructive procedure for severe cancer pain related to mesothelioma.