Treatment options for malignant mesothelioma
Which therapy?
The various treatment options in malignant mesothelioma are best discussed with the managing physician. He/she will help decide which treatment is most suitable, depending on the type of tumor and its stage. These are general guidelines only:
| Early disease (stage I) + epithelial type + patient meets fitness criteria | Extrapleural
pneumonectomy + chemotherapy + radiation
therapy or Pleurectomy + chemotherapy + radiation therapy, if there is evidence that there is little/no involvement of the visceral pleura (free pleural space without tissue invasion) Supportive treatment for symptom relief. |
| Later disease (stages II-IV) + epithelial type + patient meets fitness criteria | Supportive treatment for symptom relief.
Consider extrapleural pneumonectomy + chemotherapy + radiation therapy |
| Later disease (stages II-IV) or sarcomatous or mixed type or patient with poor performance status | ??Alimta + cisplatin
Supportive treatment for symptom relief. Consider debulking pleurectomy with decortication (for symptom relief) +/- chemotherapy and/or radiation therapy (for symptom relief). |
It is very important that a victim of malignant mesothelioma is treated in a center with doctors experienced in treating this cancer, and access to clinical trials.
For most of sufferers of malignant mesothelioma however, treatment does not offer an outright cure and the disease eventually progresses. It is therefore important to discuss the management of terminal stages of the disease with the attending doctors and to plan end-of-life decisions well in advance. Cancer centers can provide the specialized support for both the victim and his family that is needed at these times. The Hospice Foundation of America can also provide support services to sufferers and their families; information about locating hospices is available on their website.
Malignant mesothelioma treatment centers
The National Cancer Institute has designated 61 centers throughout the United States as 'Cancer Centers', 53 of which which are 'Comprehensive Cancer Centers' or 'Clinical Cancer Centers' conducting research into the treatment or prevention of different cancers. Many of these may be conducting research into malignant mesothelioma. See http://cancercenters.cancer.gov/ for contact details for these centers.