Treatment of Mesothelioma

For treatment, a team including doctors and nurses who are specialists in various areas of cancer care, will study your individual case to consider what treatment is most appropriate. They will take into account:

• The type of the mesothelioma (chest or abdomen)
• How developed it is
• Your age and general health
• Your symptoms
• And, lastly but most importantly, what you want to do about your treatment.

There is no cure for mesothelioma at the moment. If it is caught very early it can sometimes be removed by surgery. Unfortunately, this is rare. The usual treatment for mesothelioma is based on 'active symptom control' .

Active Symptom Control (ASC)

Active Symptom Control directs treatment specifically at your symptoms. The symptoms that are likely to need controlling are:

• breathlessness
• pain
• lack of energy
• lack of appetite
• constipation due to pain killers
• anxiety and depression

Treatment with steroids, various levels of painkillers, drugs to improve appetite, laxatives and drugs to improve the breathing may all help. You may also have to manage the fluid on your chest. The fluid that can build up in your chest can be removed on a regular basis. But it can become more and more difficult to do this. One way to do this is to stop the fluid accumulating altogether. This involves putting talc or another chemical into the space between the two layers of the chest lining once all the fluid has been drained off. This causes the two layers to stick together, so there is nowhere for fluid to collect.

Surgery

Surgery to remove tumours has had varying success. Trials are underway at the moment for an operation that would remove the whole of the affected lung (along with its linings, the lining of the heart and part of the diaphragm). This operation is only suitable for a very small number of people.

Radiotherapy

Radiotherapy treats cancer by using high-energy x-rays to destroy cancer cells. For mesothelioma, radiotherapy can be used in these ways:

• If you have had a needle, drain or endoscope inserted into your chest a single dose or a short course of treatment of radiotherapy is given there to stop the tumour growing through your chest wall and into your skin
• Radiotherapy can be aimed directly at the tumour to try and make it smaller.

This will help reduce pain and discomfort, and possibly breathlessness.

Chemotherapy

This is treatment with drugs; directly into your veins and/or in pill form. The aim is to kill or control the growth of cancer cells, which would help with your symptoms and improve your quality of life.

Doctors use a variety of drugs in chemotherapy - and there is one drug, Alimta (Pemetrexed), that has been licensed to treat mesothelioma in particular. But chemotherapy will not benefit everyone, and will usually only be considered if you are generally fit and strong.

You should talk with your doctor or specialist lung cancer nurse about the benefits and disadvantages of chemotherapy.

No cure for mesothelioma has yet been found but the search goes on and new drugs and new combinations continue to be tested.