Treatments and drugs

What treatment you undergo for mesothelioma depends on your health and certain aspects of your cancer, such as its stage and location. Unfortunately, mesothelioma often is an aggressive disease and for most people a cure isn't possible. Mesothelioma is usually diagnosed at an advanced stage — when it isn't possible to remove the cancer through an operation. Instead, your doctor may work to control your cancer to make you more comfortable.

Discuss treatment goals with your doctor. Some people want to do everything they can to treat their cancer, even if that means enduring side effects for a small chance of an improvement. Others prefer treatments that make them comfortable so that they can live their remaining time as symptom-free as possible.

Surgery
Surgeons work to remove mesothelioma when it's diagnosed at an early stage. In some cases this may cure the cancer.

Sometimes it isn't possible to remove all of the cancer. In those cases, surgery may help to reduce the signs and symptoms caused by mesothelioma spreading in your body.

Surgical options may include:
Surgery to decrease fluid buildup. Pleural mesothelioma may cause fluid to build up in your chest, causing difficulty breathing. Surgeons insert a tube or catheter into your chest to drain the fluid. Doctors may also inject medicine into your chest to prevent fluid from returning (pleurodesis).
Surgery to remove the tissue around the lungs or abdomen.Surgeons may remove the tissue lining the ribs and the lungs (pleurectomy) or the tissue lining the abdominal cavity (peritonectomy). This procedure won't cure mesothelioma, but may relieve signs and symptoms.
Surgery to remove as much of the cancer as possible (debulking). If all of the cancer can't be removed, surgeons may attempt to remove as much as possible. Debulking allows doctors to more accurately direct radiation treatments to relieve pain and fluid buildup caused by mesothelioma.
Surgery to remove a lung and the surrounding tissue. Removing the affected lung and the tissue that surrounds it may relieve signs and symptoms of pleural mesothelioma. If you'll be receiving radiation therapy to the chest after surgery, this procedure also allows doctors to use higher doses, since they won't need to worry about protecting your lung from damaging radiation.

Chemotherapy
Chemotherapy uses chemicals to kill cancer cells. Systemic chemotherapy travels throughout the body and may shrink or slow the growth of a mesothelioma that can't be removed using surgery. Chemotherapy may also be used before surgery (neoadjuvant chemotherapy) to make an operation easier or after surgery (adjuvant chemotherapy) to reduce the chance that cancer will return.

Chemotherapy drugs may also be heated and administered directly into the abdominal cavity (intraperitoneal chemotherapy), in the case of peritoneal mesothelioma, or into the chest cavity (intrapleural chemotherapy), in the case of pleural mesothelioma. Using this strategy, chemotherapy drugs can reach the mesothelioma directly without injuring healthy cells in other parts of the body. This allows doctors to administer higher doses of chemotherapy drugs.

Radiation therapy
Radiation therapy focuses high-energy beams, such as X-rays, to a specific spot or spots on your body. Radiation may reduce signs and symptoms in people with pleural mesothelioma. Radiation therapy is sometimes used after biopsy or surgery to prevent mesothelioma from spreading to the surgical incision.

Clinical trials
Clinical trials are studies of new mesothelioma treatment methods. People with mesothelioma may opt for a clinical trial for a chance to try new types of treatment. However, a cure isn't guaranteed. Carefully consider your treatment options and talk to your doctor about what clinical trials are open to you. Your participation in a clinical trial may help doctors better understand how to treat mesothelioma in the future.

Clinical trials are currently investigating a number of targeted drugs. Targeted drug therapy uses drugs to attack specific abnormalities within cancer cells. Targets being studied in mesothelioma include a substance that cancer cells make to attract new blood vessels that bring oxygen and nutrients to the cancer. Researchers hope drugs that target these areas can help kill mesothelioma cells.

Treatment for other types of mesothelioma
Pericardial mesothelioma and mesothelioma of tunica vaginalis are very rare. Early-stage cancer may be removed through surgery. Doctors have yet to determine the best way to treat later stage cancers, though. Your doctor may recommend other treatments to improve your quality of life.