Treatment

The treatment of mesothelioma depends on the size and location of the tumor, whether the cancer has spread, and the person’s overall health. In many cases, a team of doctors will work with the patient to determine the best treatment plan. For mesothelioma, there are three main types of treatment: surgery, radiation therapy, and chemotherapy.

This section outlines treatments that are the standard of care (the best treatments available) for this specific type of cancer. Patients are also encouraged to consider clinical trials as a treatment option when making treatment plan decisions. A clinical trial is a research study to test a new treatment to prove it is safe, effective, and possibly better than standard treatment. Your doctor can help you review all treatment options. For more information, visit the clinical trials section.

Surgery

The type of surgery for mesothelioma depends on the stage and location of the cancer. A surgeon may remove the affected lining. In the case of pleural mesothelioma, this is called a pleurectomy, and in peritoneal mesothelioma, it is called a peritonectomy. Generally, the tumor cannot be completely removed with these procedures. A more aggressive surgery for pleural mesothelioma is called an extrapleural pneumonectomy. This involves removing not just of the lining of the lung, but also the entire lung itself, a portion of the diaphragm, and often a portion of the lining around the heart. This is a difficult surgery and is recommended only after the doctor has reviewed a number of factors, including the patient’s overall health and the stage of the disease. If the entire tumor cannot be removed, other treatments such as radiation therapy or chemotherapy may be recommended.

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. The most common type of radiation treatment is called external-beam radiation, which is radiation given from a machine outside the body. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy.

Side effects from radiation therapy include tiredness, mild skin reactions, upset stomach, and loose bowel movements. Most side effects go away soon after treatment is finished.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Systemic chemotherapy is delivered through the bloodstream, targeting cancer cells throughout the body. The side effects of chemotherapy depend on the individual and the dose used, but can include fatigue, risk of infection, nausea and vomiting, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.

The chemotherapy treatment best studied in mesothelioma is the combination of pemetrexed (Alimta) and cisplatin (Platinol). These medications are given intravenously (by vein) every three weeks. The most common side effects include, but are not limited to, nausea, vomiting, damage to the kidneys, numbness and tingling in the fingers or toes, decreased hearing, rash, fatigue, lowering of the white blood count making one susceptible to infection, or lowering of the red blood count (anemia). Patients on this treatment may be given vitamins (B12 and folic acid) to decrease the risk of these side effects. Other medications, such as antinausea medications, are also available to relieve many of these side effects.

The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions through Cancer.Net's Drug Information Resources, which provides links to searchable drug databases.

Palliative therapy

The goal of palliative therapy is to relieve the symptoms that result from the cancer and cancer treatment, to improve the patient’s quality of life. Examples of palliative care for mesothelioma include draining fluid that has built up in the patient’s chest or abdomen, or using radiation therapy or chemotherapy to relieve symptoms.

To learn about the terms used in this section, read the Cancer.Net Feature: Cancer Terms to Know: During Treatment.