Mesothelioma Treatment

Mesothelioma cancer is a serious disease and new patients and their families looking for treatment should seek the support and resources they will need to better understand their diagnosis and prognosis. To help with this process, we have collected the following mesothelioma treatment information which should aid patients diagnosed with mesothelioma in deciding what the best treatment is for them.

Surgery - Surgery is a treatment that is used to remove the cancerous tumor or to reduce the pain of symptoms and suffering. When the cancer is contained, the surgery can be used to remove part of the lining of the chest or abdomen to eliminate the mesothelioma cancer cells from the body. If the mesothelioma has spread to different organs, it will be impossible to remove all of the organs infected with mesothelioma. In this situation surgery can still be used, but the effectiveness will be limited to just pain and suffering relief. Types of mesothelioma surgeries include:
- Pneumonectomy - This is a serious surgery in which one lung is removed. The surgery can be done in one of two possible ways:
  - Normal Pneumonectomy - In this case it is only the diseased lung is removed from the mesothelioma patient.
  - Extrapleural Pneumonectomy - The diseased lung, part of the pericardium, part of the diaphragm and on the same side of the chest the parietal pleura are also removed.
- Thoracentesis – A needle is inserted by a doctor into the chest cavity of the patient to obtain a diagnosis biopsy or to drain excess fluid and relieve pressure and pain.
- Pleurectomy/Decortication - The surgical removal of the pleura which is done in order to reduce pain caused by a mesothelioma tumor mass or to prevent a recurrence of pleural effusion.
Chemotherapy - A cancer treatment that consists of using different drugs to treat the cancer. These drugs can be taken in pill form or by needle injection into the bloodstream. Many of the cancer drugs used in the treatment of mesothelioma lung cancer directly kill cancer cells or stop the cells from dividing. The drugs enter into the patient's bloodstream and circulate throughout the entire body to reach and destroy the mesothelioma cells. More chemotherapy can be used with a variety of drugs to increase its effectiveness and is often used with other mesothelioma treatments, such as surgery. The current practice when not on a clinical trial is to receive treatment with chemotherapy agents like Cisplatin, Gemzar or pemetrexed (Alimta®).
Radiation - Radiation therapy involves high level radiation to destroy cancer cells in a specific area. The way it works is that the radiation prevents the cancer cells from dividing or multiplying. With each radiation treatment more of the mesothelioma cells die and then the cancer tumor shrinks. The dead mesothelioma cells are removed by the normal body processes and many of the healthy cells of the body are able to recover from this injury since they are stronger. Intensity-modulated radiation therapy (IMRT) is a new radiotherapy that involves using highly accurate three-dimensional radiation after the lung and pleura have been removed and this may lead to improved outcomes and less toxicity to the patients over hemi-thoracic external beam radiotherapy.
Palliative Care - The goal of palliative care is not to attempt to cure the mesothelioma disease, but rather to relieve and/or control symptoms associated with mesothelioma. Pain management and control is a big part of palliative care in addition to the increase in the overall quality of life. For more information visit Palliative-Care.net.

Alimta / Cisplatin

Alimta is a chemotherapy medication that is administered to mesothelioma patients intravenously. Alimta is used to treat pleural mesothelioma and is usually administered with Cisplatin, another chemotherapy drug. Both Alimta and Cisplatin are used to treat mesothelioma patients when surgery is no longer an option. Alimta is designed to block or interfere with the creation of cancer cells, targeting 3 specific enzymes that are vital in cancer cell production.

Alimta is a 3-week treatment process that runs every 21 days. During the treatment process, Cisplatin is administered for two hours approximately 30 minutes after the end of the Alimta treatment. As with other treatment methods and medications, Alimta does have side effects that include:

Nausea
Vomiting
Low blood cell production
Fatigue
Alopecia (hair loss)
Fever
Chills
Diarrhea
Mouth sores

Nausea and vomiting are the most common side effects and affects 8 out of 10 patients, while diarrhea, mouth sores, loss of appetite, and mouth sores affect less than 25 percent of patients.

Gemzar

Gemzar is an anti-cancer chemotherapy drug and is classified as an antimetabolite. Gemzar treatments are normally administered to patients who have pancreatic cancer, non-small cell lung cancer (mesothelioma), soft-tissue sarcoma, bladder cancer, and metastatic breast cancer. Gemzar is similar to Alimta as it also blocks or interferes with the cancer cell growth process. Gemzar is given intravenously and should not to be given if a patient is also undergoing radiation therapy. Gemzar treatment dosages are dependent on a patient's general overall health, weight, height, and cancer type.

Side Effects Gemzar

Diarrhea
Weakness
Alopecia (hair loss)
Mouth sores
Difficulty sleeping
Shortness of breath
Flu-like symptoms
Nausea
Vomiting
Loss of appetite
Skin rashes
Low blood count (usually in between Gemzar cycles)

Mitomycin / Mutamycin

Mitomycin is an anti-cancer drug that is classified as an antitumor antibiotic that is administered intravenously. Mitomycin is used to treat cancers of the stomach, bladder, pancreas, breast, cervical, colorectal, head and neck, and non-small cell lung cancers such as mesothelioma.

Mitomycin is a vesicant drug, which means that it is a chemical that causes extensive tissue damage and blistering, it must be administered by a well-trained physician and/or nurse in order to avoid any leaking from the veins during treatment. If any redness or swelling is seen at the IV site, contact a physician immediately. The amount in each cycle of mitomycin is determined by the physician and is based on overall health, weight, height, and type of cancer.

Mitomycin Side Effects

Low blood count
Mouth sores
Fatigue
Loss of appetite
Nausea
Vomiting
Alopecia (hair loss)

In order to achieve a higher level of comfort during treatment cycles, patients are recommended to:

Soothe any pain or swelling with ice when needed
Drink at least 2 quarts of water daily
Avoid crowds or crowded places due to weak immune system as they are prone to infections
Treat and prevent mouth sores with a soft toothbrush and a mixture of salt, baking soda and water
Take anti-nausea medications as needed
Eat small, frequent meals
Avoid sun exposure without SPF
Keep alcohol intake at a minimum or avoid altogether

Prior to beginning mitomycin treatments, it is important to disclose all medications taken with your physician. This will include all prescriptive medicines, as well as over-the-counter medicines. You are not to receive any immunizations without a physician's approval.

Patients should inform their physician know if they are pregnant, plan to be pregnant, or are pregnant. Breast feeding is not allowed during mitomycin treatment cycles. Patients should be aware that their immune systems will be weak and are more prone to infections when receiving any chemotherapy such as Alimta, Gemzar, or Mitomycin.