Mesothelioma Treatment

Common Mesothelioma Treatments

Mesothelioma is a complex cancer diagnosis, and you’ll have a number of different treatment options presented to you by your doctors. They’ll most likely include surgery, radiation and chemotherapy, as well as new, cutting edge immunotherapy treatments. In some cases, you may qualify for experimental treatments or clinical trials, such as immunotherapy. Often, the treatment your doctor proposes will include a combination of two or more therapies, commonly called multimodal treatment. Your treatment team will consider many things in coming up with a treatment plan for you. Those considerations include:

  • the cancer stage
  • which type of mesothelioma you’re dealing with
  • the primary site and type of cell affected
  • whether the cancer is confined to the mesothelium or has spread to your chest wall, lymph nodes or other sites
  • your age
  • your overall health

Why Treatment Is Important

While there is no cure for mesothelioma yet, various treatments can improve your prognosis, improve your mobility and quality of life, and reduce pain and other symptoms arising from mesothelioma. Your doctor will explain the possible benefits – and drawbacks – of each therapy offered to you, and why a particular combination of therapies is the best option in your particular case.

Standard Mesothelioma Treatments

The standard treatments options for mesothelioma include surgery, chemotherapy, and radiation therapy. Here’s a quick summary of what each may involve, as well as why each may be proposed.

Surgery

If the mesothelioma is in its early stages, your doctors may propose surgery to remove as much of the tumor(s) as possible. Depending on where the tumor is, the surgery may be limited to removing the mesothelium surrounding an organ or may include removing lymph nodes or part of your lungs or other organs.

Chemotherapy

Doctors often use chemotherapy together with surgery. They use drugs that attack fast-growing cells, such as cancer cells. Recent advances in cancer treatment have introduced cancer drugs that target cancer cells more effectively. You may also be prescribed medicines to counteract side effects, such as anti-nausea drugs.

Radiation Therapy

Radiation can help shrink tumors, making them easier to remove through surgery, and sometimes eradicating them completely.

Multimodal Mesothelioma Treatment

Cancer specialists often recommend an approach that uses a combination of the three traditional mesothelioma treatments because studies have shown the combinations to work better than using each therapy individually. For example, radiation can shrink tumors, making them easier to remove surgically, and chemotherapy may “clean up” cancer cells that remain after surgery removes the primary tumor(s).

Emerging Mesothelioma Treatments

Researchers are working to expand the options available to treat mesothelioma. There are a number of treatment options that seem very promising. Some of these are undergoing clinical trials leading up to FDA approval, and at least one, Keytruda (pembrolizumab), has recently been approved for use in treating mesothelioma and other types of cancer under certain conditions.

Immunotherapy

Immunotherapy is one of the most promising lines of research in mesothelioma treatment. It works by activating or assisting your body’s immune system in recognizing and attacking cancer cells. Your immune system looks for a certain marker on cells to identify healthy cells that should be left alone. Some cancer cells “trick” the body into thinking that they belong because they carry those markers. Your immune cells “see” those markers and don’t attack the mesothelioma cells, letting them grow and spread. Immunotherapy drugs use various mechanisms to help your body find and attack those cells. Some of these treatments include:

  • Antigen therapy sometimes called cancer vaccines, which introduces substances commonly found in cancer cells into the body, stimulating the immune system to produce antibodies against them
  • Immune checkpoint inhibitors which interfere with signals sent by cells and allow the body to attack cancer cells
  • Monoclonal antibodies, such as Keytruda, that use biomarkers to identify mesothelioma cells and attack them directly.

Phototherapy

Some treatments using photodynamic therapy have been approved by the FDA for use with certain types of cancer, and are in clinical trials for use against mesothelioma. It generally involves introducing a drug that makes certain cells sensitive to light and following up with a laser to kill the sensitized cells.

Clinical Trials

If traditional mesothelioma treatments don’t work, or have been exhausted, you may qualify to participate in clinical trials for experimental mesothelioma therapy. These clinical trials may involve surgical therapies, chemotherapy, radiation, immunotherapy, or new ways of combining treatments that may offer specific benefits. Your treatment team may suggest your participation in a clinical trial based on your type of cancer, your medical history, your treatment history and other factors. Some of the most promising clinical trials include:

  • extrapleural pneumonectomy
  • intrapleural chemotherapy
  • pleurectomy with decortication treatment
  • cytoreduction with HIPEC

Your treatment team is likely to be aware of other clinical trials that may be appropriate for you and can help you decide whether to participate.

Mesothelioma Diagnosis

You’ve Been Diagnosed, Now What?

Living with mesothelioma presents emotional, physical and practical challenges for you, your family and your caregivers. The challenges are not insurmountable, however. There are many things you can do and resources available to help you during this difficult time, and make your life more comfortable and less restrictive. These are some of the challenges you may face, along with advice and information on resources that can help you live with mesothelioma.

Emotional Effects of Mesothelioma

A diagnosis as drastic as mesothelioma takes a toll on you (and your loved ones) physically, emotionally and mentally. Everyone reacts differently, but common reactions include anxiety, depression, exhaustion and anger. Finding ways to deal with these emotions can not only help you feel better about yourself, it may actually improve your prognosis and the impact of the treatments recommended by your doctors.

Isolation

When you’re first diagnosed with mesothelioma, you may feel alone and isolated. If you choose to share your diagnosis outside your immediate family, you may find that people treat you differently. Some may seem to avoid you because they don’t know what to say or do. You can’t change the way others react and feel, but you can do other things to reduce the feelings of isolation and loneliness.

  • Join a support group for patients. Talking with others who are undergoing the same fears and experiences can help you deal with your own feelings, and make you feel less alone. While many people think of social support groups as places where people focus on negatives, the reality is that your best sources of advice, information and encouragement are people and who are dealing with or who have dealt with a mesothelioma diagnosis.
  • Encourage your mesothelioma caregivers and family members to become involved with a caregivers support group, too. The practical advice, information, and support they’ll find there will make both your life and theirs easier.

Anxiety

In addition to the anxiety and fear you feel about having mesothelioma, you may find yourself facing social anxiety and worries. Chemotherapy and radiation therapy take a toll on your physical health and your appearance. You may worry how people will perceive you and react to you if you lose your hair, or if your illness affects your physical appearance.

  • When you feel up to it, do what it takes to make yourself feel more attractive. Check around your community. You may find a spa or salon that offers special makeup consultations for people undergoing chemotherapy, or hair stylists who offer special services for people going through cancer treatment. A little pampering can pick up your spirits and help you feel better.
  • Don’t feel like you have to force yourself to interact with others or put yourself into a situation that causes you anxiety. Remember that others are there to support you. Let family members and friends take care of errands and other routine outings if you’re not feeling up to going out or being in public.

Stress

Your body is dealing with a lot of physical and emotional stress, which can actually hamper your treatment and leave you feeling overwhelmed and even more ill. More and more cancer treatment specialists recognize that mind-body treatments can help relieve the stress, and may have other beneficial effects on your treatment.

  • Check with your doctor or treatment team to see if they recommend alternative medical and therapeutic therapies, such as tai chi, quigong, yoga or meditation. If you enjoy music, art or other creative outlets, consider joining an art therapy, music therapy or other mindfulness practice to help you cope with your diagnosis.

Practical Strategies for Dealing with a Mesothelioma Diagnosis

Once you’ve been diagnosed with mesothelioma, your life and your schedule will often be dictated by medical appointments, treatment dates, and how you feel at any given moment. Some of these strategies can help you maintain some control over what’s happening in your life.

Schedule

Your friends and family may offer to help “in any way I can.” Take them at their word. One especially useful strategy is to set up an online calendar listing appointments and tasks they can do for you. Share a link to the calendar with people who offer to support you and encourage them to “sign up” if they can drive you to an appointment on Tuesday or make dinner for the family on Friday.

A Healthy Diet

It can be especially difficult to maintain a healthy diet when your treatments leave you feeling nauseous and the last thing you feel like doing is eating. Consult with a dietician or nutritionist to come up with menus and recipes that are both healthy and appealing. The right diet – along with supplements recommended by your treatment team – can ensure that you get the nutrition you need to maintain your strength during your mesothelioma treatment.

Exercise

Staying as physically active as possible is another way to help boost your mood and improve your mesothelioma prognosis. Look into programs that offer light physical exercise that can help maintain your bone and muscle strength before and after mesothelioma treatment.

Finally, keep the lines of communication open – with your spouse and family, with your caregivers, and with your doctors. The more they know about how you are feeling, both physically and emotionally, the more they’ll be able to help you stay strong and motivated while living with mesothelioma.

Mesothelioma Prognosis

Understanding Your Mesothelioma Prognosis

“How long have I got, doc?”

If you’ve just been diagnosed with mesothelioma, the question above is probably one of the first that came into your mind. Essentially, a prognosis is a prediction of the most likely course of your disease. It can be frightening and demoralizing to hear from a doctor that you only have a certain number of months to live, but it’s important to remember a few things when considering your prognosis.

First, a prognosis is not a death sentence. As the American Cancer Society notes on their website:

To get survival rates, doctors have to look at people who were treated at least several years ago. Although the numbers below are among the most current we have available, improvements in treatment since then could result in a better outcome for people now being diagnosed with mesothelioma.

It’s important to understand how doctors arrive at a prognosis, and to know that many factors affect that prognosis. Some of those factors are outside your control, but there are many things you can do to improve your diagnosis. It’s also important to recognize that any predictions about the outcome of your particular mesothelioma diagnosis is based on statistics that may be several years old, and that ongoing research and new mesothelioma treatments may significantly improve your mesothelioma prognosis.

How a Mesothelioma Prognosis Is Stated

The two most common ways to state a cancer prognosis are in life expectancy or in survival rate.

Life expectancy is exactly what it sounds like. It’s the answer to the question, “How long will I live after a mesothelioma diagnosis?” Your doctors are the only ones who can answer that question – and even then, it’s an educated guess based on statistics of other people who are in a similar situation.

The survival rate is a percentage of the number of people with your diagnosis who are still alive five years after their diagnosis. Again, the survival rate your doctors give you will be based on your specific circumstances.

Factors that Affect Your Mesothelioma Prognosis

When coming up with a prognosis, your doctors will consider a number of different factors. They include:

  • The Location – peritoneal, pleural or pericardial
  • The Stage – one, two, three or four
    • As with most cancers, the earlier you’re diagnosed, the better your prognosis. Stage one mesothelioma is much easier to treat than stage two, and so on.
  • Cell Type – epithelioidsarcomatoid or biphasic
    • Epithelial mesothelioma is the most common type of mesothelioma. It affects the cells that make up the lining for your organs and hollow cavities. It is the easiest of the three types to treat, and generally has a slightly better prognosis.
    • Sacromatoid mesothelioma is rare, and is often misdiagnosed at first. It has a worse prognosis than either of the other two tissue types.
    • Biphasic mesothelioma contains both types of cells, and accounts for 20 to 40 percent of all mesothelioma cases diagnosed. Because it’s difficult to diagnose, it’s often not detected until stage three or four, worsening the prognosis.
  • Whether the cancer has metastasized (spread beyond the original site)
    • Once mesothelioma has started to spread from its original site, it’s much more difficult to treat successfully, but new types of therapy are improving the chances of successful treatment.
  • Your age at diagnosis
    • Generally, the younger you are, the better your prognosis will be.
  • Gender
    • Women with mesothelioma generally have a better prognosis than men.
  • Your overall health
    • The healthier you are, the more treatment options are open to you, and the more able you are to handle mesothelioma treatments.

Improving Your Mesothelioma Prognosis

Mesothelioma is a particularly virulent and aggressive form of cancer, and the prognosis is generally shorter than for other forms of cancer. There are, however, things you can do to improve your prognosis, live more comfortably and extend your life.

  • Work with experienced doctors and specialists. There are many cancer treatment centers that have mesothelioma specialists on staff.
  • Check with another doctor. No doctor will be offended if you seek a second opinion. Other doctors may suggest a different treatment plan, or have access to clinical trials and new treatments.
  • Live healthy. Eating healthy and staying active will help you stay strong, improve your immune system and improve your quality of life while undergoing treatment.
  • Sign up for clinical trials. Clinical trials expand your treatment options and allow you to access new treatments that aren’t available otherwise.

How to Get the Support You Need to Fight Mesothelioma

mesothelioma diagnosis can be devastating, but you don’t have to deal with it alone. Many groups and organizations offer different types of support for patients with mesothelioma and their families. Finding and accessing those supports, though, can seem daunting when you’re already in the midst of dealing with the upheaval that comes with being diagnosed with mesothelioma. These are a few of the important supports available, and advice and tips on accessing them.

Financial Support

The three most important types of financial support for patients going through treatment and after treatment for mesothelioma are government programs, veterans’ benefits and legal compensation. Each of these have different standards of proof and application processes. Medicaid, Medicare and Social Security can help pay for treatment or provide basic income to help support yourself and your family. Many hospitals and treatment centers have patient financial advocates that will even help you through the application process for each of them.

Veterans Programs

Veterans, especially veterans of the U.S. Navy, make up a disproportionate percentage of people diagnosed with mesothelioma because of the widespread use of asbestos in furnace rooms and on board ship. Veterans who are diagnosed with mesothelioma after being exposed to asbestos during the tour of duty qualify for special benefits through the Veterans Administration. Those with an approved VA claim for mesothelioma qualify for disability compensation, special monthly compensation and service-connected death benefits for surviving family members. In addition, they are entitled to free treatment at any VA facility, and free travel for veterans who want to access mesothelioma care at the Los Angeles or Greater Boston VA health care systems, which specialize in treatment for mesothelioma.

Legal Compensation

Asbestos was widely used in manufacturing before the 1970s. A series of lawsuits against asbestos manufacturers exposed that those manufacturers had not only lied about and hidden the hazards of working with asbestos, but that they had deliberately withheld simple safety measures that may have reduced the risks of exposure. Because of their egregious behavior and the widespread nature of it, the courts have set up special trusts and funds to pay out compensation to people who have been diagnosed with mesothelioma provided by certain businesses. The process for establishing a claim for compensation is complicated, but there are many lawyers and advocates who specialize in helping people prepare and submit the paperwork to be compensated under those settlements. Generally, the rules of the settlement establish fixed amounts of compensation based on the type and extent of the diagnosed cancer.

In most cases, it is to your benefit to at least contact a lawyer to find out if you may qualify for compensation.

See Lawyers 

Travel and Flight Help for Mesothelioma Patients

If you live far from a cancer treatment center that offers an approved treatment, there are organizations that will help with your travel or flight expenses. One of the best known is the Corporate Angel Network, whose sole mission is to get people who need cancer treatment to the treatment centers that offer the treatments they need. The organization connects patients with empty seats on private flights that are flying to the destination of an approved cancer treatment center. In order to qualify, a patient must meet specific conditions:

  • They must be a cancer patient, a bone marrow donor or recipient, or a stem cell donor or recipient
  • They must be traveling to an appointment for treatment, a consultation or a follow-up appointment
  • They must be traveling to certain recognized cancer treatment centers or hospitals
  • They must be ambulatory and able to board the plane without assistance
  • They must not require medical assistance, including oxygen and IV medication while they are on the plane
  • If there is a seat available, they may also bring an adult companion with them.

Learn more about the program at the Corporate Angels website.

Lodging Assistance

Housing family members who travel with a mesothelioma patient can be expensive, but the expense shouldn’t bar someone from accessing treatment. Most cancer treatment centers provide some arrangement for family residence while a family member is an inpatient for cancer treatment. Check with the treatment center you’re considering to find out what options they offer for lodging while you or a family member is undergoing treatment. Members of the military also have the option of staying in a Fisher House, Among other things, Fisher House provides housing for military families when a family member is receiving medical treatment far from home.

Other support services exist for many different needs. Your treatment center, medical team or the social services office at your hospital can put you in touch with support groups and local groups that offer special services for people dealing with mesothelioma and other cancers. In many communities, for example, there are cleaning services who donate their time to provide house cleaning services for people living with mesothelioma, and Lipstick Angels, based in Los Angeles, CA, provides beauty services and information on cosmetics and toiletries that are especially suitable for patients undergoing cancer treatment.

Whatever your need is, there’s a good chance someone out there can help you access it. Your most valuable resource and ally is your cancer treatment team, including the social services office of your hospital or treatment center.

Ketruda Drug

Can Keytruda Help Fight Your Mesothelioma?

If you’ve sought medical advice for mesothelioma-related lung cancer, your doctor may have mentioned Keytruda (pembrolizumab) to you. Because mesothelioma-related cancers are difficult to treat, it’s exciting for many patients to hear that a new drug may help slow or stop the growth of cancer cells. At the same time, any new treatment comes with risks and plenty of questions.

Continue reading “Can Keytruda Help Fight Your Mesothelioma?”