Treatment

Treatment of mesothelioma

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Mesothelioma responds very little to the normal cancer treatments such as chemotherapy and radiotherapy. There are a number of trials being run inan attempt to improve treatment but nothing has been found to cure this disease. Any treatment offered depends on several factors. These should include patient choice, how well someone is, and how advanced the disease is.

The initial most helpful treatment is that which deals with symptoms. Removing fluid from around the lung can help to relieve breathlessness. Firstly the fluid may be drained either by drawing off fluid or inserting a small drainage tube. However the fluid often reaccumulates and the chest physician or surgeon may perform a procedure called a ‘Pleurodesis’. This is an attempt to stick the lung surface to the chest wall by inserting sterile talc into the pleural space. This may be done by a surgeon using ‘key hole surgery’ otherwise called VATS - Video Assisted Thoracoscopic Surgery.

•   Chemotherapy
•   Radiotherapy
•   Surgery'

Chemotherapy

This is drug treatment used to try to destroy or control cancer cells. Unlike some other cancers there is no evidence that chemotherapy ever cures Mesothelioma. Some trials and studies have however indicated that it may help to improve symptoms temporarily and may extend life expectancy slightly. Not all patients with Mesothelioma will benefit from chemotherapy and there is no way of knowing which patients will benefit and which will not. It is important for you to discuss this with the doctors and nurses involved in providing it.

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. The drugs work by disrupting the growth of the cancer cells. In some people, chemotherapy may control the growth of mesothelioma for a time, reducing symptoms and giving a better quality of life. Chemotherapy may help some people with mesothelioma to live for a few months longer, but can’t usually cure it. Chemotherapy may be given before surgery for pleural mesothelioma. This is sometimes called neoadjuvant chemotherapy. It can shrink the tumour making it easier to remove. Or, if there is a possibility that there are cancer cells elsewhere in the body, giving chemotherapy sooner rather than later may increase the chance of controlling them. Chemotherapy can also be given after surgery to reduce the chances of the mesothelioma coming back. It aims to destroy any cancer cells that might be left behind after the operation. This is called adjuvant chemotherapy. The effectiveness of chemotherapy in treating mesothelioma is still being researched.

Side effects

While chemotherapy drugs are acting on the cancer cells in your body, they also temporarily reduce the number of white cells in your blood (neutropenia). When the number of these cells is low, you are more likely to get an infection and you may tire easily. Contact your doctor or the hospital straight away if

• Your temperature goes above 38°C (100.4°F)

• You suddenly feel unwell, even with a normal temperature.

During chemotherapy, your blood will be tested regularly and, if necessary, you’ll be given antibiotics to treat any infection. You may be given blood transfusions if you are anaemic. Other side effects vary according to the chemotherapy drugs being used. They may include feeling sick (nausea), being sick (vomiting), diarrhoea and hair loss. Some drugs also make your mouth sore and may cause small mouth ulcers. Using mouthwashes regularly is important and the nurses will show you how to use these properly. Medicines are also available from your doctor to help you stop feeling sick (anti-emetics). Although they may seem hard to bear at the time, the side effects are temporary and will disappear once your treatment is over. If you lose your hair, it will start to grow back a couple of months after the treatment has finished. Chemotherapy affects different people in different ways. Some people are able to lead a normal life during their treatment; others find they become very tired and have to take things more slowly. Just do as much as you feel like doing and try not to overtire yourself.