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Mesothelioma

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Treatment of pleural mesothelioma

Mesothelioma is very difficult to treat. The following are treatment options for the different stages of pleural mesothelioma, which are based on whether the cancer is considered operable (resectable) or not. The types of treatments given are also based on the unique needs of the person with cancer.

Surgery may not be an option for people with sarcomatoid subtype of pleural mesothelioma. People with this subtype often have a poor outcome because it can be resistant to treatment.

Localized or stage I pleural mesothelioma

People with localized (stage I) pleural mesothelioma that is considered operable (resectable) may be offered:

People with localized (stage I) pleural mesothelioma that is considered inoperable (unresectable) and people who decide not to have radical surgery may be offered other treatments. Treatments offered to control the disease for as long as possible, manage symptoms and improve the person’s quality of life may include:

  • palliative surgical procedures
    • pleurectomy and decortication for palliation
    • thoracentesis, pleurodesis, pleuroperitoneal shunt
  • chemotherapy
  • radiation therapy

Advanced or stage II, III or IV pleural mesothelioma

People with advanced (stage II or some stage III) pleural mesothelioma that is considered operable (resectable) may be offered:

  • surgery
    • pleurectomy and decortication (P/D)
    • extrapleural pneumonectomy
  • chemotherapy before or after surgery
  • radiation therapy after extrapleural pneumonectomy

People with advanced (stage II or stage III) pleural mesothelioma that is considered inoperable (unresectable) may be offered:

  • palliative surgical procedures
    • pleurectomy and decortication for palliation
    • thoracentesis, pleurodesis, pleuroperitoneal shunt
  • chemotherapy
  • radiation therapy
  • supportive care

Extensive surgery is not used for stage IV pleural mesothelioma because of the extent of disease at this stage. Chemotherapy is often the mainstay of treatment. Radiation therapy and other supportive care measures, such as thoracentesis or pleurodesis, may also be used to control symptoms of advanced mesothelioma, control the disease for as long as possible and improve the person’s quality of life.

Recurrent pleural mesothelioma

If pleural mesothelioma comes back (recurs) after it has been treated, treatment options depend on:

  • the location of the cancer
  • the treatments that have already been used
  • the person’s overall health

Treatment options similar to unresectable pleural mesothelioma may be used for recurrent mesothelioma. Chemotherapy may be used to try to shrink or slow the growth of the cancer and relieve symptoms. Radiation therapy and other supportive care measures may be used to relieve symptoms.

Clinical trials

People with mesothelioma may be offered the opportunity to participate in clinical trials. For more information, go to clinical trials.

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