Mesothelioma (also known as malignant mesothelioma) is a rare cancer that affects the thin layer of tissue (mesothelium) lining the chest, abdominal cavities and most of the organs within them.
Mesothelioma tumors are typically associated with asbestos and erionite exposure, although only a small fraction of individuals exposed to erionite or asbestos actually develop mesothelioma. The risk is increased for those individuals who carry the BAP1 gene mutation.
Each year, approximately 3,000 new cases of mesothelioma are diagnosed. The majority of those diagnosed are over 65 years of age since symptoms often don't appear until two or more decades after exposure.
Malignant Mesothelioma Treatments
There are three types of treatment typically used for patients with malignant mesothelioma: surgery, radiation therapy and chemotherapy. The treatment depends on the stage of the cancer, where it is located (in the chest or in the peritoneal lining), and whether it is the first time it has been diagnosed or if it has recurred after treatment.
Surgical procedures to treat malignant mesothelioma in the chest include:
- Wide local excision to remove the cancer and some of the healthy tissue around it
- Pleurectomy and decortication to remove part of the covering of the lungs and lining of the chest and part of the outside surface of the lungs
- Extrapleural pneumonectomy to remove one whole lung and part of the lining of the chest, the diaphragm and the lining of the sac around the heart
- Pleurodesis, which uses chemicals or drugs to create a scar in the layers of the pleura to prevent the build-up of fluid in the pleural cavity
Both external and internal radiation can be used for malignant mesothelioma, depending on the cancer's type and stage.
- External radiation therapy uses high-energy X-ray beams outside the body to send radiation to the location of the cancer.
- Internal radiation therapy uses a radioactive substance sealed in needles, seeds, or wires that are placed directly into or near the cancer.
There are several types of chemotherapy used for malignant mesothelioma.
- Systemic chemotherapy is administered either orally or by injection into the vein. It travels through the bloodstream and attacks cancer cells throughout the body.
- Regional chemotherapy involves delivering the chemotherapy drug specifically to the area where cancer cells are located, either by placing it into the cerebrospinal fluid, an organ or a body cavity such as the chest or peritoneum.
- Hyperthermic intraperitoneal chemotherapy, used for mesothelioma that has spread to the peritoneum (tissue that lines the abdomen and covers most of the organs in the abdomen), is used after surgical removal of all visible cancer. It involves pumping a heated chemotherapy solution into and out of the abdomen.
The FDA has approved the following drugs for use in treating malignant mesothelioma:
- Alimta (Pemetrexed Disodium)
- Pemetrexed Disodium
- Platinol (Cisplatin)
- Platinol-AQ (Cisplatin)
- Gemcitabine-Cisplatin combination
Sarah Cannon is currently conducting clinical trials for novel treatments for mesothelioma patients. For more information, call askSARAH at (844) 482-4812.
American Cancer Society What's new in malignant mesothelioma research and treatment?
Malignant mesothelioma (Pak J Med Sci. 2013)
National Cancer Institute (NCI) Drugs Approved for Malignant Mesothelioma
National Cancer Institute (NCI) Treatment Option Overview
NIH-funded researchers discover genetic link to mesothelioma (NIH press release)
The Cancer Genome Atlas Mesothelioma