What Therapeutic Options Are Available For Treating Mesothelioma?
Chemotherapy is the first line of treatment for most mesothelioma patients, and is typically combined with other therapies. The drug combination of the antifolate pemetrexed and the platinum analog cisplatin improves both symptoms and survival. Radiation may shrink tumors, but it must be controlled to prevent lung damage. Surgical options include tumor removal, which improves symptoms but does not affect survival. For pleural mesothelioma, this includes removal of the pleura, as well as neighboring diaphragm and pericardium, depending on the degree of involvement. Pain may be controlled by draining fluid from the chest (thoracentesis) or abdomen (paracentesis). In pleurodesis, another palliative option, the pleural space is closed, preventing local fluid accumulation. Aggressive surgical treatments include extrapleural pneumonectomy (EPP), which removes most potential tumor cells by resection of the lung, pleura, diaphragm, and local pericardium. Candidates for this surgery must have sufficient pulmonary performance to function without a lung.
