Malignant mesothelioma is an aggressive disease that is challenging to treat. But it is manageable with the right treatments – and there is no single treatment plan that’s best for everyone, and not everyone starts treatment right away.
As a comprehensive cancer center designated by the National Cancer Institute, Roswell Park doesn’t just offer more treatment options, we offer you better, personalized treatment options that can lead to better outcomes.
Surgery for mesothelioma
There are two main types of surgeries for mesothelioma: pleurectomy decortication, which spares the lung and extra pleural pneumonectomy, in which the lung itself is removed. Roswell Park’s surgical program emphasizes lung-sparing surgery, so pleurectomy decortication is the preferred surgical treatment for malignant mesothelioma. Patients who undergo pleurectomy decortication face an extended recovery period, but the procedure has been shown to extend survival time in carefully selected patients.
Medical therapy for mesothelioma
Medical therapies use drugs to kill cancer cells or slow their growth. These are called systemic therapies because the medications travel through the blood to the whole body to find and attack cancer cells. These treatments may be used to treat your mesothelioma before or after surgery, as a primary treatment if you cannot undergo surgery, or in combination with other treatments such as radiation therapy. Your personalized treatment plan may include one or more of the following approaches.
- Chemotherapy uses powerful drugs to kill cancer cells and may be used both before and after surgery, or to treat patients who are unable tolerate surgery. Chemotherapy is also used as a palliative treatment to reduce pain, maintain lung function and preserve quality of life in patients with advanced disease.
- Immunotherapy is a newer type of cancer treatment that uses drugs to help the body’s immune system find and destroy cancer cells.
- Angiogenesis inhibitors block the creation of blood vessels that a tumor needs to get oxygen and fuel for continued growth.
Radiation therapy for mesothelioma
When a malignant mesothelioma tumor develops near the heart and lungs, it’s challenging to provide the intensive therapy needed to shrink it. However, intensity-modulated radiotherapy (IMRT), which is available at only a few centers nationwide, including Roswell Park, can accurately target cancer cells and avoid damaging healthy tissue.
Other treatments for mesothelioma
Photodynamic therapy (PDT) was developed in the late 1970s at Roswell Park. It is a targeted anticancer treatment that kills tumor cells without permanently damaging surrounding tissue. Patients are given a nontoxic drug intravenously that settles into tumor cells and makes them highly sensitive to a certain type of light.
This is followed by the application of laser light to target and kill the cancer cells.
At Roswell Park, PDT is used in combination with surgery to treat localized mesothelioma and other select types of cancer. The addition of PDT to conventional therapy has improved survival rates and quality of life for patients with early-stage disease.
Cytoreductive surgery/Hyperthermic Intraperitoneal chemotherapy (CS/HIPEC) was established in 2002 at Roswell Park and is today routinely used as a treatment for peritoneal mesothelioma, once considered fatal with patients surviving an average of only one year after diagnosis.
CS/HIPEC surgically removes all visible tumors, then circulates high doses of heated chemotherapy drugs throughout the abdominal wall to kill cancer cells. Because the drugs are restricted to the abdomen, higher doses can be used without additional side effects on other healthy tissue and organs.
The results of CS/HIPEC can be highly effective, with about 70% of patients surviving for five years. Roswell Park is the only center in New York State to offer this cutting-edge therapy; we treat patients who come here from across the United States and Canada.
Intrapleural heated chemotherapy (HITOC), a treatment very similar to HIPEC, also used for treatment of pleural mesotheliomas. In the operating room, immediately following surgery, surgeons spray heated chemotherapy drugs directly into the thoracic cavity before closing up the chest.
Clinical trials for mesothelioma
Roswell Park’s dedication to clinical research is a hallmark of our mission to understand, prevent and cure cancer. We do not have any current clinical trials for mesothelioma available at Roswell Park, but you can check the National Cancer Institute website for cancer clinical trials that are currently enrolling patients with recurrent malignant mesothelioma.