Recurrent malignant mesothelioma is cancer that has recurred (come
back) after it has been treated. The cancer may come back in the chest
or abdomen or in other parts of the body.
Treatment Option Overview
There are different types of treatment for patients with malignant mesothelioma.
Different
types of treatments are available for patients with malignant
mesothelioma. Some treatments are standard (the currently used
treatment), and some are being tested in clinical trials. A treatment
clinical trial is a research study meant to help improve current
treatments or obtain information on new treatments for patients with
cancer. When clinical trials show that a new treatment is better than
the standard treatment, the new treatment may become the standard
treatment. Patients may want to think about taking part in a clinical
trial. Some clinical trials are open only to patients who have not
started treatment.
Three types of standard treatment are used:
Surgery
The following surgical treatments may be used for malignant mesothelioma:
- Wide local excision: Surgery to remove the cancer and some of the healthy tissue around it.
- Pleurectomy
and decortication: Surgery 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: Surgery 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:
A surgical procedure that uses chemicals or drugs to make a scar in the
space between the layers of the pleura. Fluid is first drained from the
space using a catheter or chest tube and the chemical or drug is put
into the space. The scarring stops the build-up of fluid in the pleural
cavity.
Even if the doctor removes all the cancer that can
be seen at the time of the surgery, some patients may be given
chemotherapy or radiation therapy after surgery to kill any cancer cells
that are left. Treatment given after surgery, to increase the chances
of a cure, is called adjuvant therapy.
Radiation therapy
Radiation
therapy is a cancer treatment that uses high-energy x-rays or other
types of radiation to kill cancer cells or keep them from growing.
There are two types of radiation therapy. External radiation therapy
uses a machine outside the body to send radiation toward the cancer.
Internal radiation therapy uses a radioactive substance sealed in
needles, seeds, wires, or catheters that are placed directly into or
near the cancer. The way the radiation therapy is given depends on the
type and stage of the cancer being treated.
Chemotherapy
Chemotherapy
is a cancer treatment that uses drugs to stop the growth of cancer
cells, either by killing the cells or by stopping them from dividing.
When chemotherapy is taken by mouth or injected into a vein or muscle,
the drugs enter the bloodstream and can reach cancer cells throughout
the body (systemic chemotherapy). When chemotherapy is placed directly
into the spinal column, an organ, or a body cavity such as the abdomen,
the drugs mainly affect cancer cells in those areas (regional
chemotherapy). Combination chemotherapy is the use of more than one
anticancer drug. The way the chemotherapy is given depends on the type
and stage of the cancer being treated.
New types of treatment are being tested in clinical trials.
This
summary section describes treatments that are being studied in clinical
trials. It may not mention every new treatment being studied.
Information about clinical trials is available from the NCI Web site.
Biologic therapy
Biologic
therapy is a treatment that uses the patient’s immune system to fight
cancer. Substances made by the body or made in a laboratory are used to
boost, direct, or restore the body’s natural defenses against cancer.
This type of cancer treatment is also called biotherapy or
immunotherapy.
Patients may want to think about taking part in a clinical trial.
For
some patients, taking part in a clinical trial may be the best
treatment choice. Clinical trials are part of the cancer research
process. Clinical trials are done to find out if new cancer treatments
are safe and effective or better than the standard treatment.
Many
of today's standard treatments for cancer are based on earlier clinical
trials. Patients who take part in a clinical trial may receive the
standard treatment or be among the first to receive a new treatment.
Patients
who take part in clinical trials also help improve the way cancer will
be treated in the future. Even when clinical trials do not lead to
effective new treatments, they often answer important questions and help
move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some
clinical trials only include patients who have not yet received
treatment. Other trials test treatments for patients whose cancer has
not gotten better. There are also clinical trials that test new ways to
stop cancer from recurring (coming back) or reduce the side effects of
cancer treatment.
Clinical trials are taking place in many parts
of the country. See the Treatment Options section that follows for links
to current treatment clinical trials. These have been retrieved from
NCI's clinical trials database.
Follow-up tests may be needed.
Some
of the tests that were done to diagnose the cancer or to find out the
stage of the cancer may be repeated. Some tests will be repeated in
order to see how well the treatment is working. Decisions about whether
to continue, change, or stop treatment may be based on the results of
these tests. This is sometimes called re-staging.
Some of the
tests will continue to be done from time to time after treatment has
ended. The results of these tests can show if your condition has changed
or if the cancer has recurred (come back). These tests are sometimes
called follow-up tests or check-ups.
