Mesothelioma Treatment Options

After asbestos exposure and a mesothelioma diagnosis, what will a treatment regimen look like?

Asbestos exposure has been linked to health problems for decades, with the most serious asbestos-related illness being a form of cancer called mesothelioma. While mesothelioma is typically considered a fatal illness, treatment can extend an asbestos plaintiff's life for months, even years, and a treatment regimen can proceed alongside an asbestos-mesothelioma lawsuit.

In this article, we'll cover:

  • common mesothelioma screening methods, and
  • treatment options for mesothelioma patients, including a recently-approved combination drug therapy.

Screening for Mesothelioma

If a preliminary medical exam prompts your doctor to perform follow-up tests for the possibility of mesothelioma, here's a look at the kinds of screening procedures that might be used.

Imaging tests. Your doctor may use a number of imaging tests to screen for asbestos-related health problems. These might include x-ray, MRI (magnetic resonance imaging), PET (positron emission tomography) scans, and CT (computed tomography) scans. The CT scan is the most modern (and most valuable) technique for screening at-risk patients for signs of mesothelioma. That's because the CT scan produces a cross-section image of a patient's lung or abdomen, giving radiologists a view that standard x-rays can't provide.

Fluid removal and testing. If examination of a patient's chest or abdomen indicates the presence of fluid, the doctor may want to drain the fluid and examine it further. This is done by inserting a needle into the chest (a procedure called thoracentesis) or abdomen (paracentesis) and drawing the fluid out so it can be tested.

Thoracoscopy (tissue sampling). In this procedure, your doctor will use a device called a thoroscope to take a look inside your chest cavity. Like a biopsy, a thoracoscopy involves a small incision in your chest and the removal of a portion of tissue for examination. Patients might feel some pressure in their chest area during this procedure, but it is usually relatively pain-free. (While thoracoscopy involves examination of tissue in the chest, a similar procedure uses a tool called a peritoneoscope to examine tissue in the abdomen.)

Treating Mesothelioma

While there is no cure for malignant mesothelioma, a number of treatment methods—especially when used in combination—can be effective in managing the disease and prolonging life.

Keep in mind that doctors who specialize in the treatment of mesothelioma patients typically use a combination of the therapies described below (called a "multimodal" approach). Also remember that some of the treatment methods discussed below may be in the experimental stages of development.

FDA Approves New Combination Drug Therapy

In October 2020, the U.S. Food and Drug Administration (FDA) approved two drugs for use in combination—Opdivo (nivolumab) and Yervoy (ipilimumab)—to treat malignant pleural mesothelioma that cannot be treated through surgery. This combination is the FDA's first drug regimen approved for treatment of mesothelioma in 16 years.

According to the FDA, Opdivo and Yervoy "are both monoclonal antibodies that, when combined, decrease tumor growth by enhancing T-cell function." And this newly-approved combination compares favorably with chemotherapy treatment. In studies, "patients who received Opdivo in combination with Yervoy survived a median of 18.1 months while patients who underwent chemotherapy survived a median of 14.1 months," FDA says.

Chemotherapy

Chemotherapy uses anti-cancer medications (called cytotoxic drugs) and chemicals in an attempt to kill malignant mesothelioma cells. A number of different drugs have been developed and tried in mesothelioma patients over the years, but all have achieved only limited success, so chemotherapy is almost always used in combination with other treatment methods. Specific types of chemotherapy treatments for mesothelioma include Alimta (pemetrexed) and vinorelbine.

Radiation Therapy

Radiotherapy (or radiation therapy) involves the use of localized and high-dose radiation to treat malignant mesothelioma tumors. Radiation therapy is almost always used in combination with other mesothelioma treatment methods, like surgery and chemotherapy, and isn't always an option if a tumor is very large or is situated close to vital organs.

Photodynamic Therapy

Also called PDT, photodynamic therapy involves the use of a drug to sensitize cancerous cells to light, and then the utilization of fiber-optic cables to focus the right frequency of light on the cancerous growth. The sensitizing drug and the light work in concert to produce a toxic molecule that kills the cancerous cells. Like most mesothelioma treatment methods, photodynamic therapy is typically used in combination with other treatment techniques to achieve optimal results.

Anti-Angiogenesis Therapy

Angiogenesis is the medical term for the growth of blood vessels that nourish cells in the body, including cancer cells. Drugs called "angiogenesis inhibitors" are used to stop—or at least slow—the angiogenesis of cancer cells and, in effect, starve tumors in mesothelioma patients. A number of experimental anti-angiogenesis drugs are currently in development and evaluation, including endostatin, combrestatin, angiostatin, and thrombospondin.

Immunotherapy and Gene Therapy

This kind of treatment tries to boost the mesothelioma patient's immune system and their ability to fight off cancerous cells, while stemming the harshest effects of the disease.

In gene therapy, a gene is delivered directly into the cancerous growth in order to allow drugs to do the work of destroying cancerous cells. This treatment carries some risk, but the idea is to target the tumor itself while leaving healthy cells unharmed (unlike chemotherapy, which kills both cancerous and healthy cells).

Another immunotherapy treatment method for mesothelioma involves the use of small proteins (called cytokines) that occur naturally in the human body. Cytokine protein molecules called interferons and interleukins may be used to successfully block or stunt the growth of malignant cancer cells.

Surgery

Sometimes surgery can be effective in providing relief from symptoms of mesothelioma, and removal of most of a cancerous growth is possible in some instances. But surgery may not be an effective option (or may not be an option at all) in some cases, especially when a malignant mesothelioma tumor is situated close to a vital organ.

For surgical treatment of pleural mesothelioma (found in the lining of the chest cavity and lungs), there are usually two options: extra-pleural pneumonectomy (EPP) and pleurectomy/decortications. Both procedures involve surgical removal of the pleura, the thin membrane surrounding the lungs and chest cavity, but EPP also involves the removal of the entire lung that is involved with the tumor.

Getting Legal Help

To best understand your options and protect your legal rights in the wake of a mesothelioma diagnosis, you may want to talk to an experienced attorney. Learn more about hiring the right asbestos lawyer for you and your case, and what to expect if you decide to file an asbestos-mesothelioma lawsuit.

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