| Mesothelioma Symptoms Diagnosis
and Treatment |
| Mesothelioma is typically first
detected after having symptoms of shortness of breath, difficulty
breathing, pain in the chest or pain or swelling in the abdomen.
When these symptoms are present the physician will usually
order a chest x-ray and listen to the chest. In Many cases,
the chest x-ray will reveal that fluid has accumulated in
the lung. This accumulation of fluid is called a pleural
effusion and is a common sign of mesothelioma. |
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| Pleural Effusion |
| The symptoms of the pleural
effusion can be relieved by a procedure known as a thorocentesis.
The procedure is performed by inserting a needle through
the chest wall between the ribs into the area of the lung
where the fluid has accumulated. The fluid is then drained
out and the lung can more fully expand, thus giving the patient
some immediate relief from the breathing difficulties and
shortness of breath. |
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| Treatment Option Overview |
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| How malignant mesothelioma is treated |
| There are treatments for all patients with malignant mesothelioma.
Three kinds of treatment are used: |
| 1. surgery (taking out the cancer) |
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| 2. radiation therapy (using high-dose x-rays or other high-energy
rays to kill cancer cells) |
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| 3. chemotherapy (using drugs to fight the cancer) |
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| Surgery is a common treatment of malignant mesothelioma.
The doctor may remove part of the lining of the chest or
abdomen and some of the tissue around it. Depending on how
far the cancer has spread, a lung also may be removed in
an operation called a pneumonectomy. Sometimes part of the
diaphragm, the muscle below the lungs that helps with breathing,
is also removed. |
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| Radiation therapy uses high-energy x-rays to kill cancer
cells and shrink tumors. Radiation may come from a machine
outside the body (external radiation therapy) or from putting
materials that produce radiation (radioisotopes) through
thin plastic tubes in the area where the cancer cells are
found (internal radiation therapy). |
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| If fluid has collected in the chest or abdomen, the doctor
may drain the fluid out of the body by putting a needle into
the chest or abdomen and using gentle suction to remove the
fluid. If fluid is removed from the chest, this is called
thoracentesis. If fluid is removed from the abdomen, this
is called paracentesis. The doctor may also put drugs through
a tube into the chest to prevent more fluid from accumulating. |
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| Chemotherapy uses drugs to kill cancer cells. Chemotherapy
may be taken by pill, or it may be put into the body by a
needle in the vein or muscle. Chemotherapy is called a systemic
treatment because the drug enters the bloodstream, travels
through the body, and can kill cancer cells throughout the
body. In mesothelioma, chemotherapy may be put directly into
the chest (intrapleural chemotherapy). |
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| Intraoperative photodynamic therapy is a new type of treatment
that uses special drugs and light to kill cancer cells during
surgery. A drug that makes cancer cells more sensitive to
light is injected into a vein several days before surgery.
During surgery to remove as much of the cancer as possible,
a special light is used to shine on the pleura. This treatment
is being studied for early stages of mesothelioma in the
chest. |
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| Treatment by stage |
| Treatment depends on where the cancer is, how far it has
spread, and the patient's age and general health. |
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| Standard treatment may be considered because of its effectiveness
in patients in past studies, or participation in a clinical
trial may be considered. Not all patients are cured with
standard therapy and some standard treatments may have more
side effects than are desired. For these reasons, clinical
trials are designed to find better ways to treat cancer patients
and are based on the most up-to-date information. Clinical
trials are ongoing in many parts of the country for many
patients with malignant mesothelioma. To learn more about
clinical trials, call the Cancer Information Service at 1-800-4-CANCER
(1-800-422-6237); TTY at 1-800-332-8615. |
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| Localized Malignant Mesothelioma
(Stage I) |
| If the cancer is only in one place in the chest or abdomen,
treatment will probably be surgery to remove part of the
pleura and some of the tissue around it. |
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| If the cancer is found in a larger part of the pleura,
treatment may be one of the following: |
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| 1. Surgery to remove the pleura and the tissue near it
to relieve symptoms, |
| with or without radiation therapy after surgery. |
| 2. Surgery to remove sections of the pleura, the lung,
part of the |
| diaphragm, and part of the lining around the heart. |
| 3. External beam radiation therapy to relieve symptoms. |
| 4. A clinical trial of surgery followed by chemotherapy
given inside the |
| chest. |
| 5. A clinical trial of surgery, radiation therapy, and/or
chemotherapy. |
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| Advanced Malignant Mesothelioma (Stages II, III, and IV) |
| Treatment may be one of the following: |
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| 1. Draining of fluid in the chest or abdomen (thoracentesis
or paracentesis) |
| to reduce discomfort. Drugs also may be put into the chest
or abdomen to |
| prevent further collection of fluid. |
| 2. Surgery to relieve symptoms. |
| 3. Radiation therapy to relieve symptoms. |
| 4. Chemotherapy. |
| 5. A clinical trial of surgery, radiation therapy, and
chemotherapy. |
| 6. Chemotherapy given in the chest or abdomen. |
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| Recurrent Malignant Mesothelioma |
| Treatment depends on many factors, including where the
cancer came back and what treatment the patient received
before. Clinical trials are testing new treatments. |
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| To Learn More |
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| For more information, U.S. residents may call the National
Cancer Institute's (NCI's) Cancer Information Service toll-free
at 1-800-4-CANCER (1-800-422-6237) Monday through Friday
from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing callers
with TTY equipment may call 1-800-332-8615. The call is free
and a trained Cancer Information Specialist is available
to answer your questions. |
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| Web sites and Organizations |
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| The NCI's Cancer.gov Web site (http://cancer.gov) provides
online access to information on cancer, clinical trials,
and other Web sites and organizations that offer support
and resources for cancer patients and their families. There
are also many other places where people can get materials
and information about cancer treatment and services. Local
hospitals may have information on local and regional agencies
that offer information about finances, getting to and from
treatment, receiving care at home, and dealing with problems
associated with cancer treatment. |
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| Publications |
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| The NCI has booklets and other materials for patients,
health professionals, and the public. These publications
discuss types of cancer, methods of cancer treatment, coping
with cancer, and clinical trials. Some publications provide
information on tests for cancer, cancer causes and prevention,
cancer statistics, and NCI research activities. NCI materials
on these and other topics may be ordered online or printed
directly from the NCI Publications Locator (http://cissecure.nci.nih.gov/ncipubs).
These materials can also be ordered by telephone from the
Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237),
TTY at 1-800-332-8615. |
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| LiveHelp |
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| The NCI's LiveHelp service, a program available on several
of the Institute's Web sites, provides Internet users with
the ability to chat online with an Information Specialist.
The service is available from 9:00 a.m. to 7:30 p.m. Eastern
time, Monday through Friday. Information Specialists can
help Internet users find information on NCI Web sites and
answer questions about cancer. |
