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Malignant Mesothelioma
Information
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Malignant
Mesothelioma - General Information
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What
is malignant mesothelioma?
Malignant mesothelioma, a
rare form of cancer, is a disease in which cancer (malignant) cells are found in the sac
lining the chest (the pleura) or abdomen (the peritoneum). Most people with malignant
mesothelioma have worked on jobs where they breathed asbestos.
A doctor should be seen if a person has shortness of breath, pain in the
chest, or pain or swelling in the abdomen. If there are symptoms, the doctor may order an
x-ray of the chest or abdomen.
The doctor may look inside the chest cavity with a special instrument
called a thoracoscope. A cut will be made through the chest wall and the thoracoscope will
be put into the chest between two ribs. This test, called thoracoscopy, is usually done in
the hospital. Before the test, the patient will be given a local anesthetic (a drug that
causes a loss of feeling for a short period of time). Some pressure may be felt, but
usually there is no pain.
The doctor may also look inside the abdomen (peritoneoscopy) with a
special tool called a peritoneoscope. The peritoneoscope is put into an opening made in
the abdomen. This test is also usually done in the hospital. Before the test is done, a
local anesthetic will be given.
If tissue that is not normal is found, the doctor will need to cut out a
small piece and have it looked at under a microscope to see if there are any cancer cells.
This is called a biopsy. Biopsies are usually done during the thoracoscopy or
peritoneoscopy.
The chance of recovery (prognosis) depends on the size of the cancer,
where the cancer is, how far the cancer has spread, how the cancer cells look under the
microscope, how the cancer responds to treatment, and the patient's age. |
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Stage
Information
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Stages of
malignant mesothelioma
Once malignant mesothelioma
is found, more tests will be done to find out if cancer cells have spread to other parts
of the body. This is called staging. A doctor needs to know the stage of the cancer to
plan treatment. The following stages are used for malignant mesothelioma. |
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Localized
malignant mesothelioma
Stage I: The cancer is
found in the lining of the chest cavity near the lung and heart or in the diaphragm or the
lung. |
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Advanced
malignant mesothelioma
Stage II: The cancer has
spread beyond the lining of the chest to lymph nodes in the chest.
Stage III: Cancer has spread into the chest wall, center of the chest,
heart, through the diaphragm, or abdominal lining, and in some cases into nearby lymph
nodes.
Stage IV: Cancer has spread to distant organs or tissues. |
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Recurrent
malignant mesothelioma
Recurrent disease means
that the cancer has come back (recurred) after it has been treated. It may come back in
the lining of the chest or abdomen or in another part of the body. |
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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:
- surgery (taking out the
cancer)
- radiation therapy (using
high-dose x-rays or other high-energy rays to kill cancer cells)
- chemotherapy (using drugs to
fight the cancer)
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.
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).
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.
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).
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.
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.
If the cancer is found in a
larger part of the pleura, treatment may be one of the following:
- 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:
- 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
Call
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.
Web sites and Organizations
The National Cancer
Institute'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.
Publications
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
(https://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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