Mesothelioma summary of treatment for pleural mesothelioma

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

The treatment options vary for the different stages, subtypes, and resectability of pleural mesothelioma. The types of treatment given are also based on the unique needs of the individual with cancer.^[1]

The treatment options vary for the different stages, subtypes, and resectability of pleural mesothelioma. The types of treatment given are also based on the unique needs of the individual with cancer.^[1]

• Individuals with localized (stage I) pleural mesothelioma that is considered resectable may be offered, which include:^[1]

• Surgery

• Pleurectomy and decortication (P/D)
• Extrapleural pneumonectomy (EPP)

• Chemotherapy after surgery
• Radiation therapy after extrapleural pneumonectomy

• Individuals with localized (stage I) pleural mesothelioma that is unresectable and people who decide not to have radical surgery may be offered other treatments. Treatments offered to control the disease for as long as possible, manage symptoms, and improve the person’s quality of life may include:^[1]

• Palliative surgical procedures

• Pleurectomy and decortication for palliation
• Thoracentesis, pleurodesis, pleuroperitoneal shunt

• Chemotherapy
• Radiation therapy

• Individuals with advanced (stage II or some stage III) pleural mesothelioma that is considered resectable may be offered:^[1]

• Surgery

• Pleurectomy and decortication (P/D)
• Extrapleural pneumonectomy

• Chemotherapy before or after surgery
• Radiation therapy after extrapleural pneumonectomy

• Individuals with advanced (stage II or stage III) pleural mesothelioma that is considered unresectable may be offered, which include:^[1]

• Palliative surgical procedures

• Pleurectomy and decortication for palliation
• Thoracentesis, pleurodesis, pleuroperitoneal shunt

• Chemotherapy
• Radiation therapy
• Supportive care

• Extensive surgery is not used for stage IV pleural mesothelioma because of the extent of disease at this stage. Chemotherapy is often the mainstay of treatment. Radiation therapy and other supportive care measures, such as thoracentesis or pleurodesis, may also be used to control symptoms of advanced mesothelioma, control the disease for as long as possible, and improve the individual’s quality of life.

• If pleural mesothelioma recurs after it has been treated, treatment options depend on:^[1]

• the location of the cancer
• the treatments that have already been used
• the person’s overall health

• Treatment options similar to unresectable pleural mesothelioma may be used for recurrent mesothelioma. Chemotherapy may be used to try to shrink or slow the growth of the cancer and relieve symptoms. Radiation therapy and other supportive care measures may be used to relieve symptoms.^[1]

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