Mesothelioma can be treated surgically to remove the cancer cells, with radiation therapy (using high-dose X-rays to kill cancer cells), and chemotherapy (using high-dose anti-cancer medication to kill the cancer cells).
The two main surgical procedures for mesothelioma are:
- A pleurectomy, in which the surgeon removes part of the lining of the chest or abdomen and some of the tissue around it;
- An extrapleural pneumonectomy, in which the entire lung, along with its pleural lining, and the diaphragm (the breathing muscle located below the lungs) are all removed.
If the cancer has spread too far to be treated with surgically, surgery may still be performed to relieve symptoms, which is called palliative surgery because it is not meant as a cure. For example, fluid in the chest can be relieved by placing a needle in the chest cavity. A similar procedure can be used to remove fluid in the abdomen and heart. Fluid can also be removed in a pleuroscopy, in which the surgeon looks into the pleural cavity through a small hole or holes, and empties the fluid under direct vision. (This procedure also allows directed sampling, or biopsies, of the cancer when a diagnosis is still being sought.) Often, this procedure is completed with a chemical pleurodesis, in which a pleural irritant--most commonly talcum powder--is left in the pleural cavity to minimize the risk of the fluid coming back.
Radiation therapy can be performed externally or internally. External radiation uses a machine outside the body. Internal radiation, also called brachytherapy, involves the insertion of radioisotopes (materials that produce radiation) through thin plastic tubes directly into the place where cancer cells are found.
Chemotherapy may be taken in pill form or given intravenously.