Treatment for Mesothelioma

Mesothelioma Expertise at Fred Hutch

Surgery

Surgical procedures for pleural mesothelioma include:

• Removing the lining inside your chest and over your lung (pleurectomy/decortication) on the side of your cancer. Sometimes surgeons also need to remove and reconstruct the lining around the heart, diaphragm (breathing muscle below your lungs) or both. Typically people who have this surgery also have other forms of treatment, like chemotherapy and radiation therapy.
• Removing your entire lung with the lining inside your chest wall, the diaphragm and the lining around the heart on the side of your cancer (extrapleural pneumonectomy). Most people have other treatments, like chemotherapy and radiation therapy, along with this surgery.
• Making a small incision to place medicine inside your chest through a tube (VATS pleurodesis). This is done to adhere your lung to the inside of your chest wall so fluid cannot build up in your chest and make it hard for you to breathe.
• Making a small incision to put a tube in the space around your lung (VATS indwelling catheter placement). If fluid inside your chest makes breathing difficult, you can drain the fluid through the tube without having to go to the doctor's office.

Even if your tumor has spread too far to hope to remove it completely with surgery, your team might recommend surgery to relieve your symptoms (palliative surgery).

Radiation Therapy

For mesothelioma, radiation therapy may be given externally or internally. 

• External radiation uses a machine outside your body to aim high-energy beams at your tumor. 
• Internal radiation, also called brachytherapy, involves inserting radioisotopes (materials that produce radiation) through thin plastic tubes directly into the place where cancer cells are.

Chemotherapy

Chemotherapy medicines for mesothelioma are usually given through an intravenous (IV) line so they can travel through your bloodstream.

Recent studies suggest an increasing role for immunotherapy in treating this disease. Fred Hutch has been involved in clinical studies exploring the addition of immunotherapy in mesothelioma treatment.

Your Fred Hutch team will talk with you about the specific medicines we recommend for you, how you’ll receive them, your treatment schedule and what to expect. We’ll also explain how to take the best possible care of yourself during treatment and after, and we’ll connect you with medical and support resources throughout Fred Hutch.

Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS-HIPEC)

This treatment is for people with mesothelioma of the abdomen that has spread to the abdominal lining (peritoneum). Cancer that has spread here is called peritoneal carcinomatosis, or peritoneal cancer.

CRS-HIPEC may be able to control advanced disease while also giving you good quality of life. It combines two parts in one operation:

• A surgery to remove all the cancer that surgeons can see
• Chemotherapy, in liquid form, that is warmed and then put into your abdomen to kill any cancer cells left behind after surgery

Fred Hutch has an experienced team that provides CRS-HIPEC. 

Learn more about CRS-HIPEC