Mesothelioma is diagnosed most often in late-stages when the disease has already spread to other organs and tissues in the body. As mesothelioma becomes more advanced and progresses through the stages of cancer, the treatment options become increasingly limited.
Although there is no cure for any stage of mesothelioma, other forms of treatments are available to increase survival, improve quality of life and promote comfort in the end stages of the disease.
What Is Palliative Care?
At late-stage mesothelioma, individuals are not candidates for traditional surgeries to remove localized tumors. The treatment lens is often shifted from the goal of a cure to the goal of comfort, which is referred to as palliative care.
Palliative care is multidisciplinary, holistic care provided to patients with terminal illnesses. The palliative care approach encompasses treatment of physical symptoms of the illness as well as emotional stress.
Common Treatments for End-Stage Mesothelioma
Palliative options for individuals with end-stage mesothelioma include any combination of chemotherapy, radiation and surgery as well as novel therapies like immunotherapy and clinical trials.
Chemotherapy is a very common treatment option for late-stage mesothelioma. Chemotherapy can be administered intravenously, having a systemic effect on the body, or it can sometimes be administered directly into a specific organ in the body.
- For peritoneal mesothelioma patients, doctors may administer chemotherapy directly into the abdomen in efforts to increase exposure of chemotherapeutic agents to malignant cells in the peritoneum.
- For pleural mesothelioma patients, doctors may administer chemotherapy into the pleural space (the space between the two lung linings). Chemotherapy can shrink tumors, causing less physical discomfort or pain.
Chemotherapy can also slow the progression of tumor growth, which may prolong the individual’s life expectancy.
Radiation therapy may also be used in late-stage mesothelioma treatment. It is often used in conjunction with chemotherapy. Unlike systemic chemotherapy, radiation is localized to specific tumor locations.
Radiation can reduce the size of tumors that may be causing pain, difficulty breathing or general discomfort.
Surgical intervention for late-stage mesothelioma patients is palliative in nature, meaning they are not intended to cure the disease but to treat symptoms, improve quality of life and prolong life expectancy.
Peritoneal Surgery: Late-stage peritoneal patients can undergo a paracentesis—when a physician makes a small perforation of the peritoneal cavity in the abdomen with a hollow needle to drain excess fluid buildup caused by tumors. This treatment is not permanent but can provide short-term comfort.
Pleural Surgery: Options for pleural mesothelioma include a thoracentesis or a pleurodesis. A thoracentesis is where a hollow needle is inserted into the pleural space (lung lining) to drain fluid buildups called pleural effusions. Pleural effusions often cause shortness of breath and impaired oxygen gas-exchange to the body.
A pleurodesis can be a permanent solution to frequent pleural effusions, as it involves the adherence of both lung linings (pleurae) so that there is no space in-between.
Furthermore, surgeries may be done to remove large or problematic tumors to relieve pain and improve breathing for patients suffering from end-stage mesothelioma.
Immunotherapy and clinical trials may be available to some patients as experimental treatment. Some studies have found a significant increase in late-stage pleural mesothelioma survival rate among patients who undergo immunotherapy and novel treatments.
If you are interested in experimental treatments or clinical trials, connect with your physician to see if you are an eligible candidate and to review the options available to you.
Less invasive measures can also help with end-stage mesothelioma care. Medical management typically involves prescribing medication to promote comfort.
Medications may be used for:
- Alleviating pain
- Managing and preventing nausea
- Relieving anxiety
- Clearing airways to allow easier breathing
Non-medical symptom-management includes holistic approaches like:
- Guided imagery therapy
- Music therapy
- Reiki therapy
Social Workers and Mesothelioma Care
During end-stage care, healthcare professionals prioritize patient dignity, family and respect for patient’s wishes throughout end-of-life care. To achieve this, an excellent resource available to individuals with mesothelioma is social workers.
Social work is a service that can be of great benefit to both patients and their families. Social workers are able to assist areas of social and spiritual stress, counseling for individual and/or family, and grief and bereavement planning.
Social workers are often available to navigate financial assistance options to unburden the patient of financial stress. Furthermore, social workers can be a community liaison to connect patients with other resources available in their communities or through other support options.
Mesothelioma Patients Require Multimodal Therapy
The above treatment options are often used together for a multimodal approach to treating mesothelioma to promote prolonged life expectancy, improved quality of life and comfort. In addition to medical and surgical treatment options, palliative care encompasses a holistic approach to care.