Mesothelioma Symptoms

What are the most common warning signs of mesothelioma?

Mesothelioma is difficult to diagnose because the early signs and symptoms of the disease can be subtle or mistaken. Symptoms are all too frequently ignored or dismissed by people who are inclined to attribute them to common every day ailments. Sometimes patients live with symptoms for up to 6 months before being diagnosed but usually the symptoms are present for two to three months prior to a mesothelioma diagnosis.
About 60% of patients diagnosed with pleural mesothelioma experience lower back pain or side chest pain, and there are frequent reports of shortness of breath. Lower numbers of people may experience difficulty swallowing, or have a persistent cough, fever, weight loss or fatigue. Additional symptoms that some patients experience are muscle weakness, loss of sensory capability, coughing up blood, facial and arm swelling, and hoarseness.
Peritoneal mesothelioma originates in the abdomen and as a result, symptoms often include abdominal pain, weight loss, nausea, and vomiting. Fluid buildup may occur in the abdomen as well as a result of the cancer.
Asbestos exposure is considered the primary risk factor for the development of the cancer. Anyone previously exposed to asbestos displaying any of these symptoms should seek medical attention from their doctor first, only to be referred to a doctor who specializes in the treatment of mesothelioma and thoracic oncology after receiving a positive diagnosis.

How long does it take for mesothelioma symptoms to appear?

One of the most unique facts about mesothelioma is that the disease is characterized by a long latency period that is very often associated with the disease. The latency period is the amount of time that elapses from the first point of asbestos exposure to the point where symptoms begin to appear so that a diagnosis can be made. In some mesothelioma cases the latency period is reported to be 10 years but the average latency for the majority of cases is between 35 and 40 years. As a result, the cancer often progresses to later stages before a diagnosis is made. When diagnosed in the later stages, mesothelioma treatment options become more limited and are less effective.

Symptoms of Mesothelioma

Provided below is a list of symptoms that mesothelioma patients may experience. Please click on a symptom to learn more about it.

Anemia

Mesothelioma patients diagnosed with anemia have a lower than normal red blood cell count or hemoglobin in the blood.

Blood Clotting Disorder

A symptom experienced by many mesothelioma patients that can lead to anemia and other serious complications if not given appropriate medical attention.

Bowel Obstruction

Bowel obstructions can be a direct effect of the cancer. It is a very painful symptom that can sometimes develop in peritoneal mesothelioma patients.

Chest Pain

Often experienced in pleural mesothelioma and pericardial mesothelioma patients, chest pain can develop as the tumor grows and places strain on the lungs and heart.

Dysphagia

Pleural mesothelioma patients often develop difficulty swallowing (esophageal dysphagia) as the mesothelium continues to grow on the lungs.

Fluid Effusion

An effusion can occur in mesothelioma patients when there is fluid buildup affecting either the pleura or pericardium. This may need to be drained in a relatively limited surgical procedure to control the effusion and associated symptoms.

Hemoptysis

Hemoptysis, or the symptom of coughing up blood, can have its origins in the lungs, bronchi or trachea of mesothelioma patients.

Nausea

Nausea is experienced in a number of cancer patients, as it is often a side effect of chemotherapy treatment and sometimes the underlying cancer. Those diagnosed with peritoneal mesothelioma may also experience nausea as a result of increasing abdominal pressure.

Peritoneal Effusion

Peritoneal mesothelioma patients may experience a buildup of fluid in the peritoneum as the tumor continues to grow. This can result in an effusion which can inhibit the function of abdominal organs.

Peritoneal Effusion

In pleural mesothelioma patients, pleural effusion may develop when there is a large amount of fluid present in the pleura, the lining between the lungs and chest cavity.

Weight Loss

Weight loss can occur in mesothelioma patients as a side effect from cancer treatment or as the result of other symptoms that may also be present, such as difficulty swallowing or nausea.

Stage IV Mesothelioma Treatment

In Stage IV, mesothelioma treatment focus changes to end-of-life care, emotional support and management of physical symptoms. Invasive surgery may offer temporary relief from pain but is not recommended for this late stage of malignant mesothelioma.

What is Stage IV Mesothelioma?

Stage IV Mesothelioma is terminal. The cancer has spread to vital organs through the lymphatic system and blood stream. Tumors occur beyond the point of origin in the pleura, pericardium or peritoneum. The removal of large or primary tumors may provide comfort, but at this stage, removing all tumors from affected tissues is impossible and does not prevent future metastasizing.
With Stage IV Pleural Mesothelioma, the entire lung (s) may be involved, along with the esophagus and lymph nodes in the neck and under the arms.
With Stage IV Pericardial Mesothelioma, the cancer may have metastasized beyond the heart into the chest cavity. Through the blood stream, mesothelioma may travel to remote parts of the body.
With Stage IV Peritoneal Mesothelioma, not only does the cancer spread throughout the entire abdominal cavity, it may have metastasized to nearby lymph nodes in the groin and to other organs.
At this stage, metastasized cells may have penetrated organs near the original site.

What are the Common Treatments for Stage III Mesothelioma?

Surgery / Radiation / Chemotherapy

Conventional multimodal treatment plans that combine surgery, radiation and chemotherapy are not typically used for Stage IV Mesothelioma patients. They are, however, sometimes used for pain management reasons.
Surgery may remove the primary tumor, but it does not guarantee relief from further metastasizing or reoccurrence.
With pleural mesothelioma, surgery may remove the primary tumor to ease pressure on the lungs and improve breathing. Similarly, surgery for pericardial and peritoneal mesothelioma may reduce pressure on the heart and abdomen and provide pain relief.
Chemotherapy may lessen pain for some patients, but at this advanced stage of mesothelioma, there are considerable risks. In some cases, after removing the primary tumor, chemotherapy may help slow metastasizing.
A Stage IV prognosis is terminal and the treatment plan is palliative rather than curative.

Thoracentesis / Paracentesis / Pericardiocentesis

Draining excess fluid from the affected areas may provide symptomatic relief but is not a curative option for Stage IV Mesothelioma.
Thoracentesis drains excess fluid in the lungs; paracentesis drains excess fluid in the abdomen; and pericardiocentesis drains fluid from the heart.
These procedures, however, may only provide temporary relief because there is a significant risk for fluid buildup to reoccur.

Palliative Care

With advanced stages of mesothelioma, treatment turns to palliative care, ensuring that the patient is pain free and comfortable.
Hospice care provides a dignified option for some Stage IV Mesothelioma patients. Quality of life is a primary goal of hospice care along with providing necessary emotional support not only for the patient but for loved ones as well.
Integrating alternative options with palliative care may provide additional physical, emotional and spiritual support. For those with Stage IV Mesothelioma, meditation or art therapy may provide a necessary emotional outlet and help cope with the terminal nature of the disease. Other alternative mesothelioma treatments may not be appropriate for Stage IV Mesothelioma patients because many of them require movement.

Stage III Mesothelioma Treatment

Stage III Mesothelioma has a much less favorable prognosis than Stages I and II and the Mesothelioma treatment options most often used focus on maximizing patient comfort and minimizing symptomatic pain.

What is Stage III Mesothelioma?

Depending on the staging system used, Stage III Mesothelioma likely includes the metastasizing of cells to other areas of the body, lymphatic system and blood.
Stage III Mesothelioma is typically incurable and inoperable because the malignancy has spread to other vital organs.
With Stage III Mesothelioma, the cancer has spread past the pleura or the protective linings of the lungs, heart or abdomen. In some cases, the cancerous cells traveled into the lymphatic system or blood stream. When the cancer spreads to the lymph nodes, containing the mesothelioma is nearly impossible.

What are the Common Treatments for Stage III Mesothelioma?

Surgery

With Stage III Mesothelioma, surgery is typically palliative. With operable tumors, surgery is an option to ease symptomatic suffering and aid in quality of life. However, surgery may only remove the main tumor, but since the cancer has spread through the lymphatic system, blood and other organs, surgery cannot remove the remaining cancerous cells.
Location of the tumor or tumors dictates whether surgery is an option or potentially detrimental to the overall health of patient.
At this stage of mesothelioma, surgery depends entirely on the individual and type of mesothelioma. In most cases, surgery is not an option.

Radiation Therapy

For Stage III Mesothelioma patients, radiation therapy also provides symptomatic relief. Though radiation therapy typically inhibits metastases of cells, radiation therapy may specifically target areas of the body where tumors associated with Stage III Mesothelioma are painful and severely affect quality of life.
Administering radiation at this stage only provides palliative care.

Thoracentesis / Paracentesis / Pericardiocentesis

Thoracentesis is a palliative treatment option for pleural mesothelioma in which excess fluid is drained from the lungs. Paracentesis also drains excess fluid built up in the abdomen for peritoneal mesothelioma while pericardiocentesis drains fluids from the pericardium. These treatments alleviate pain and pressure, but do not cure the disease.

Palliative Care

Palliative care plans are individualized and target the specific issues that each patient faces. They almost always include a pain management component, however, to ensure that the patient is not suffering.
Medical professionals may also prescribe dietary and lifestyle changes aimed at improving patient comfort. Proper nutrition and maintaining hydration is critical. Many conventional treatment options – radiation therapy or chemotherapy – rob the body of vital vitamins and minerals.
The emotional impact of Stage III Mesothelioma may be more painful than the disease itself, not only for the patient but also for loved ones and care givers. Counseling may be a necessary part of any palliative care plan.
Integrating alternative therapies into a conventional palliative care plan is also a viable option. Massage therapy, for example, may provide temporary relief to sore muscles and joint tissue. However, most alternative therapies provide short-term comfort and are not a replacement for conventional treatments.
Ultimately, a palliative care plan is individual. Determining what quality of life means is unique as the individual with Stage III Mesothelioma.

Stage II Mesothelioma Treatment

Mesothelioma may affect the lungs (pleural), heart (pericardial) or the abdomen (peritoneal). The extent of mesothelioma determines what sorts of treatment options are available. For Stage II cancer, the mesothelioma treatment strategies are somewhat similar to that of Stage I.

What is Stage II Mesothelioma?

Much like Stage I, Stage II Mesothelioma is a rare diagnosis. Most mesothelioma cancer diagnoses stem from late detection and it is fairly rare to have an early stage (Stage I or Stage II) mesothelioma diagnosis. If you have been diagnosed with Stage I or Stage II mesothelioma, however, this is far more promising news.
Fundamentally, Stage II Mesothelioma has encased the pleura of the lungs, heart or abdomen. In some cases the lymphatic system is involved, typically only with pleural mesothelioma, which is the most common form of the cancer.
Further, whether the mesothelioma is resectable, or in an operable place, is also a quantifying factor of staging. Most cases of Stage II Mesothelioma are resectable; however, as each individual is different, so are the treatment options.
It is important to understand that while earlier stages of mesothelioma are far easier to diagnose and treat, a cure for the disease has not yet been discovered.

What are the Common Treatments for Stage II Mesothelioma?

Surgery

As with Stage I Mesothelioma, if the cancer is resectable or operable, mesothelioma surgery is the best treatment option for Stage II.
Treatments options will vary from patient to patient, however, and it is always best to consult with your oncologist or primary care physician to see what your available options are.

Radiation Therapy

As a collaborative and supportive treatment along with surgery and chemotherapy, radiation is a typical therapy method for Stage II Mesothelioma. Specifically, radiation therapy targets the cancerous cells, damaging the inherent DNA. By destroying the cancerous cells, radiation therapy inhibits any metastases.

Chemotherapy

Similarly to radiation therapy, chemotherapy stops the metastases of cancer by killing off the cancerous cells with chemotherapy drugs. Chemotherapy is a common treatment for many types of cancers and is commonly used to treat Stage II Mesothelioma.

Gene Therapy

Gene therapy is showing promise as a treatment option for Stage II Mesothelioma patients. During treatment, an individual's healthy genes are implanted into the patient with the aim of having the new, healthy genes replace cancerous cells. In some cases, genes can be manipulated to target specific cancerous cells. On-going research for this treatment modality continues and remains encouraging.

Immunotherapy

Immunotherapy, much like gene therapy, is still in its infancy but some studies are suggesting positive results in mesothelioma patients. With any type of cancer, especially mesothelioma, the disease compromises the immune system. Immunotherapy causes the white blood cells to target and invigorate unhealthy or cancerous cells. The long-term benefits and applications of immunotherapy are continuing to be researched.

Alternative Therapies

Alternative therapies may provide relief from symptoms and the side effects of cancer treatment. Acupuncture and massage therapy are both alternative treatments that integrate well with conventional treatment methods and provide much needed pain and stress relief to patients undergoing mesothelioma treatment.

Palliative Care

Palliative care is always provided to those with Stage II Mesothelioma. As there is no mesothelioma cure, most treatment plans include a palliative approach. This approach is aimed at alleviating the symptomatic pain and discomfort associated with conventional treatment such as chemotherapy. Palliative care designed is to provide the best quality of life for anyone suffering from a terminal disease.
Additional mesothelioma treatments may also be available. Consult with an oncologist to understand the full range of options that may be available to you

Stage I Mesothelioma Treatmen

After a mesothelioma diagnosis, further testing is required to determine the stage of the cancer. Depending on the type of mesothelioma, different methods of testing may be used. Diagnostic tools assess whether the cancer is in Stage I, Stage II, Stage III or Stage IV.
The most common staging tools are x-rays, computed tomography scan (CT) or a magnetic resonance imaging scan (MRI).
In cases of pleural mesothelioma, bronchoscopy allows oncologists to have a visual image of the airways and bronchi, to help determine the stage that the cancer has advanced to.
There are three mesothelioma staging systems typically used by physicians: TNM Classification of Malignant Tumors, Butchart Staging System and the Brigham Staging System.
TNM is the most common grading system for all types of mesothelioma in which “T” refers to the size of the tumor; “N” if the lymph nodes are involved; and “M” whether the has cancer metastasized to other organs.
The Butchart Staging System, used mainly for pleural mesothelioma, determines the size and metastases of the mesothelioma.
Staging designation within the Brigham Staging System is based on whether or not the mesothelioma is operable and whether the lymphatic system is involved.

What is Stage I Mesothelioma?

Within the range of progressive staging metrics, Stage I Mesothelioma is the most treatable form of the disease. Stage I mesothelioma is an extremely rare diagnosis, however, as symptoms do not usually present until after the disease has progressed to advanced stages.
Stage I mesothelioma is classified in cases where the cancer is localized to a specific region – lungs, heart or abdomen – and has not yet metastasized to other organs or reached the lymphatic system.
With pericardial or peritoneal mesothelioma, the cancer has yet to breach the lining of the heart or abdomen.
Stage I Mesothelioma is typically operable and treatable with chemotherapy or radiation but as mentioned earlier, is rare.

What are the Common Treatments for Stage I Mesothelioma?

The range of Mesothelioma treatment options available for Stage I patients is the broadest available because, at this stage, the cancer is still localized. Conventional treatments and / or participation in clinical trials are most often recommended for patients presenting with early stages of mesothelioma.

Surgery

For Stage I Mesothelioma, surgery is the first treatment option explored, and in most cases, it is usually the best option. Surgery removes the affected lining around the lungs, heart or abdomen.

Radiation Therapy

Typically used in conjunction with surgery and chemotherapy, radiation is a common treatment method for Stage I Mesothelioma. Radiation therapy targets and controls the metastases of cancerous cells. By destroying cancerous cells, radiation therapy inhibits the spread of mesothelioma. Though there are some side effects associated with the treatment, like fatigue and joint pain, radiation therapy usually yields positive results for Stage I Mesothelioma.

Chemotherapy

Another common treatment option for Stage I Mesothelioma is chemotherapy. By administering high doses of specific medications, chemotherapy targets the cancerous cells and destroys them. With chemotherapy, however, the side effects of the treatment can be worse than the symptoms of the cancer itself.

Hyperthermia and Chemotherapy

Recent studies have shown that cancerous cells are more responsive to chemotherapy in cases of hyperthermia due to the increase of body temperature. Currently this treatment modality shows only a minimal impact on overall life expectancy and is still in its infancy.

Gene Therapy

A breakthrough in carcinoma treatment, gene therapy involves implantation of healthy genes that target cancerous cells. Though not commonly used for Stage I Mesothelioma, gene therapy is a growing treatment for several types of cancer, and is under going further research.

Immunotherapy

By “enhancing” the immune system’s ability to fight off disease, immunotherapy is showing some promise for treating Stage I Mesothelioma. Through intravenous immune-enhancing drugs, the immune system is “jump-started” to attack invading cancerous cells. Research for this type of treatment is still ongoing and results, thus far, are inconclusive as to whether immunotherapy is a viable option for Stage I Mesothelioma.

Clinical Trials

For some mesothelioma patients, taking part in a clinical trial may be the best option. Clinical trials often test treatment and drug options on mesothelioma patients that have already undergone vigorous scientific testing. Many clinical trials use a placebo as a control, and mesothelioma patients should consult with their doctor to understand the risk involved before entering any trial.

Mesothelioma Treatment by Stage

The treatment protocol for mesothelioma differs based on the stage that the cancer has progressed to at the time of diagnosis. Although there is currently no cure for this disease, recent medical advances have made a wider range of treatment options available to help improve patient comfort and quality of life. While there are a number of staging systems available to assess how far mesothelioma cancer has advanced in the body, the Butchart staging system remains the most widely used, especially for pleural mesothelioma.

Stage 1 Mesothelioma Treatment

Mesothelioma surgery is the most commonly recommended course of treatment for pleural mesothelioma patients having a Stage 1 diagnosis. The procedures that are likely to be performed are pleurectomy/decortication or extrapleural pneumonectomy. Post surgery, doctors may further evaluate the patient to determine if chemotherapy or radiation treatment is necessary. It is often determined with stage 1 mesothelioma that those adjunct therapies are not required.

Stage 2 Mesothelioma Treatment

Patients diagnosed with Stage II Mesothelioma still have a fairly wide range of treatment options available to them. Chemotherapy and radiation therapy are the most common treatments that will be recommended. Surgery may or may not continue to be a viable treatment option at this stage. There are also a variety of experimental and alternative treatments that may be used to slow the progression of the disease and help manage the pain and stress associated with conventional treatment therapies.

Stage 3 Mesothelioma Treatment

The treatment options for Stage III Mesothelioma patients are fewer than those available for Stage I and II patients as the cancer, in this stage, has typically spread beyond the point of origin to other vital organs in the body or the lymphatic system. Treatments recommended for Stage III patients are primarily focused on providing patient comfort and improving quality of life.

Stage 4 Mesothelioma Treatment

A diagnosis of stage 4 mesothelioma usually indicates a very unfavorable mesothelioma prognosis. At this stage, the cancer has usually metastasized throughout the body to other organs and as with stages 2 and 3, cannot be cured. In this stage, symptoms generally increase in severity and pain management becomes the primary focus of the medical team. Therapies such as chemotherapy and radiation are typically not offered at this stage unless they are needed to support pain management objectives. Oftentimes families find that it is most helpful to seek out additional support through a local Hospice program. Hospice programs focus on providing patient care, developing a pain management protocol and providing support for both the patient and family members at this difficult time. Patients with stage 4 mesothelioma may also be interested in participating in specialized clinical trials offered at leading cancer hospitals and centers and are encouraged to seek out those programs if desired.

Thermography

Most individuals have probably heard of thermography. It’s been around for a while and is quite often associated with things other than clinical medicine. For example, firefighters might use thermography to see through smoke to find people trapped in a fire or engineers may use this technology to spot things like faulty power lines or leaky insulation.
However, thermography - which can record the heat produced by different parts of the body - is often used to study blood flow and to detect tumors. Lately, the technique has also made its way into the realm of alternative medicine. More and more, practitioners are using thermography to detect problems within the body and to keep an eye on the healing process.
The image map produced by the thermograph shows abnormal hot or cold areas, which can be indicative of a number of different diseases.  While, the U.S. Food and Drug Administration has not approved the use of thermography for screening for diseases, there is evidence to suggest it may be helpful in the future for diagnostic procedures involving breast cancer, vessel diseases of the head and neck (extra-cranial), neuro-musculo-skeletal disorders, and vascular disease of the lower extremities.
Most importantly, note proponents of alternative medicine, thermography is non-invasive and non-radiative, making it far safer than the standard x-ray and while it is not currently an approved diagnosis technique there is hope that one day it may become an  alternative diagnostic procedure for those with a variety of diseases wishing to limit their radiation exposure.

Cancer’s Connection to Thermography

While thermography is now used extensively to detect breast cancer and measure metastases, those who tout the use of this diagnostic procedure also note that this type of thermal imaging can spot certain types of cancerous masses long before more conventional imaging techniques, including mesothelioma disease.
Hopes are that, in the future, this form of digital imaging may be able to help detect   cancer at early stages, including difficult-to-diagnosis types of cancer like mesothelioma, which remains latent in the body for decades and is usually not able to be diagnosed until it reaches Stage 3 or 4 and is, at that point, difficult to manage.
This kind of medical imaging can also display pain by detecting any changes in skin surface temperature that can accompany pain states, note those who practice regular use of thermography. Hence, alternative medicine practitioners are better able to access the amount of pain a cancer patient is experiencing and may also be better able to address specific pain via complementary therapies including massage, touch therapy, energy field therapy, or other common complementary techniques.

Art Therapy

The use of art to promote healing and manage physical and emotional problems has been around for a few centuries, but “art therapy” as a science has become especially popular during the last 30-40 years or so. This is thanks in part to the formation of the American Art Therapy Association and the offering of college degree programs in art therapy. Art therapy is now known to be extremely valuable to those battling difficult cancers like mesothelioma.

How Does it Work?

Art therapy is most often used to help patients come to grips with or express concerns about their disease, especially in the case of terminal patients.These days, many mesothelioma clinics and cancer centers employ art therapists on staff and make them a part of the teams of medical professionals that treat cancer patients.
In an inpatient setting, art therapists can work with individuals or with groups of patients who are dealing with the same challenges. There is no need for patients to have experience in art or to be “artistic” – i.e. able to draw or paint – in order to participate in this form of therapy.
Generally, art therapy provides a way for a patient to express themselves, whether it’s through creating art or observing art. Certified art therapists also work to help the patient deal with stress, fear, and anxiety. Patients, such as those battling mesothelioma cancer for example, may be asked to draw an image of themselves with cancer, and through this image, patients may be able to express conscious or unconscious concerns about their disease. Therapists aren’t looking for expert drawings; just a vehicle to initiate discussion.
Art therapy may also involve looking at paintings or photographs – usually chosen by the therapist – and patients may then be asked to express their feelings about what they’ve observed.

Does it Work?

A number of clinical trials have been conducted involving the use of art therapy for patients with a number of different disorders and diseases, both physical and mental, including cancer. For example, a 2002-2006 study at Thomas Jefferson University Hospital Kimmel Cancer Center in Philadelphia reported on the use of “mindfulness-based art therapy” in cancer patients and showed a reduction of pain and anxiety in those who attended eight (8) 2.5-hour therapy sessions.
Similarly, an art therapy study involving 41 breast cancer patients “strongly supports art therapy as a powerful tool in rehabilitation of patients with breast cancer and, presumably, also in the care of patients with other types of cancer,” said study leader Dr. Jack Lindh of Umea University, Umea, Sweden. Researchers involved in this study noted that the 5 therapy sessions in which the women participated allowed the patients to “process and express” their emotions, therefore improving their quality of life. Coping skills also improved in those who participated in the therapy sessions.
Art therapists do not profess to be able to cure cancer in any way. However, they do aim to provide an artistic outlet for those battling cancer and, as a result, prompt a reduction of stress, anxiety, or depression. In addition, those who participate in art therapy while experiencing acute or chronic pain often report a reduction in pain, most likely attributed to the fact that they were otherwise engaged during the pain and, hence, were not concentrating on their discomfort.

What You Need to Know

Art therapy is safe for anyone of any age. However, patients should never be forced to participate in this activity. Furthermore, it should be understood that the expressing of emotions connected with their cancer may cause temporary distress for some patients.
Art therapy is an alternative/complementary therapy and should never be used alone but in conjunction with traditional therapies designed to treat cancer.

Aromatherapy

There are essentially two categories of therapy for cancer patients like those with mesothelioma cancer. Clinical therapies, such as chemotherapy, surgery, and radiation therapy are likely the most medicinally beneficial. However, this is not to say that other, complementary therapies are not important as well. These complementary therapies may not be able to cure the disease, but will often treat the holistic wellbeing of the person. Cancer patients, such as those with mesothelioma, often take advantage of these services. One of the more common complementary therapies used by patients with asbestos cancer is aromatherapy. Aromatherapy is not for all patients and offers no cure for the disease. However, when used in conjunction with other more traditional therapies, aromatherapy has helped many cancer patient's lives much more manageable as they battle their disease.
Aromatherapy, as a therapy, is a relatively recent phenomenon in the alternative treatment of cancer patients, but its uses can be traced back thousands of years in other capacities. The idea of the therapy is to stimulate the senses and perceptions in such a way to create a relaxing and calm environment. The senses are incredibly related to a given person's levels of anxiety. Therefore, when the senses are relaxed it is possible to ease levels of stress and anxiety in some people. Using certain essential oils, these scents trigger emotional ease, which can be highly valuable for a patient battling terminal illness.
In some cases, aroma therapy will be coupled with massage therapies, which can ease the entire body in both sensory perception and muscle relaxation. In certain trials, certain patients have experienced an easing of symptoms related to chemotherapy, such as nausea and fatigue, when subjected to controlled aromatherapy environments. These trials were not clinical in nature and may not demonstrate the same results in all patients.
It is important to keep in mind with most alternative therapies that they are strictly based on personal preference and results will vary greatly from one patient to another. It is also important to consult with any doctors that a patient may be working with before engaging in any complementary therapies. Although beneficial, the patient needs to be conscious of the goals of the traditional therapies first and ensure they are compromised.

Acupuncture

Acupuncturist inserting an acupuncture needle into the "Lung Meridian" for optimal lung function

Acupuncture is not only an ancient methodology of pain control but is also an avenue toward healing changes with respect to hormones, digestion, brain function, immune response, etc. Acupuncture was first implemented thousands of years ago in China. Acupuncture consists of the very strategic insertion of tiny needles into predetermined "acupoints" on the body. The placement of needles is very specific in an effort to ease physical pain and restore balance and calm to the soul. The ancient Chinese believed that the appropriate placement of these tiny needles could provide a variety of medical benefits.
Although acupuncture may seem to be an unconventional method of pain management, it is very popular in the United States. Acupuncture is so widely used, in fact, that the Food and Drug Administration has classified acupuncture needles as "medical devices" and has approved acupuncture as a treatment method for various health conditions.
Individuals turn to acupuncture for various health concerns, and many cancer patients, including mesothelioma sufferers, rely on acupuncture to manage the discomfort that is a result of their debilitating disease. Mesothelioma cancer inflicts great pain on those who suffer from the disease, and acupuncture is often a very effective method of lessening and controlling this pain. Several clinical studies have been conducted during which malignant mesothelioma patients receive a combination of traditional cancer treatments, such as chemotherapy, along with acupuncture. The patients that have participated in such studies report that the inclusion of acupuncture as a means of pain management was quite successful, as many of these individuals were able to forego some of their traditional pain medication.
In addition, studies have shown that cancer patients who incorporated acupuncture into their mesothelioma treatment strengthened their immune systems and also experienced a decrease in the uncomfortable effects of chemotherapy. These patients felt less fatigued, maintained a healthy weight, and experienced less nausea during the chemotherapy sessions.
In general, alternative treatments, like acupuncture are safe for the majority of people. Common side effects associated with acupuncture include soreness at the insertion site or a feeling of lightheadedness after an acupuncture session, but these symptoms were quite minimal. The vast majority of cancer patients who experienced acupuncture believe that they benefited greatly.

Alternative Mesothelioma Treatment Options

There are many options for treatment upon receiving a mesothelioma diagnosis. Traditional treatments, such as chemotherapy, surgery, or radiation, may be the very first option that a physician will recommend. These, however, are not the only options, and many individuals suffering from mesothelioma choose to couple the traditional forms of mesothelioma treatment with alternative options.
Alternative treatments that may benefit individuals who suffer from asbestos cancer include:

Acupuncture

Acupuncture is often used as a palliative therapy, involving the insertion of very narrow needles into the skin at specific pressure points. This has been proven to relieve pain in many individuals suffering from a wide variety of ailments, including mesothelioma.

Aromatherapy

This method of therapy involves the use of aromatic oils, plants, and other substances to be used in conjunction with massage and or baths. These fragrances can result in a heightened mood, which can promote good health and pain relief.

Art Therapy

Art therapy is an alternative therapy than can help cancer patients deal with the physical and emotional challenges that they often experience during treatment.

Biofeedback Therapy

Biofeedback, also known as mind-body therapy, can help individuals diagnosed with mesothelioma manage the pain that is often associated with the disease.

Bowenwork

Bowenwork can help elicit the relaxation response in mesothelioma cancer patients to help lessen the side effects associated with traditional treatments like chemotherapy and radiation.

Chiropractic Care

Chiropractic care is an alternative therapy used to help mesothelioma cancer patients manage pain while going through conventional treatments like chemotherapy.

Craniosacral Therapy

Craniosacral Therapy is an alternative treatment that can help manage pain and the side effects of more conventional treatments for mesothelioma.

Dance Therapy

Dance therapy is an expressive method of treatment that helps patients connect with the emotional issues that exist when dealing with a serious illness like mesothelioma cancer.

Emotional Freedom Technique

The Emotional Freedom Technique (EFT) is used as a complementary therapy to other conventional mesothelioma cancer treatments to help relieve pain and anxiety in patients.

Feng Shui

The Chinese practice of Feng Shui recommends making changes to a cancer patient's environment to enhance the flow of Qi. This complementary therapy can support mesothelioma cancer patients throughout their mesothelioma treatment.

Healing and Therapeutic Touch Therapy

Healing Touch Therapy is an emerging therapy that is becoming more widely used by patients battling cancer like mesothelioma. This therapy invokes the relaxation response in patients and can help lessen the negative side effects associated with conventional cancer treatments.

Health Coaching

Health Coaching can help mesothelioma patients enjoy better quality of life, lessen pain and stress and make important lifestyle changes that can help speed up recovery from their cancer treatment.

Herbal & Nutritional Supplements

Many natural herbs have natural medicinal aspects which have been used to treat seemingly incurable ailments. Many times, nutritional Supplements work in conjunction with herbal remedies to provide the body with the necessary vitamins and minerals to fight off infection and other illness.

Homeopathy

Many cancer patients, including those battling malignant mesothelioma, have turned to homeopathy because it is a natural alternative to aggressive conventional cancer treatment drugs and can help manage the adverse side effects associated with them.

Hypnotherapy

Guided hypnosis sessions can have substantial positive effect on a patient undergoing treatment for cancer, including mesothelioma. For this reason, hypnosis is now being increasingly integrated into alternative cancer treatment regimens.

Light Therapy

Light therapy is a complementary therapy that some cancer patients find helpful to throughout the course of their conventional treatment to help reduce pain, stress and anxiety.

Lymph Drainage Therapy

Manual lymph drainage therapy is a technique that uses very gentle manipulation to help reduce swelling in the body after surgery or radiation treatment in mesothelioma cancer patients.

Manual Therapy

Integrative manual therapy is a gentle, non-invasive form of therapy that can be very helpful for cancer patients looking to ease pain and anxiety from their illness.

Massage

Massage therapy is the practice of hands-on physical manipulation of the body's soft tissue. Massage can be both relaxing and pain-relieving. Massage methods include Acupressure, Anma, and Balinese, all of which have differing effects on the body. Massage is often used during treatments for certain health conditions, like cancer, to ease muscle tension and induce relaxation.

Meditation

Meditation is the process of moving into deep relaxation. It is therapeutic in the sense that it can help patients develop a calm mind to make sound decisions and be at peace with health conditions they may have, including cancer like mesothelioma.

Music Therapy

Music therapy is a complementary therapy than can help alleviate the uncomfortable side effects of cancer treatment as well as help reduce both chronic and acute pain.

Myofascial Therapy

Myofascial therapy can be used by cancer patients, including those who have been diagnosed with mesothelioma, to help manage the pain that sometimes accompanies traditional cancer treatment.

Naturopathy

Naturopathy is an alternative paradigm of medicine that focuses on nature's remedy and the body's intrinsic ability to heal itself. Naturopathy favors a holistic approach to treating illnesses like mesothelioma through the use of mineral, diet, and lifestyle-based remedies.

Nutritional Resources

Proper nutrition and a healthy lifestyle can prove to be an important factor in the treatment of someone who has been diagnosed with mesothelioma.

Osteopathy

Osteopathy is a complementary therapy that mesothelioma cancer patients find helpful for reducing stress, fatigue and some of the unpleasant side effects of chemotherapy.

Personal Fitness and Training

Maintaining some level of movement can be a tremendous help to cancer patients undergoing treatment and can lead to improved outlook and quality of life. There are personal fitness trainers that are specifically trained to provide this type of support to cancer patients.

Pet Therapy

Pet Therapy, or animal-assisted therapy, utilizes dogs and other animals as a soothing and relaxing modality for patients battling mesothelioma and other cancer.

Reflexology

Foot reflexology is an alternative treatment therapy designed to help mesothelioma cancer patients manage pain.

Reiki

Reiki promotes a deep sense of relaxation and well-being and is an alternative therapy that many mesothelioma cancer patients are now using as part of their overall treatment plan.

Sound Therapy

Some cancer patients welcome the use of more non-invasive therapies, like sound therapy, that can help alleviate the stress and pain that is often associated with more traditional forms of cancer treatment.

TENS Therapy

Transcutaneous Electric Nerve Stimulation is used as a palliative care option. An electrical stimulation is directed through different areas of the body resulting in pain relief which can increase the level of endorphins. TENS Therapy is typically administered by a physical therapist, but can also be done at home if a patient has the necessary documentation for TENS equipment.

Thermography

Thermography, which is a type of medical imaging, can help detect problems in the body, like mesothelioma cancer, and can also aid in monitoring the healing process.

Yoga

Yoga is a combination of meditation and movement. Yoga is of Hindu origin and is designed to promote a heightened sense of oneness between body and mind, inducing relaxation and contentment.

Why should I consider alternative treatment?

When paired with traditional treatment methods, alternative options can be an important component of a mesothelioma treatment plan. These alternative methods are most helpful in controlling pain and maintaining balance and peace within an individual's mind and body. Many patients find treatments, such as massage or meditation, to be a welcome distraction from the ongoing cycle of hospital visits, medication, and general stress associated with a cancer diagnosis.
It is very important to consult with your physician before pursuing any new form of treatment. A doctor will be able to determine whether or not a patient is healthy enough to incorporate alternative treatment practices into their already-established treatment plan.

Mesothelioma Brachytherapy

Also known as "internal radiation therapy", brachytherapy is a form of radiation treatment that targets a tumor or the area around the tumor with concentrated radiation that is implanted directly at the affected region of the body. Often used for mesothelioma patients, it kills fewer healthy cells than traditional radiation and also causes fewer side effects.
Brachytherapy for mesothelioma cancer patients is often used after surgery to remove any remaining asbestos cancer or may be used in tandem with chemotherapy. There are two types of brachytherapy that mesothelioma doctors generally consider.

• Permanent - This kind of treatment involves the implantation of tiny seeds of radioactive material in or near the tumor. With permanent brachytherapy, the seeds remain in the body even after they stop emitting radiation.
• Temporary - With this type of brachytherapy, radioactive seeds or rods are implanted for a pre-determined amount of time and are then removed. The length of time depends on the tumor and what the doctor is hoping to accomplish.

Like traditional external beam radiation, brachytherapy is a mesothelioma treatment generally performed in an outpatient setting, and though the procedure may sound complicated, it takes less than an hour to complete from start to finish.
When the patient enters the treatment room, he is given a light sedative and the area where the seeds will be implanted is numbed. Next, the seeds are inserted with a catheter or needle. The radiologist generally uses a CT scan or other imaging device to help him determine where to implant the seeds. After all is complete, the patient is generally free to return home.
Side effects of brachytherapy may include swelling, bruising, and mild pain. Individuals who recently underwent brachytherapy are advised to stay away from others who may be most susceptible to the negative effects of radiation, including pregnant women and small children.

Mesothelioma Pleurodesis

Several medical conditions including malignant pleural mesothelioma can cause lymphatic fluid to accumulate between the lining of the chest wall (parietal pleura) and the lining of the lungs (visceral pleura). This is known as pleural effusion; symptoms include dyspnea (shortness of breath) as well pain due to the pressure exerted on the body's organs.
Pleurodesis is a treatment for patients that have received a pleural effusion diagnosis. A chemical substance (usually talc) in injected into the space between the pleural membranes using a large needle or a thoracoscope (a tube that enters the chest). This causes irritation of the pleural membranes, which become inflamed and bond together as a result, eliminating this space so that fluid cannot accumulate. Pleurodesis is not a treatment of the mesothelioma cancer itself however.
Pleurodesis may be performed at the bedside or in the operating room, depending on the condition of the patient. When done as a bedside procedure a local anesthetic is administered. During the procedure, mesothelioma doctors will insert a large needle into the chest cavity. When this mesothelioma surgery is performed in the operating room, it is done under general anesthetic with the use of video-assisted thoracoscopy, which helps the surgeon in guiding the needle.
In both cases, the tip of the needle is inserted into the pleural space between the membranes and attached to a drainage tube. This drainage is done slowly in order to avoid a drastic reduction in blood pressure. Once the excess lymphatic fluid is removed, the doctor uses the needle in order to inject the talc solution into the pleural space. This drain is clamped in place for an hour; afterwards, the doctor may attach the drain to a suctioning device in order to ensure that the pleura layers bond properly.

Mesothelioma Pleurocentesis

Mesothelioma patients experience many uncomfortable symptoms associated with their disease. One of the most debilitating symptoms of pleural mesothelioma is the build-up of fluid in the pleura space around the lungs. This collection of fluid makes it very difficult to breathe and also can cause severe pain. It greatly impacts the quality of life for the patient and can make it difficult to do every day tasks. Although there is no known cure for mesothelioma cancer, this type of treatment can relieve uncomfortable symptoms.
The best way to relieve this discomfort is to have the fluid removed by means of a pleurocentesis. Also known as a thoracentesis, this type of mesothelioma surgery can be performed as many times as necessary and is done in an outpatient setting, in most cases.

What to Expect

Before this procedure is performed, the patient will probably undergo a CT scan or some other sort of imaging test so that the mesothelioma doctor can determine the amount of fluid present. After that, an appointment will be scheduled for the procedure.
During the pleurocentesis, the patient sits up and generally leans on a table. The doctor cleans and numbs the area where a long, thin needle will be inserted to draw out the fluid, generally between the ribs. Little pain is felt during the procedure though the patient may experience a feeling of pressure. Once an ample amount of the fluid is removed, the needle is withdrawn and the area is covered with a bandage. The procedure generally takes less than 30 minutes total, depending on the amount of fluid to be removed. However, the patient may remain longer for monitoring purposes.
Once sent home, the patient will be instructed to rest for at least 24 hours in order to avoid complications, which could include bleeding or infection. In very rare cases, pneumothorax - the collapse of the affected lung - could occur.

Mesothelioma Pleurectomy

Pleurectomy is a procedure in which the mesothelial lining of the lung and chest cavity is removed. Surgery is typically performed by thoracic or cardiothoracic surgeons and may involve concurrent resection of the pericardium (mesothelial lining of the heart) or the peritoneum (mesothelial lining of the abdominal cavity). Each of these internal structures performs a similar function and is composed of similar cells.
Patients may undergo pleurectomy for any number of conditions, including malignant pleural mesothelioma, pleural effusion, or trauma. Mesothelioma is a rare, aggressive cancer and relatively asymptomatic in its earlier stages.
One of the primary symptoms of mesothelioma is pleural effusion, a condition that is created when fluid excreted by mesothelial cells builds up and puts pressure on the lung and chest wall. While pleurocentesis may be used to reduce fluid buildup and relieve symptoms, often full pleurectomy is recommended to provide more sustaining patient comfort. Pleurectomy is particularly common in concert with more extensive procedures, including pneumonectomy, extrapleural pneumonectomy, and other cardiothoracic resections.
During surgery, an incision is made in the area where the disease is located. The surgeon then removes the pleura. In some cases, diseased tissue from the affected lung is also removed (pneumonectomy).
Pleurectomy is an invasive procedure that will typically require a total anesthetic. Following surgery, the surgeon will conduct a post-operative interview during which they will likely recommend deep breathing and frequent changing of bandages to prevent infection.

Mesothelioma Extrapleural Pneumonectomy

Extrapleural pneumonectomy is a surgical treatment for malignant mesothelioma. It involves the removal of a lung, a portion of the diaphragm, the linings of the lungs and heart (parietal pleura and pericardium). This is a serious operation that is performed only on those patients whose cancer is confined to the chest cavity, and are deemed to be sufficiently healthy.
Extrapleural pneumonectomy inhibit metastasis in mesothelioma cases. Patients who undergo this operation enjoy significant increases their mesothelioma survival rate when treated with radiation and chemotherapy in addition to the surgery.
This mesothelioma surgery is nonetheless controversial and quite dangerous. Some doctors believe that the risks outweigh the benefits. Such risks include:

• hemorrhage (internal bleeding)
• respiratory failure
• pneumonia
• empyema (accumulation of pus in the chest cavity)
• blood clotting in the veins of the inner thigh or leg
• death

Mesothelioma cancer may recur after the operation as well. Alternatives include pleurectomy (partial removal of a lung) and other conventional mesothelioma treatment.
Because the procedure is so demanding from a technical standpoint, extrapleural pneumonectomies are usually done in larger, better-equipped medical centers The procedure itself requires that the patient is put under general anesthesia. A large incision in the chest is made and the sixth rib may be removed in order to expose the diseased lung and open up the working space. Next, the diseased lung is collapsed and its major blood vessels and main bronchial tube are clamped; these will be stitched or stapled shut later on. The diseased lung is then removed, along with the pleural lining, pericardium and parts of the diaphragm. These are replaced with patches synthetic material. Finally, the chest incision is sutured shut, and a temporary drain is inserted into the chest cavity.

Mesothelioma Pneumonectomy

A pneumonectomy is the surgical removal of all or part of a lung, usually performed as a cancer treatment. Because this mesothelioma surgery will significantly reduce the patient's breathing capacity, mesothelioma doctors will choose less extreme options if available. Before committing to a pneumonectomy, the oncologist will order extensive testing in order to insure that the remaining lung will have enough capacity to take over the respiration process.

A pneumonectomy may either be of the traditional or extrapleural type. A traditional pneumonectomy consists of removing the affected lung only; an extrapleural pneumonectomy involves the removal of the diseased lung along with a portion of the pericardium (membrane covering the heart and affected in pericardial mesothelioma), part of the diaphragm, and the parietal pleura (membrane lining the chest cavity) on the same side of the chest. This is sometimes the best treatment option for malignant pleural mesothelioma patients.
An extrapleural pneumonectomy can slow metastasis (spreading) in mesothelioma cases and allow the patient to breathe more easily. Studies indicate that mesothelioma patients treated with a combination of extrapleural pneumonectomy, radiotherapy, and mesothelioma chemotherapy enjoy better survival rates. Of all mesothelioma treatments, extrapleural pneumonectomy allows for the highest survival rates.
Extrapleural pneumonectomies are usually done in larger cancer centers with better facilities, since these procedures are quite complicated. The operation requires general anesthesia; the surgeon begins by making a large incision in the chest and may need to remove the sixth rib in order to help expose the diseased lung and make enough space for the procedure. Next, the surgeon collapses the diseased lung, ties off its major blood vessels, and clamps the main bronchial tube, which will later be stapled. The diseased lung is then cut away. Lining of the chest wall that is removed as well as parts of the pericardium and diaphragm are replaced by patches of synthetic material. The chest incision is closed with sutures, and a temporary drain is inserted into the chest cavity.
Patients are administered an epidural anesthetic for pain in the days following the operation; recovery normally requires a two-week hospital stay.

Mesothelioma Surgery

When an individual is diagnosed with cancer, treatment options will be one of the first topics discussed with the oncologist. The available treatment options will vary from patient to patient depending on the type of mesothelioma that has been diagnosed and the stage that the disease has progressed to at the time of diagnosis. Mesothelioma, in particular, is a very serious and aggressive form of cancer for which treatment options have traditionally been quite limited.
When a recently-diagnosed mesothelioma patient is presented with options for treatment, surgery may be recommended. There are different forms of mesothelioma surgery and some are proposed as a curative measure, while others are designed to relieve symptoms of the disease that can be quite debilitating and interfere with the patient's quality of life.

Curative Surgeries

Due to the nature of mesothelioma and the fact that by the time a diagnosis is made the disease has usually reached an advanced stage, a surgical cure is not a likely option. However, in some cases, surgery is suggested in order to remove as much of the cancer as possible and is often followed by other mesothelioma treatments such as chemotherapy and/or radiation.
Ideally, candidates for these surgeries will be in the early stages of the disease where the tumor is still fairly localized and metastasis has not occurred. In addition, the patient will need to be in overall good health and free of other medical issues that can complicate these procedures and lengthen the recovery period. Extant medical issues—heart disease, hypertension, and diabetes—are often an issue with older mesothelioma patients. These issues can further limit treatment options and make aggressive surgical procedures a less favorable choice.
However, if the doctor determines that the patient is strong enough, the following surgeries may be recommended:

Pneumonectomy

A pneumonectomy is a radical surgery that involves the removal of the diseased lung. Candidates for this procedure have mesothelioma that is limited to just one lung. Performed under general anesthesia, this is quite a complicated surgery that can take up to three hours to perform. During the surgery, the diseased lung will be deflated and after several steps to prevent bleeding into the chest cavity, the lung is removed through a fairly large incision. At times, part of the fifth rib must be removed as well to provide better access to the lung. A drainage tube will then be inserted and the incision closed. The patient will remain in surgical intensive care for about 48 hours and then in a regular hospital room for one to two weeks, depending on complications, which are very common with this procedure and occur in some 50 percent of patients. It can also take up to six months for the healthy lung to learn to do the job of both lungs; hence, shortness of breath is a considerable problem for pneumonectomy patients and many take several months to resume their normal activity.

Extrapleural Pneumonectomy

Recommended only in rare cases, this surgery involves the removal of the affected lung as well as the areas surrounding it. It is a very risky surgery and carries with it a long list of complications including heart failure and serious gastrointestinal problems. The procedure is similar to that of the pneumonectomy and candidates are those who are in the earlier stages of mesothelioma, which has not spread to the lymph nodes. Candidates should also be in otherwise good health. The recovery period can last for up to a half-year or longer.

Pleurectomy

A pleurectomy involves the removal of the visceral and parietal pleura, which is the lining of the lungs. This may be used as a potential curative procedure but also may be performed to address pleural effusion, the build-up of fluid in the lungs. This surgery is performed under general anesthesia. To perform a pleurectomy, an incision is made in the affected area, which has been numbed with a local anesthesia. Through this incision, both the inner and outer linings of the lungs are removed. The surgeon may also opt to remove the lung tissue beneath the pleura. The procedure is sometimes followed by chemo or radiation to remove any remaining cancerous tissue. The post-surgery stay for the pleurectomy is generally about a week but may be longer if complications arise during or after surgery, including bleeding or infection.

Palliative Surgeries

Surgeries that relieve mesothelioma symptoms like pain and other problems associated with mesothelioma disease are as follows:

Pleurocentesis

This procedure is used to address pleural effusion, the build-up of fluid in the pleural area surrounding the lungs. The fluid can make it very painful and difficult for a mesothelioma patient to breathe. The procedure is performed in an outpatient area by means of a long, thin needle that is inserted into the pleural space to withdraw fluid. The patient may return home a few hours after the procedure is complete and when the doctor is satisfied that no adverse reactions will occur.

Paracentesis

Essentially the same procedure as pleurocentesis, a paracentesis is performed to remove fluid that has collected in the abdominal area to provide more comfort to patients with peritoneal mesothelioma.

Pleurodesis

This more serious surgery is used to halt the build-up of fluid for a longer amount of time and involves inserting talc into the pleural space. The talc causes inflammation and stops the fluid from collecting, often for as long as a few years. It is an inpatient procedure performed under general anesthetic, requiring a hospital stay of at least 72 hours, during which time a chest tube may remain in place to drain any additional fluids. Recovery time is 6 to 8 weeks for most patients.

Conventional Treatments

Conventional mesothelioma therapies include surgery, radiation and chemotherapy. You should keep in mind that if you choose one course of action for mesothelioma treatment, you may preclude other courses. All of your options should be considered as soon as possible.

Mesothelioma Surgery

Depending on the stage of a mesothelioma, surgery may be used to remove the cancer and some of the surrounding tissue. Often, however, an operation is not appropriate and the patient may have only minimally invasive procedures to relieve symptoms. A thoracentesis, where fluid in the chest is removed by placing a needle into the chest cavity, may be done to make a patient more comfortable. Sometimes talc or an antibiotic may be injected into the chest cavity to try to prevent the fluid from returning. These techniques are successful in controlling the fluid, at least temporarily, in as many as 90% of patients. Because pleural fluid can compress the lung and cause shortness of breath, these procedures can help patients breathe more easily, however, they do not cure the cancer. In the case of peritoneal mesothelioma, a needle may be inserted into the abdomen to drain the fluid. Similarly, a needle inserted into the pericardium (sac around the heart) can drain the fluid caused by pericardial mesothelioma and help relieve circulatory problems. However, draining this fluid may result in complications. Sometimes the cancer cells spread along the needle path, and a tumor nodule may form under the skin of that area.
Surgery for mesothelioma may be performed for one of two reasons: for palliation (to relieve pain and discomfort caused by the tumor), or to cure. Palliative surgery is typically done in cases where the tumor has already spread beyond the mesothelium and is difficult to completely remove, or in cases where the patient is too ill to tolerate a more extensive operation. Curative surgery is offered when the patient is in otherwise good health and the tumor is thought to be localized and can be completely removed. Unfortunately, microscopic spread of cancer cells into the chest wall and diaphragm are common even when such spread cannot be detected by routine tests. Therefore, given the extent of these operations and their very limited success, the exact role of surgery in treating mesothelioma is often debated.
There are two types of operations that may be offered to patients with pleural mesothelioma: pleurectomy/decortication and extrapleural pneumonectomy. Pleurectomy/decortication is usually a palliative (relieves symptoms without curing the cancer) operation in cases where the entire tumor cannot be removed. It involves removal of the pleura, where the majority of the tumor is located. It is effective in controlling effusions (fluid accumulation) and decreasing the pain caused by the cancer.
Extrapleural pneumonectomy is a far more extensive operation and most often used in cases of localized mesothelioma. The operation is technically difficult and performed only by surgeons in large specialized medical centers. It involves removing the pleura, diaphragm, pericardium, and the whole lung on the side of the tumor. The patient must be in overall good health with no other serious illnesses in order to tolerate the large operation. This operation is intended to remove all or most of the cancer and some surrounding tissues as well.
Surgical treatment of peritoneal mesothelioma is often performed either to help relieve symptoms or to attempt to remove the tumor from the wall of the abdomen and other digestive organs. As with pleural mesothelioma, these tumors are often too extensive to remove completely. Similar operations can be performed to remove a mesothelioma from the pericardium (the sac around the heart).

Mesothelioma Radiation

Radiation therapy uses high-energy x-rays to kill cancer cells. External beam radiation therapy uses radiation delivered from outside the body that is focused on the cancer. This type of radiation therapy is often used to treat mesothelioma. These treatments are much like getting a diagnostic x-ray except for a longer time. Brachytherapy involves radioactive material being placed directly into the chest or the abdomen at the site of the mesothelioma. Radiation therapy is sometimes used as the main treatment of mesothelioma cancer in some patients, especially those whose general health is too poor to undergo surgery. Adjuvant radiation therapy can be used in addition to surgery to kill small deposits of cancer that cannot be seen and removed during surgery. Palliative radiation therapy can also be used to ease symptoms of mesothelioma such as shortness of breath, pain, bleeding, and difficulty swallowing.
Side effects of radiation therapy may include fatigue and mild skin changes that resemble a sunburn. Often these side effects are temporary. Radiation may also make the side effects of chemotherapy worse. Chest radiation therapy may cause lung damage and lead to difficulty breathing and shortness of breath. Abdominal radiation therapy may cause nausea, vomiting and diarrhea. If you are having any of these side effects of radiation therapy, talk with your doctor since there are ways to help control these symptoms.

Mesothelioma Chemotherapy

Chemotherapy is the use of drugs for treating cancer. The drugs can be swallowed in pill form or they can be injected by a needle into a vein or muscle. Chemotherapy is systemic therapy. This means that the drug enters the bloodstream and circulates throughout the body (through the whole system) to reach and destroy the cancer cells.
In treating mesothelioma, these drugs may also be given intrapleurally (directly into the chest cavity), or intraperitoneally (into the abdominal cavity). Depending on the type and stage of mesothelioma, chemotherapy may be given as the primary (main) treatment or as an adjuvant (addition) to surgery.
Several anticancer drugs have been used to treat mesothelioma. The drug most effective when given alone is doxorubicin (Adriamycin). Other drugs that may be given alone include cisplatin and methotrexate. These anticancer drugs are often given in combination to try to increase their effectiveness. Combinations of drugs used in the treatment of mesothelioma include methotrexate and vincristine. Cisplatin, Alimta®, Gemcitabine (Gemzar), Navelbine (Vinorelbine), Carboplatin and Onconase (Ranpirnase) are also effective chemotherapy drugs. Other drugs such as paclitaxel and irinotecan are currently being studied to determine their effectiveness in treating mesothelioma.
Chemotherapy drugs kill cancer cells but also damage some normal cells. Therefore, careful attention must be given to avoiding or minimizing side effects, which depend on the specific drugs, the amount taken, and the length of treatment. Temporary side effects might include nausea and vomiting, loss of appetite, loss of hair, and mouth sores. Because chemotherapy can damage the blood-producing cells of the bone marrow, patients may have low blood cell counts. This can result in an increased risk of infection (due to a shortage of white blood cells), bleeding or bruising after minor cuts or injuries (due to a shortage of blood platelets), and fatigue or shortness of breath (due to low red blood cell counts).
Most side effects disappear once treatment is stopped. There are remedies for many of the temporary side effects of chemotherapy. For example, antiemetic drugs can be given to prevent or reduce nausea and vomiting. If you experience any side effects, be sure to talk with your doctor.

Physical Therapy

Physical Therapy is a complementary therapy that can help asbestos cancer patients recover from surgery or the side effects of mesothelioma chemotherapy or radiation therapy.

Diagnosis and Follow Up Tests

Laboratory Tests
Chromogranin A (CgA) - At A Glance
Why test? Read more . . .
Elevated Plasma Chromogranin A Is the First Indication of Recurrence in Radically Operated Midgut Carcinoid Tumors (Full Text)
Published online: January 29, 2009
Staffan Welin, Mats Stridsberg, Janet Cunningham, Dan Granberg,
Britt Skogseid, Kjell Öberg, Barbro Eriksson, Eva T. Janson
Department of Medical Sciences, Unit of Endocrine Oncology, Clinical   Chemistry, University Hospital, Uppsala, Sweden
Conclusion: P-CgA was the first marker to indicate tumor recurrence in the majorityof radically operated midgut carcinoid patients. To avoid unnecessaryand costly examinations in asymptomatic patients,we suggest that follow-up should comprise measurementsof P-CgA twice a year and annual ultrasonographyuntil P-CgA is elevated or clinical symptoms occur, at which time all efforts should be made to identify recurrent tumorlesions in order to give the patient the best possible treatment which, if possible, should be surgical removal of the recurrence.
NOTE: The importance of Chromogranin A as a neuroendicrine marker has been known and documented in the medical literature for over 20 years.

CgA Medical References (Share these references with your doctor)
From the Medical Director of the Carcinoid Cancer Foundation
LETTER OF MEDICAL NEED AND EXPLANATION FOR UNUSUAL BLOOD TESTS BEING USED ROUTINELY
Note: The test for Octreotide (Sandostatin) blood levels is still considered experimental by most insurance companies and these companies may therefore NOT pay for this test. For more information regarding this test contact InterScience Institute.
How to Diagnose and Monitor Carcinoid (neuroendocrine tumors): Which Tests and How Often?
Compiled by Susan L. Anderson – September 9, 2002, Updated September 2007
Susan (a carcinoid patient) has compiled a summary of "Which tests and how often" from information provided by Drs. Anthony, Warner and Woltering. After her summary there is additional information from each of these doctors based on their own experience and additional information for the physician. Susan has provided information and support to the carcinoid community since early 1997.
Testing preparation

Preparing for the 24-hour Urine 5HIAA Test
How and Why the 5HIAA Test Is Performed, Normal Range (from Medline Plus, a service of the U.S. National Library of Medicine, National Institutes of Health)
Imaging
(4/28/10) Functional Imaging of NeuroendocrineTumors: A Head-to-Head Comparison of Somatostatin Receptor Scintigraphy, 123I-MIBG Scintigraphy, and 18F-FDG PET
Tina Binderup, Ulrich Knigge, Annika Loft, Jann Mortensen, Andreas Pfeifer, Birgitte Federspiel, Carsten Palnaes Hansen, Liselotte Højgaard, and Andreas Kjaer
Authors’ Affiliations: Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen, Denmark; Cluster for Molecular Imaging, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
J Nucl Med 2010; 51:704–712
Abstract: Functional techniques are playing a pivotal role in the imaging of cancer today. Our aim was to compare, on a head-to-head basis, 3 functional imaging techniques in patients with histologically verified neuroendocrine tumors: somatostatin receptor scintigraphy (SRS) with 111-Indiethylenetriaminepentaacetic acidoctreotide, scintigraphy with 123I-metaiodobenzylguanidine (MIBG), and 18F-FDG PET. Methods: Ninety-six prospectively enrolled patients with neuroendocrine tumors underwent SRS, 123I-MIBG scintigraphy, and 18F-FDG PET on average within 40 d. The functional images were fused with low-dose CT scans for anatomic localization, and the imaging results were compared with the proliferation index as determined by Ki67. Results: The overall sensitivity of SRS, 123I-MIBG scintigraphy, and 18F-FDG PET was 89%, 52%, and 58%, respectively. Of the 11 SRS-negative patients, 7 were 18F-FDG PET-positive, of which 3 were also 123I-MIBG scintigraphy–positive, giving a combined overall sensitivity of 96%. SRS also exceeded 123I-MIBG scintigraphy and 18F-FDG PET based on the number of lesions detected (393, 185, and 225, respectively) and tumor subtypes. 123I-MIBG scintigraphy was superior to 18F-FDG PET for ileal neuroendocrine tumors, and 18F-FDG PET was superior to 123I-MIBG scintigraphy for pancreaticoduodenal neuroendocrine tumors. The sensitivity of 18F-FDG PET (92%) exceeded that of both SRS (69%) and 123I-MIBG scintigraphy (46%) for tumors with a proliferation index above 15%. Conclusion:The overall sensitivity of 123I-MIBG scintigraphy and 18F-FDG PET was low compared with SRS. However, for tumors with a high proliferation rate, 18F-FDG PET had the highest sensitivity. The results indicate that, although SRS should still be the routine method, 18F-FDG PET provides complementary diagnostic information and is of value for neuroendocrine tumor patients with negative SRS findings or a high proliferation index.
PMID: 20395333 [PubMed - as supplied by publisher]

What is an OctreoScan®?
From the Ohio State University Medical Center website.
Scintigraphic Evaluation of Neuroendocrine Tumors (MIBG, Octreoscan)
from Applied Radiology
Michael W. Hanson, MD
Division of Cardiology at Duke University Medical Center, Durham, NC.
Appl Radiol 30(6):11-17, 2001. © 2001 Anderson Publishing, Ltd

Whole-body 11C-5-hydroxytryptophan positron emission tomography as a universal imaging technique for neuroendocrine tumors - comparison with somatostatin receptor scintigraphy and computed tomography
(Full text)
Orlefors H, Sundin A, Garske U, Juhlin C, Oberg K, Langstrom B, Bergstrom M, Eriksson B.
J Clin Endocrinol Metab. 2005 Mar 8
Conclusion: This study indicates that WB-(11)C-HTP-PET can be used as a universal imaging method for detection of NET's. This study also shows that WB-(11)C-HTP-PET is sensitive in imaging small NET-lesions, such as primary tumors, and can in a majority of cases image significantly more tumor lesions than SRS and CT. Presently only available at Uppsala Medical Center, Sweden.

Gallium-68 PET: a new frontier in receptor cancer imaging.
The recent introduction of PET imaging with gallium-68 has major bearings in current and future clinical practice. Its labelling with DOTA compounds has cleared the way for somatostatin receptor imaging with a viable PET agent, with all its inherent imaging advantages compared to single photon imaging. The pre-clinical and clinical applications of this technique has been successful in a variety of tumours, particularly Neuroendocrine Tumors (NETs) and its labelling with other ligands and molecules will improve the management of other tumours and the assessment of infection.