Treatments for asbestos mesothelioma may vary depending upon the part of the body affected and the stage of cancer. Unlike other cancers, mesothelioma, cancer in the lining of an organ, is not classified by stages such as Stage I, Stage II, Stage III, and Stage IV, according to the American Cancer Society. The stage of diagnosis, however, often defines survival statistics.

How Is Mesothelioma’s Progression Categorized?

Most cases of mesothelioma start in the pleura, the lining of the lungs. The American Cancer Society says the stages of progression of pleural mesothelioma are:

• Localized means the cancer is only in the pleura
• Regional means cancer has spread to lymph nodes or nearby tissues
• Distant means cancer has spread to the pleura on the other side of the patient’s body or to other organs or bones

What Are Survival Rates for Those Stages?

The five-year survival rate for localized mesothelioma is 18%, regional is 11%, and distant is 5%. Many factors affect an individual’s survival, including overall health, age, how well the cancer responds to treatment, among and other variables.

What are the Symptoms of Mesothelioma?

Although mesothelioma is a condition that may take years or decades to be diagnosed, there are some side effects and symptoms that those who are at risk of developing the condition may be able to watch for. Most people who are diagnosed with mesothelioma experience symptoms of the condition prior to diagnosis. The symptoms may vary depending on whether mesothelioma has developed in the abdomen or chest, or has spread to other parts of the body.

Common symptoms of mesothelioma include shortness of breath and chest pain. Some with the disease may also experience unexplained weight loss, painful coughing, a feeling of tightness in the chest, abdominal swelling or pain, chest or lower back pain, bowel obstructions, fever, anemia, nausea, excessive sweating, fatigue, or blood clotting abnormalities.

If mesothelioma affects the lungs, abnormal tumors or lumps of tissue may be felt under the skin on the chest. If cancer has spread beyond the abdomen or chest, sufferers may also experience difficulty swallowing, swelling of the arms, or pain and swelling in the neck or face.

As mesothelioma is relatively rare, these symptoms do not always indicate mesothelioma. However, in some cases, mesothelioma symptoms may be mistaken for symptoms of less serious conditions.

If you have a history of exposure to asbestos and have experienced potential mesothelioma symptoms, a physician may be able to run some tests to determine whether you have developed the disease.  While there are some treatments, many people with mesothelioma may only be able to treat the symptoms caused by the disease.

What Can Be Done If I Am Diagnosed with Pleural Mesothelioma?

In some cases, surgery may be performed to decrease fluid that’s collected in the chest, which can cause breathing difficulties. A surgeon may insert a catheter into the chest to allow fluid the drain.

Sometimes the pleural tissue is surgically removed, which may offer relief from symptoms even though it isn’t a cure for the disease.

Is It Possible My Lung Would Be Removed?

Yes, removing the lung that is affected by pleural mesothelioma may help stop the symptoms of struggling to breathe on that side. Once the lung is gone, the oncologist may suggest using a high dose of radiation to eliminate any remaining cancer cells because there’s no longer a lung that needs protection from such radiation.

What About Treatment with Pemetrexed?

The U.S. Food and Drug Administration (FDA) has approved the use of pemetrexed in combination with a platinum complex that is treated with Optune, a medical device designed to treat tumors. Novocure makes Optune and ran the clinical trial on 80 patients with inoperable mesothelioma. Novocure reported a 40% overall response rate to the treatment, according to an Oct. 25, 2019, article by Dr. Derek Raghavan on Healio.com.

What Other Treatments for Mesothelioma Are Available?

Dr. Raghavan wrote about the MERIT study conducted by Japanese researchers. Thirty-four patients with different kinds of mesothelioma cancer received Opdivo (nivolumab), manufactured by Bristol-Myers Squibb.

The overall reported response rate was 29% and the median overall survival rate was just more than 17 months.

What Treatments for Mesothelioma Might Be Used if First Line Methods Aren’t Helping?

According to the Mayo Clinic, if traditional treatment is not successful, your doctor might suggest immunotherapy. When cancer cells produce certain proteins, they become invisible to the immune system’s fighter cells. Immunotherapy allows the immune system’s cells to ‘see’ cancer cells and try to fight them off.

FDA Approves New First-Line Treatment

The FDA recently announced that it had approved the use of a drug combination as a first-line treatment for malignant pleural mesothelioma. According to the agency, Opdivo (nivolumab) and Yervoy (ipilimumab) can be combined as a first-line mesothelioma treatment in adults whose cancer cannot be removed by surgery.

“Today’s approval of nivolumab plus ipilimumab provides a new treatment that has demonstrated an improvement in overall survival for patients with malignant pleural mesothelioma,” said the director of the FDA’s Oncology Center of Excellence and acting director of the Office of Oncologic Diseases in the FDA’s Center for Drug Evaluation and Research. “In 2004, FDA approved pemetrexed in combination with cisplatin for this indication, and now patients have an important, additional treatment option after more than a decade with only one FDA-approved drug regimen.”

The new treatment is meant for malignant pleural mesothelioma (MPM), the most common type of mesothelioma. MPM affects approximately 20,000 Americans each year, according to the FDA, and its overall survival rate is poor.

An FDA review of the new treatment was conducted as part of Project Orbis, an initiative that enhances the cooperation of international partners in the review of oncology products.

The FDA review of the new mesothelioma treatment included more than 600 patients with MPM. The patients received test drugs or regular treatment for two years. Those who received the test drugs reportedly lived an average of four additional months than those who underwent regular treatment.