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Medical Author:

Winston W Tan, MD

Coauthor:

Shehnaz Shaikh, MD

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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The objective of surgery is to remove the mesothelioma. If the tumor has spread to many organs, it is impossible to remove all the cancer cells from the body. In such cases, surgery may still be done to provide pain relief.

Depending on the stage of the tumor, the surgeon may decide on the type of surgery. Types of surgeries for pleural mesothelioma include pleurectomy and extrapleural pneumonectomy.

• Pleurectomy: In this type of surgery, the surgeon strips off both the layers of the affected mesothelial lining surrounding the lung. It is not a curative surgery because complete removal of all the mesothelial lining is not possible; therefore, the tumor recurrence rate is high. However, this procedure provides pain relief.
• Extrapleural pneumonectomy: This is a very extensive surgery in which not only the affected pleural lining is surgically removed but that side of the lung, diaphragm, and mesothelial lining of the heart are also removed. This type of surgery is used when the tumor has not spread to the mediastinal lymph nodes.

Clinical Trials

Because mesothelioma is difficult to treat, clinical trials are being conducted to find new and better methods of treatment. Research is being conducted at various cancer centers all over the United States. Before any new treatment can be used at large, specialists conduct trials in a limited number of people to ascertain whether the treatment is useful and safe. If you have mesothelioma, you have an option of enrolling in the various clinical trials being conducted.

If you are considering enrolling yourself in a clinical trial, you may find the booklet Taking Part in Clinical Trials: What Cancer Patients Need to Know useful. This booklet published by the National Cancer Institute explains how research studies are done and describes their possible benefits and risks. You can order the booklet by calling Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.

Web sites giving information about ongoing clinical trials include the following:

• http://www.cancer.gov/clinicaltrials
• http://www.centerwatch.com/patient/studies/cat192.html
• http://www.mesotheliomaweb.org/clinical.htm
• http://cpmcnet.columbia.edu/dept/medicine/mesothelioma/clinmeso.html

Palliative Care

In some people, age, other health problems, or advanced disease may make aggressive treatment of mesothelioma difficult. In such people, palliative care (treats the symptoms, but not the disease itself) is an option. Palliative care is a specialized form of care that lessens pain and other symptoms. The goal of palliative care is not to prolong life or hasten death, but rather to enhance the quality of your life, while offering support to you and your family.

If you opt for palliative care, it is very important to communicate openly with your health-care provider. With palliative care, many symptoms of mesothelioma can be substantially reduced. At every visit, you should tell your health-care provider how you feel, what discomfort you have, and your level of pain.

Palliative care offers you emotional and physical comfort and relief from pain. Other symptoms managed through palliative care include shortness of breath, fatigue, loss of appetite, gastrointestinal problems, skin problems, anxiety, and depression.

Palliative and terminal care is often given in a hospital, hospice, or nursing home; however, it can also be provided at home. The following organization can help you with palliative and terminal care:

National Hospice and Palliative Care Organization (NHPCO)
Suite 625
1700 Diagonal Road
Alexandria, VA 22314
(703) 837-1500, (800) 658-8898 (Helpline)
Email: info@nhpco.org
Web site: http://www.nhpco.org

Hospice Association of America (HAA)
Address: 228 Seventh Street, SE.
Washington, DC 20003
(202) 546-4759
Web site: http://www.nahc.org/HAA/home.html

Hospice Education Institute
190 Westbrook Road
Essex, CT 06426-1510
(860) 767-1620, (800) 331-1620
Email: HOSPICEALL@aol.com
Web site: http://www.hospiceworld.org

Hospice Net
Email: questions@hospicenet.org
Web site: http://www.hospicenet.org