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PDQ
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PDQ is a computer system that gives up-to-date information on cancer and its prevention, detection, treatment, and supportive care. It is a service of the National Cancer Institute (NCI) for people with cancer and their families and for doctors, nurses, and other health care professionals.
To ensure that it remains current, the information in PDQ is reviewed and updated each month by experts in the fields of cancer treatment, prevention, screening, and supportive care. PDQ also provides information about research on new treatments (clinical trials), doctors who treat cancer, and hospitals with cancer programs. The treatment information in this summary is based on information in the PDQ summary for health professionals on this cancer.
PDQ can be used to learn more about current treatment of different kinds of cancer. You may find it helpful to discuss this information with your doctor, who knows you and has the facts about your disease. PDQ can also provide the names of additional health care professionals who specialize in treating patients with cancer.
Before you start treatment, you also may want to think about taking part in a clinical trial. PDQ can be used to learn more about these trials. A clinical trial is a research study that attempts to improve current treatments or finds information on new treatments for patients with cancer. Clinical trials are based on past studies and information discovered in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help patients with cancer. Information is collected about new treatments, their risks, and how well they do or do not work. When clinical trials show that a new treatment is better than the treatment currently used as "standard" treatment, the new treatment may become the standard treatment. Listings of current clinical trials are available on PDQ. Many cancer doctors who take part in clinical trials are listed in PDQ.
To learn more about cancer and how it is treated, or to learn more about clinical trials for your kind of cancer, call the National Cancer Institute's Cancer Information Service. The number is 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. The call is free and a trained information specialist will be available to answer cancer-related questions.
PDQ is updated whenever there is new information. Check with the Cancer Information Service to be sure that you have the most up-to-date information.
Malignant mesothelioma, a rare form of cancer, is a disease in which cancer (malignant) cells are found in the sac lining the chest (the pleura) or abdomen (the peritoneum). Most people with malignant mesothelioma have worked on jobs where they breathed asbestos.
Like most cancer, malignant mesothelioma is best treated when it is found (diagnosed) early. You should see your doctor if you have shortness of breath, pain in your chest, or pain or swelling in your abdomen. If you have symptoms, your doctor may order an x-ray of your chest or abdomen.
Your doctor may look inside your chest cavity with a special instrument called a thoracoscope. A cut will be made through your chest wall and the thoracoscope will be put into the chest between two ribs. This test, called thoracoscopy, is usually done in the hospital. Before the test, you will be given a local anesthetic (a drug that causes you to lose feeling for a short period of time). You may feel some pressure, but you usually do not feel pain.
Your doctor may also look inside your abdomen (peritoneoscopy) with a special tool called a peritoneoscope. The peritoneoscope is put into an opening made in the abdomen. This test is also usually done in the hospital. Before the test is done, you will be given local anesthetic.
If tissue that is not normal is found, your doctor will need to cut out a small piece and have it looked at under a microscope to see if there are any cancer cells. This is called a biopsy. Biopsies are usually done during the thoracoscopy or peritoneoscopy.
Your chance of recovery (prognosis) depends on the size of the cancer, where the cancer is, how far the cancer has spread, how the cancer cells look under the microscope, how the cancer responds to treatment, and your age.
Once malignant mesothelioma is found, more tests will be done to find out if cancer cells have spread to other parts of the body. This is called staging. Your doctor needs to know the stage of your cancer to plan treatment. The following stages are used for malignant mesothelioma.
Stage I: The cancer is found in the lining of the chest cavity near the lung and heart or in the diaphragm or the lung.
Stage II: The cancer has spread beyond the lining of the chest to lymph nodes in the chest.
Stage III: Cancer has spread into the chest wall, center of the chest, heart, through the diaphragm, or abdominal lining, and in some cases into nearby lymph nodes.
Stage IV: Cancer has spread to distant organs or tissues.
Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the lining of the chest or abdomen or in another part of the body.
There are treatments for all patients with malignant mesothelioma. Three kinds of treatment are used:
Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy).
If fluid has collected in the chest or abdomen, your doctor may drain the fluid out of your body by putting a needle into the chest or abdomen and using gentle suction to remove the fluid. If fluid is removed from the chest, this is called thoracentesis. If fluid is removed from the abdomen, this is called paracentesis. Your doctor may also put drugs through a tube into the chest to prevent more fluid from accumulating.
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells throughout the body. In mesothelioma, chemotherapy may be put directly into the chest (intrapleural chemotherapy).
Intraoperative photodynamic therapy is a new type of treatment that uses special drugs and light to kill cancer cells during surgery. A drug that makes cancer cells more sensitive to light is injected into a vein several days before surgery. During surgery to remove as much of the cancer as possible, a special light is used to shine on the pleura. This treatment is being studied for early stages of mesothelioma in the chest.
Your treatment depends on where the cancer is, how far it has spread, your age, and your general health.
You may receive treatment that is considered standard based on its effectiveness in a number of patients in past studies, or you may choose to go into a clinical trial. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are going on in many parts of the country for many patients with malignant mesothelioma. If you want more information, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.
If the cancer is only in one place in the chest or abdomen, your treatment will probably be surgery to remove part of the pleura and some of the tissue around it.
If the cancer is found in a larger part of the pleura, your treatment may be one of the following:
Your treatment may be one of the following:
Your treatment depends on many factors, including where the cancer came back and what treatment you received before. Clinical trials are testing new treatments.
TO LEARN MORE..... CALL 1-800-4-CANCER
To learn more about malignant mesothelioma, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. By dialing this toll-free number, you can speak with someone who can answer your questions.
The Cancer Information Service can also send you booklets. The following general booklets on questions related to cancer may be helpful:
You can also write to the National Cancer Institute at this address:
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Treatment