Treatment of mesothelioma

Once the doctors know the stage of the mesothelioma they will be able to plan the most appropriate treatment.

The treatment for mesothelioma depends on whether it is only in one place or has spread. Currently, there is no cure for mesothelioma, unless it can be removed by an operation. Unfortunately, when mesothelioma is diagnosed, it has usually already spread beyond the point where it could be removed surgically.

The usual treatment for mesothelioma in this situation is active symptom control.

Radiotherapy may be used as part of treatment to try to cure mesothelioma. Most often it is used to control symptoms. Chemotherapy can also be used to control symptoms and to slow the growth of mesothelioma.

Multidisciplinary team

If your tests show that you have mesothelioma, you will be looked after by a multidisciplinary team. This is a team of staff who specialise in treating mesothelioma and in giving information and support. It will normally include:

• surgeons who are experienced in chest surgery
• specialist nurses who give information and support
• oncologists – doctors who have experience in mesothelioma treatment using chemotherapy and radiotherapy
• symptom-control specialists
• radiologists who help to analyse x-rays
• pathologists who advise on the type and extent of the cancer.

Other staff will also be available to help you if necessary, such as:

• physiotherapists
• counsellors and psychologists
• social workers
• dietitians.

Together they will be able to advise you on the best course of action taking into account a number of factors. These include your age, general health, and how the mesothelioma is affecting you.

Occasionally your doctors may offer you a choice of treatments. Sometimes people find it very hard to make a decision. If you are asked to make a choice, make sure that you have enough information about the different treatment options, what is involved and the side effects you might experience, so that you can decide what is the right treatment for you.

Remember to ask questions about any aspects that you do not understand or feel worried about. You may find it helpful to discuss the benefits and disadvantages of each option with your cancer specialist, nurse specialist or with the nurses in our cancer support service.

If you have any questions about your own treatment, don't be afraid to ask your doctor or nurse. It often helps to make a list of questions and to take a close friend or relative with you.

Second opinion

Even though a number of cancer specialists work as a team to decide on the most suitable treatment, you may want to have another medical opinion. Most doctors will be willing to refer you to another specialist for a second opinion if you feel that it will be helpful. The second opinion may take some time to organise and may cause a delay in the start of your treatment, so you and your doctor need to be confident that it will be helpful.

If you do go for a second opinion, it may be a good idea to take a friend or relative with you, and to have a list of questions so you can make sure your concerns are covered during the discussion.

Giving your consent

Before you have any treatment your doctor will explain its aims to you. You will usually be asked to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form, you should have been given full information about:

• the type and extent of the treatment you are advised to have
• the advantages and disadvantages of the treatment
• any other treatments that may be available
• any significant risks or side effects of the treatment.

If you do not understand what you have been told, let the staff know straight away so that they can explain again. Some treatments are complex, so it is not unusual for people to need their treatment to be explained more than once.

Patients often feel that hospital staff are too busy to answer their questions, but it is important for you to be aware of how the treatment is likely to affect you and the staff should be willing to make time for you to ask questions.

You can always ask for more time to decide about the treatment, if you feel that you can't make a decision when it is first explained to you. You are also free to choose not to have the treatment, and the staff can explain what may happen if you do not have it.

Benefits and disadvantages of treatment

Many people are frightened at the idea of having cancer treatments, particularly because of the side effects that can occur. Some people ask what would happen if they did not have any treatment.

Although cancer treatments can cause side effects, these can usually be controlled with medicines.

Treatment can be given for different reasons and the potential benefits will vary depending upon the individual situation. For the few people with early-stage mesothelioma, surgery and radiotherapy may be given with the aim of curing the cancer.

However, in most people with mesothelioma, the cancer is at a more advanced stage and any treatment given is with the aim of controlling it, which for some people may lead to an improvement in symptoms and a better quality of life. But, for some people in this situation the treatment will have no effect upon the cancer and they will get the side effects of the treatment without any of the benefit.

When a cure is not possible and the aim of treatment is to control the cancer for a period of time, it may be difficult to decide whether to go ahead with treatment. Making decisions in these circumstances is always hard, and you may need to discuss your treatment and symptom control in detail with your doctor.