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Step 1
Manage mesothelioma with surgery, chemotherapy, radiotherapy or a combination of therapies. Surgery is frequently relied on exclusively when the disease is confined to the pleural cavity.
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Step 2
Perform surgical resection as the preferred treatment because chemotherapy and radiotherapy are generally ineffective as primary treatments. The two procedures to be considered are an extrapleural pneumonectomy and a pleurectomy with decortication. An extrapleural pneumonectomy is more extensive with a higher mortality rate because it removes the entire pleural sac. A pleurectomy with decortication involves a decortication of the pleura and reconstruction. Both of these procedures have a high recurrence rate.
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Step 3
Follow clinical trials for chemotherapy of mesothelioma. The most effective agents known are alkylating agents, anthracycline and platinum, but their response rates are only in the 10 to 20 percent range.
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Step 4
Use radiation to relieve chest pain and reduce metastasis to the chest wall in some patients.
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Step 5
Combine surgery, chemotherapy and radiation in a trimodal approach. The most common example of this type of treatment is an extrapleural pneumonectomy followed by chemotherapy and radiotherapy to prevent recurrence.
