What are my most likely treatment options?
In general, there are three types of treatment for any cancer - surgery, chemotherapy, and radiation therapy. Because it is such a rare cancer, and because few treatments show much success, there are no absolute standards of care for mesothelioma. There are a few treatments that have shown the most success, and these will probably be offered to you if you would benefit from them. In the case of mesothelioma, radiation therapy has not been very useful so far, but surgery and chemotherapy are making a difference for patients with this cancer.
In terms of surgery, if you have pleural mesothelioma that can be removed surgically by EPP, and you are pronounced healthy enough to go through the procedure, that would probably be the treatment of choice, along with chemotherapy to make sure no tumor remains. The same might be done with a decortication/pleurectomy and chemotherapy.
Pleural Mesothelioma Treatments
For peritoneal mesothelioma, if it is possible to remove the visible tumor masses surgically, that will probably be done. Studies have shown a benefit to instilling chemotherapeutic agents into the abdominal cavity, so that might be done, or surgery might be followed by systemic chemotherapy.
Many patients with pleural mesothelioma are not candidates for surgery. If you are not a candidate for surgery, there is now a two-agent chemotherapy regimen that shows great promise in treating mesothelioma, and it will probably be the chemotherapy regimen offered to you. It consists of Alimta and cisplatin.
Alimta can also be given with other chemotherapeutic drugs related to cisplatin, including carboplatin. Other two-combination chemotherapy is also used. Clinical trials are ongoing to try and find the best ways to use surgery, chemotherapy, and radiation together, in different combinations, to treat mesothelioma.