Making treatment decisions for malignant mesothelioma

After the tumor is found and staged, your cancer care team will discuss your treatment options with you. The main factors in selecting a treatment for mesotheliomas are the size and location of the tumor, whether it has spread to lymph nodes or other organs, and your health and personal preferences.

Because mesothelioma is a rare cancer, it has been hard for doctors to compare the value of different treatments. Only a few large clinical trials of treatments for mesothelioma have been done. In addition, many doctors have little or no experience treating this disease. They usually refer patients with this cancer to specialists who treat large numbers of mesothelioma patients at major medical centers.

You may have different types of doctors on your treatment team, depending on the stage of your cancer and your treatment options. These doctors may include:

• A thoracic surgeon: a doctor who treats diseases of the lungs and chest with surgery.
• A radiation oncologist: a doctor who treats cancer with radiation therapy.
• A medical oncologist: a doctor who treats cancer with medicines such as chemotherapy.
• A pulmonologist: a doctor who specializes in medical treatment of diseases of the lungs.

Many other specialists may be involved in your care as well, including nurse practitioners, nurses, respiratory therapists, social workers, and other health professionals.

Mesothelioma is often hard to treat because it typically does not grow as a single tumor mass. It tends to spread along nearby surfaces, nerves, and blood vessels. This makes it very difficult, except in rare situations, to completely get rid of it with surgery and/or radiation.

Before deciding on a treatment option, it's very important to have an idea of its likely benefits and possible risks. You will probably have many questions about the treatment options suggested. Mesotheliomas are rare, so if time permits it is often a good idea to seek a second opinion from a doctor who has a lot of experience in treating people with these cancers. A second opinion can provide more information and help you feel more confident about the treatment plan that you choose.