Mesothelioma treatment depends on several factors, including the stage of mesothelioma, the location of the tumor, and the age and overall health of the patient. Treatments for mesothelioma are divided into two categories:

1. Traditional mesothelioma treatments
2. New mesothelioma treatments.

1. Traditional mesothelioma treatments are the same as those used to treat most other cancers, and include:

• Surgery
• Chemotherapy
• Radiation therapy

2.   New treatments for mesothelioma include:

• Development of new chemotherapy agents
• Intensity modulated radiation therapy (IMRT)
• Photodynamic therapy (PDT)
• Immunotherapy
• Gene therapy

A number of alternative therapies can also be combined with traditional treatment options. Many patients choose to add alternative therapies such as massage, acupuncture, or TENS therapy to their conventional treatment approach in an effort to enhance or compliment the treatment process. A variety of alternative therapies, including aromatherapy, meditation, or yoga, are often added to a treatment regimen to provide pain relief and foster relaxation.

Following a healthy diet has a major impact on cancer survivability. While proper nutrition is not intended as a replacement for traditional treatments, eating health-giving foods helps stimulate your immune system, deters cancer growth and lessens the negative side effects of traditional therapies. If cancer patients do not eat properly, they can become malnourished and pass away not from cancer, but from an infection or other illness in their weakened state. Some of the symptoms experienced by patients with mesothelioma and other forms of cancer occur as a result of radiation therapy, chemotherapy and other mesothelioma treatments.

Chemotherapy can cause anorexia {poor appetite}, constipation and diarrhea. Nausea and vomiting are two of the most common symptoms. Alimta and Cisplatin, two chemotherapy medications often prescribed to patients with malignant mesothelioma, can cause both nausea and vomiting. Although some patients are unable to eat without a feeding tube, others require no assistance.

Following advice offered by the National Cancer Institute (NCI) for patients undergoing cancer treatment:

• Low saturated fats, moderate good fats, and a high fiber intake.
• Eat foods that are easy to digest
• Eat when you’re feeling best
• If chemotherapy does not make you nauseous, eat a few hours beforehand, as this may make you feel better following treatment (many people feel sick following chemotherapy sessions)
• Stay hydrated, but don’t drink so much that it fills you up and suppresses hunger
• Avoid eating when you feel nauseous, which may make you feel more sick and discourage you from eating at other times
• Eating modest quantities is fine, just make sure that they add up to a full day’s worth of meals

If you are unable to eat full meals, consider eating multiple nutritious snacks throughout the day, taking advantage of the times when you are most hungry. Focus on foods you like that are high in calories and proteins, and avoid snacks that might exacerbate your symptoms; shakes are a good way to accomplish both of these tasks.

Following are some general guidelines of what various nutrients provide in the diet.

• Protein:

Protein helps ensure growth, repairs body tissues damaged by surgery, chemotherapy and/or radiation, and helps to maintain a healthy immune system. Most patients require additional protein during and after aggressive treatments to help heal tissues and lower the risk of infection.

• Fats and carbohydrates:

Fats and carbohydrates help supply the body with the majority of its daily caloric intake. Each patient’s age, frame size and level of physical activity will determine what is considered normal for them.

• Vitamins and minerals:

Vitamins and minerals help ensure growth and development, in addition to allowing the body to use the calories supplied by the foods eaten. While it is not always necessary to supplement vitamins and minerals during times when one is maintaining good eating habits, it may become more important when the challenges of being ill or undergoing treatment make eating difficult.

• Water:

Water is essential for life. Without enough water, the body becomes dehydrated. Discuss how much water you should be drinking each day with your doctor or nutritionist.

The ACS has a very useful chart showing good snacks for patients suffering from cancers such as mesothelioma. The chart below shows good sources of protein and calories.

Proteins are essential for patients suffering from mesothelioma treatment-related fatigue, as are fluids and vitamins. None of these, however, is a substitute for calories, a lack of which causes wasting syndrome (cachexia), or massive weight loss, in many mesothelioma patients.

Your dietician can also teach you how to pack more calories into small meals, and can help you overcome symptoms such as difficulty swallowing, fullness and taste changes.

Brigham Staging System

It is the most recent staging system for mesothelioma and looks at variables such as lymph node status and tumor resectability (ability to surgically remove a tumor). The Brigham staging system consists of four stages:

TNM Staging System

This system considers three components; the first letter of each forming the name of the system. Doctors using TNM will look at the tumor, lymph nodes, and whether the cancer has metastasized. Like the Butchart system, it is divided into four stages.

An important aspect is that as pleural mesothelioma is the most common among all types of cancer and occurs frequently, these staging systems are devised to mark its stages.

The three established and recognized clinical staging systems for mesothelioma are:

• The Butchart System
• TNM Staging
• The Brigham System

The Butchart Staging System:

Butchart is the oldest system and is still the most commonly used.  Its four stages are based on the extent of primary tumor mass.

Staging is the process of finding out how far the mesothelioma cancer has spread. Doctors determine which treatments to use based on the mesothelioma stage, or the severity of the disease. Staging of mesothelioma is based on imaging studies such as x-rays, CT scans, and MRI scans.

To keep a track of mesothelioma cancer, the extent of its spread and the size of tumor(s); mesothelioma has been divided into a few stages or staging systems. These mesothelioma staging systems keep a track of the development of cancer in the human body. The tests and scans when diagnosing cancer give some information about the stage. It is important because treatment is often decided according to the stage of a cancer.
Some elements common to most staging systems are:
• Location of the primary tumor.
• Size and number of the tumors.
• Lymph node involvement.
• Cell type and tumor grade.
• Metastasis.

Many cancer registries, such as the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program (SEER) use summary staging, a system used for all types of cancer. Summary staging groups cancer into five main categories:

• In situ – cancer that is present only in the layer of cells in which it began.

• Localized – cancer that is limited to the organ in which it began with no evidence of spread.

• Regional – cancer that has spread from the primary site to nearby lymph nodes or organs.

• Distant – cancer that has spread from the primary site to distant lymph nodes or organs.

• Unknown – cases where not enough information exists to indicate stage.