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How We Treat Mesothelioma

  • Treatment for mesothelioma is provided at the International Mesothelioma Program (IMP). Our team of surgical, medical and radiation oncologists, pathologists and radiologists — all specialized lung cancer experts — work together to determine the right choices for your individual treatment. You will also have access to an array of support programs and services, including many developed specifically for mesothelioma patients.

    Timely Appointments

    Patients with either suspected or proven mesothelioma should be seen as soon as possible for timely diagnosis and treatment.

    Our new patient coordinators will work with you to quickly schedule an appointment with our specialists.

    Phone: 617-732-5922
    Online: Complete the Appointment Request Form

    There is no universally accepted standard therapy for mesothelioma, so our experts develop an ideal therapeutic approach for each patient. Options for therapy include surgery, chemotherapy, radiation therapy, or a combination of these therapies. A combined approach is typically most effective for the majority of mesothelioma patients.

    Collaboration is the key to success. Our surgeons, medical oncologists, radiation oncologists, radiologists and pathologists are working together in a unique, collaborative model that focuses exclusively on the diagnosis and treatment of lung cancer, mesothelioma, and other related conditions. Our staff members meet daily as a group to evaluate the most effective options for each patient.

    Surgery

    Dr. Raphael Bueno (right) views a video-scope during thoracic surgery.

    Our thoracic surgeons at the International Mesothelioma Program (IMP) have pioneered and refined the most advanced surgical treatments for mesothelioma, including the introduction of interoperative chemotherapeutic drugs. Today, clinicians from around the world come to Boston to learn from our experts.

    The purpose of surgery is to remove all visible disease, with the goal of extending life. Surgical options for malignant mesothelioma include:

    • Pleurectomy (P/DC): removal of the lining of the chest.
    • Extrapleural pneumonectomy (EPP): removal of the affected lung along with the lining of the chest (pleura), portions of the covering of the heart (pericardium), and the diaphragm.

    Our IMP clinician-scientists have pioneered a novel way to administer chemotherapy to improve the effectiveness of surgical treatment. This strategy involves surgery to remove all visible disease, and then infusing a heated bath of the chemotherapy drug or drugs into the chest cavity (intracavitary lavage). Heating enhances the effectiveness of the drug therapy to eradicate tumor cells. In addition, other drugs are administered to protect normal cells from the chemotherapy agents and reduce side effects.

    Chemotherapy

    Medical oncologists administer chemotherapy, a cancer treatment that uses drugs to stop the growth of cancer cells. Chemotherapy is almost always part of a therapeutic plan aimed at controlling mesothelioma, with the goal of extending life, while improving the quality of life for patients.

    Chemotherapy for mesothelioma is typically administered intravenously, or by a surgeon during a surgical procedure. The choice of specific drugs to be administered will be based on your individual needs. Many of the chemotherapies for mesothelioma are given along with a vitamin regimen that minimizes toxicity and maximizes effectiveness.

    Our oncologists use their extensive expertise to determine the right care plan for each patient:

    • At the first meeting, we address difficult symptoms you may be experiencing, including pain, shortness of breath, and emotional distress. We will also arrange meetings with our extensive support services staff, including palliative care, nutrition, and social work services.
    • We provide efficient and rapid processes to begin treatment as soon as possible through coordination of diagnostic testing, evaluation, and diagnosis with the entire team.
    • We have experience with the latest therapies and have the expertise to tailor these therapies to each patient for the greatest likelihood of success. Our team will discuss these options with you and help to determine the right care plan.

    Radiation Therapy

    Radiation therapy is a noninvasive form of cancer treatment that uses various forms of radiation to kill cancer cells. Our thoracic radiation oncologists specialize in radiation therapy techniques that effectively target cancer cells while sparing healthy tissue. In the case of mesothelioma, radiation therapy has two potential roles:

    • Radiation is given to palliate (relieve) symptoms from mesothelioma.
    • Radiation can be given to reduce or eliminate cancer cells remaining after surgery.

    Our radiation oncologists have access to the most advanced tools for radiation therapy. Depending on your individual needs, treatment may be administered through one of several techniques:

    • Image-guided radiation therapy (IGRT) involves daily imaging to ensure the tumor is centered within the radiation beams for each treatment.
    • Intensity-modulated radiation therapy (IMRT) or 3D-conformal radiation therapy (3D-CRT) both involve sophisticated computerized planning techniques to maximize delivery of radiation to the tumor while sparing nearby healthy tissues.

    Novel Treatments and Clinical Trials

    A number of laboratory investigators at Dana-Farber/Brigham and Women's Cancer Center (DF/BWCC) are focused on scientific discovery and drug development in mesothelioma. As part of these ongoing efforts, we are actively pursuing new clinical trials for malignant mesothelioma.

    Clinical trials are an important part of the cancer research process that enable investigators to explore if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. We are also working hard to understand the basic biology of this disease in order to develop more effective treatments.

    Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not responded to other treatments. There are also clinical trials that test new ways to stop cancer from recurring or reduce the side effects of cancer treatment.

    Find out more about clinical trials at Dana-Farber/Brigham and Women's Cancer Center.

    In-Patient Care

    Patients requiring surgery for mesothelioma are cared for by a dedicated team of thoracic specialists who are part of our specialized surgical oncology team. Our medical, nursing, and support staff all have expertise in working with patients with mesothelioma — providing treatment and assisting each patient through a medically and emotionally challenging time.

    Surgery takes place in the operating rooms at Brigham and Women's Hospital, whose mesothelioma surgery program is recognized widely as one of the best in the country. Post-surgical care and other inpatient care are provided by the Dana-Farber/Brigham and Women's Cancer Center team either at Brigham and Women's Hospital or at Dana-Farber's Inpatient Hospital located within Brigham and Women's Hospital. The Thornton House, located across the street from the main entrance of Brigham and Women's Hospital, provides housing for mesothelioma patients and families undergoing treatment.

    Radiation therapy is also provided by the Dana-Farber/Brigham and Women's Cancer Center team at Brigham and Women's Hospital.

    Most of our outpatient care takes place at Dana-Farber Cancer Institute. Infusion therapy (chemotherapy) is provided at the Yawkey Center for Cancer Care, one of the most advanced outpatient centers in the country, which was designed with the input of patients and families to meet their specific needs.

    For Referring Physicians

    Because the patient's primary care physician or community specialist is an integral part of the patient's care team, we are committed to collaborating in the care of your patient. If you are a physician and have a patient with mesothelioma, we look forward to working with you.

    Our new patient coordinators will work with you to quickly schedule an appointment with our specialists.

    Phone: 617-732-5922
    Online: Complete the Appointment Request Form

    Symptom Management

    At the International Mesothelioma Program (IMP), our specialists work exclusively with patients who are coping with mesothelioma and related diagnoses. Our dedicated team will help you manage your symptoms and any side effects you may be experiencing. Support services available through our Program include:

    • Pain management. Our palliative care specialists work with your doctors to provide treatment for pain, which is a common side effect of mesothelioma.
    • Help with non-emergency concerns. Our on-call nursing staff can help you manage issues such as skin rashes and shortness of breath.
    • Emotional support. The IMP offers monthly out-patient groups and annual patient forums, connecting survivors with one another and keeping you abreast of new discoveries and treatments.
    • Help finding wigs, hats, and other items. Friends' Place boutique helps you cope with hair loss and other treatment side effects.
    • Recovery of strength and stamina. Our on-call nurses will help set up appropriate, convenient post-treatment occupational or physical therapy, as well as integrative therapies to ease stress and fatigue.
    • Home care services. We can help you set up your home with oxygen, skilled nursing, or, if appropriate, hospice care.

    Mesothelioma Support Services and Follow-Up Care

    The ribbon cutting of Thornton and Naumes Mesothelioma House and The Patrick Thompson Suites opened the doors to patients and families.

    A diagnosis of mesothelioma can be a frightening, lonely and unexpected experience; often coming as a shock to an otherwise healthy person. A cancer diagnosis affects not only patients but also their families, loved ones and friends. Its impact is not only physical, but also emotional, spiritual and financial.

    Our dedicated Mesothelioma Support Team of social workers, chaplains, and patient liaisons supports patients and families through this process. We provide counseling, emotional and spiritual support, and assist you with housing and travel needs. We are here to help you navigate through all aspects of your care.

    Thornton and Naumes House, located across the street from the main entrance of Brigham and Women's Hospital, provides housing for mesothelioma patients and their family members.

    Explore additional programs and services for our patients and their families at Dana-Farber Cancer Institute and at Brigham and Women's Hospital.

    For a full list of our support services, as well as contact information, refer to the Dana-Farber/Brigham and Women's Cancer Center Support and Resources brochure

    Follow-up and Survivorship Care

    Follow-up services are provided through Dana-Farber Cancer Institute's Adult Survivorship Program, a member of the LIVESTRONG Survivorship Center of Excellence Network. The Adult Survivorship Program provides clinical care and services for adult-onset cancer survivors, including research that focuses on finding solutions to key problems adult survivors may face after cancer treatment.

    Our physicians, nurses, researchers, and psychologists are experts in survivorship, and will work with you and your primary care physician to create a plan for living well beyond cancer.