Recurrent Malignant Mesothelioma
Recurrent malignant mesothelioma occurs when the cancer returns after treatment and a period of remission, presenting new challenges for patients who must navigate additional treatment options and adjust their approach to living with this aggressive disease.
Table of contents
- What Is Recurrent Mesothelioma?
- Treatment Options for Recurrent Disease
- Understanding Your Prognosis
- Improving Quality of Life
- Support Resources and Self-Care
What Is Recurrent Mesothelioma?
Recurrent malignant mesothelioma means the cancer has returned after treatment and a period when symptoms decreased or disappeared.[1] Mesothelioma is a rare and aggressive cancer that forms in the thin tissue lining organs, most commonly in the tissue around the lungs called the pleura.[1]
Recurrence is common with mesothelioma because of the cancer’s aggressive nature.[20] The cancer can return in the same location where it originally developed, or it can spread to other parts of the body.[9] After surgical removal, the pattern of recurrence depends on the type of surgery performed. Patients who had less extensive surgery may experience recurrence in the chest area, while those who had more aggressive surgery may develop cancer in distant sites.[14]
Remission refers to a period when cancer tumors have decreased in size by at least half or symptoms have improved for at least one month.[20] However, even after achieving remission, the cancer may return, requiring renewed attention to treatment strategies.
Treatment Options for Recurrent Disease
Treatment for recurrent mesothelioma depends on several factors including where the cancer has returned, how much it has spread, and the patient’s overall health.[1] There is no single established standard treatment for patients whose disease has progressed after initial therapy with chemotherapy drugs like cisplatin and pemetrexed.[14]
Several treatment approaches may be considered for recurrent mesothelioma:
- Chemotherapy involves using special medicines to shrink or kill cancer cells. The drugs can be pills or medicines given through your veins.[3]
- Surgery removes cancer tissue through an operation where doctors cut out the tumor.[3]
- Radiation therapy uses high-energy rays similar to x-rays to kill cancer cells.[3]
- Immunotherapy uses special medicines that help your body’s immune system fight the cancer.[3]
- Targeted therapy uses drugs to block the growth and spread of cancer cells, available as pills or intravenous medicines.[3]
For some patients with recurrent disease, doctors may consider repeating treatment with pemetrexed, a chemotherapy drug used in first-line treatment. Studies suggest this approach, called rechallenge, may help selected patients.[14] Another option is vinorelbine, a chemotherapy drug that has shown modest effectiveness with tolerable side effects in clinical trials, though response rates vary.[14]
Clinical trials offer access to new treatment options that are being studied. These trials test new drugs and treatment approaches that may not be available otherwise.[3] Patients with recurrent disease may want to discuss clinical trial options with their medical team.
Understanding Your Prognosis
Several factors can affect how well treatment works and how long patients may live after a mesothelioma diagnosis. These factors include the stage of the cancer, the patient’s age, how well they can perform daily activities, and the type of cells in the tumor.[13]
Doctors use prognostic scoring systems to help predict outcomes. These systems consider multiple factors together. For example, patients with better performance status, younger age, and certain blood test results tend to have better outcomes.[13] However, every person’s situation is unique, and survival can vary widely from these general predictions.
Getting an early diagnosis is one of the most important factors for patients who survive longer with mesothelioma. Catching the cancer early allows patients to benefit from more aggressive and effective treatments.[22] If you have been exposed to asbestos in the past, speak with your doctor about regular cancer screenings and watch carefully for symptoms.[22]
Improving Quality of Life
Living with recurrent mesothelioma brings physical and emotional challenges, but there are steps you can take to improve your quality of life. Research shows that patients who maintain a positive quality of life often have better health outcomes.[24]
Palliative care focuses on providing relief from symptoms and improving comfort. This type of care helps manage pain, shortness of breath, and other symptoms caused by the cancer or its treatment.[3] Palliative care teams work alongside your cancer treatment team and can be helpful at any stage of the disease.[24]
Managing symptoms effectively is crucial for feeling better. Common symptoms of mesothelioma include chest pain, coughing, shortness of breath, and tiredness.[3] Your healthcare team can help address these symptoms through medications and other supportive measures.
Nutrition plays an important role in maintaining strength during cancer treatment. While specific dietary needs vary from person to person, focusing on good nutrition can help you feel better and maintain your energy.[24]
Starting treatment as soon as possible after recurrence is important. Early treatment helps slow tumor growth, prevents tumors from spreading, and in some cases may eliminate cancer cells.[22] Patients should work with their medical team to explore all available treatment options for which they are good candidates.
Support Resources and Self-Care
People with recurrent mesothelioma can access several types of support to help manage their condition and improve their quality of life. You do not have to face this disease alone.[19]
Support groups create a sense of community by connecting you with others experiencing similar challenges. Research has found that professionally led support groups can effectively reduce mood disturbances, distress, and pain in people with advanced cancer.[19] Many cancer centers offer support groups, and there are also online options available.
Finding the right medical team is essential. Mesothelioma is a rare cancer, so not many physicians specialize in it. If you have recurrent disease, look for specialists who have experience treating mesothelioma.[22] A mesothelioma treatment team should include oncologists, surgeons, radiologists, and other support staff. For the best outcome, find a cancer treatment center with mesothelioma specialists on staff.[22]
Identify your personal support team of family members or close friends who can help you. They can accompany you to doctor’s appointments, help take notes, ask questions you may have forgotten, and provide comforting presence.[22] Your support team can also help advocate for you to ensure your treatment plan makes sense for you as an individual.
Counseling and therapy services can help you manage anxiety, stress, and other emotional challenges that come with a cancer diagnosis. Individual therapy helps patients cope with their feelings, while family counseling supports caregivers and loved ones.[19]
Many patients also benefit from second opinions, especially when facing recurrent disease. Getting another doctor’s perspective can help confirm your diagnosis and treatment plan or provide additional options to consider.[18] It is within your rights as a patient to seek a second opinion and to advocate for yourself by asking questions.
Financial assistance programs may be available to help cover treatment costs. Social workers at cancer centers can help coordinate resources for transportation, in-home care, and other practical needs.[19] Some organizations also provide information about insurance programs and other sources of financial support.
Taking care of your emotional and mental health is just as important as treating the physical disease. Many patients find that staying informed, maintaining connections with others, and working closely with their healthcare team helps them feel more in control during a difficult time.
