If mesothelioma is not operable, what is the recommended treatment?

If mesothelioma is not operable, what is the recommended treatment?

• A. Definitive chemotherapy
• B. Radiation therapy alone
• C. Antibiotics
• D. Observation

Answer: (A)

When mesothelioma cannot be removed surgically, systemic chemotherapy is the treatment to pursue. The disease is typically diffuse along the pleura, so removing it completely isn’t feasible and localized therapy won’t control the spread. Systemic chemotherapy—most commonly pemetrexed with a platinum agent (cisplatin or carboplatin)—targets cancer cells throughout the pleural space and any micrometastases, providing symptom relief and a survival benefit compared with doing nothing or relying on local therapies alone. Radiation therapy alone isn’t adequate here because it’s generally too focal to control the widespread disease. Antibiotics have no role in treating cancer, and observation would allow progression and worsening symptoms.

When mesothelioma cannot be removed surgically, systemic chemotherapy is the treatment to pursue. The disease is typically diffuse along the pleura, so removing it completely isn’t feasible and localized therapy won’t control the spread. Systemic chemotherapy—most commonly pemetrexed with a platinum agent (cisplatin or carboplatin)—targets cancer cells throughout the pleural space and any micrometastases, providing symptom relief and a survival benefit compared with doing nothing or relying on local therapies alone. Radiation therapy alone isn’t adequate here because it’s generally too focal to control the widespread disease. Antibiotics have no role in treating cancer, and observation would allow progression and worsening symptoms.