Medical management of mesothelioma

Abstract

Mesothelioma is a malignant tumour of pleura and other serosal tissues. It arises many years after asbestos exposure. There is currently no highly effective therapy and the median survival is approximately 10-12 months from diagnosis. Most patients cannot be treated surgically due to the advanced stage of the disease at diagnosis or are unfit for radical surgery. New antifolate drugs (pemetrexed or raltitrexed) in combination with platinum are associated with longer median survival than platinum alone, an increase which averages about three months. Radiation therapy is limited by its toxicity to the underlying lung, but newer field and dose planning methods are under investigation. Mesothelioma presents major challenges for the palliative management of dyspnoea, pain, and cancer cachexia syndrome