Mesothelioma Treatment There are three main types of treatment for mesothelioma - radiation and chemotherapy, surgery.  Which treament is reccomended will depend on the location of the cancer, which stage it is in, and the patient's age and general health. Radiation treatment or radiation therapy uses high energy rays that are targeted at the cancerous cells and the surrounding area.  Doctors will try to limit the patient's exposure to the radiation to minimize the side effects of damaging healthy tissue.   Chemotherapy is the treatment with anticancer drugs that kill, interfere with the growth or stop the spread of the cancer cells.  Extremly high doses may be needed depending on how advanced the disease is.    Surgery is a radical but freuqent treatment for mesothelioma. If the disease has not spread much, doctors may remove the affected lung, part of the abdominal lining and surrounding tissue.  There are many clinical trials being conducted to explore new treatments for mesothelioma.  Drugs like Avastin and Eributx are being tested and have shown some positive signs to improve the treament available to mesothelioma patients. For advanced information on mesothelioma treatments please refer to these completed research papers. Advances in the Treatment of Malignant Pleural Mesothelioma D. Sterman, L. Kaiser, and S. Albelda, University of Pennsylvania Medical Center Malignant pleural mesothelioma is commonly fatal and for which there are no widely accepted curative approaches. Mesothelioma is unresponsive to most chemotherapy and radiotherapy regimens, and it typically recurs even after the most aggressive attempts at surgical resection. Multimodality approaches have been of some benefit in prolonging survival of very highly selected subgroups of patients, but they have had a relatively small impact on the majority of the patients diagnosed with this disease. This review discusses the roles of chemotherapy, radiotherapy, surgery, and combined modality approaches in the treatment of pleural mesothelioma, as well as experimental techniques, such as photodynamic therapy, immunotherapy, and gene therapy. Cisplatin and Gemcitabine Treatment for Malignant Mesothelioma M. J. Byrne, J. A. Davidson, A. W. Musk, J. Dewar, G. van Hazel, M. Buck, N. H. de Klerk, B. W.S. Robinson, Sir Charles Gairdner Hospital, Western Australia. This study performed a phase II study of combined cisplatin 100 mg/m2, given intravenously on day 1, and gemcitabine 1,000 mg/m2, given intravenously on days 1, 8, and 15 of a 28-day cycle for six cycles among patients with advanced measurable pleural mesothelioma. Combined cisplatin and gemcitabine is an active combination in malignant mesothelioma and produces symptomatic benefit in responding patients. Induction of Apoptosis in Mesothelioma Cells by Antisurvivin Oligonucleotides Chunyao Xia, Zhidong Xu, Xiaocheng Yuan, Kazutsugu Uematsu, Liang You, Kai Li, Li Li, Frank McCormick and David M. Jablons, University of California, San Francisco, California In this study, it was investigated the expression of survivin, a member of the inhibitors of apoptosis protein gene family, in mesothelioma and an antisense oligonucleotide-based gene therapy for mesothelioma using survivin as a target. Initially, it was documented the expression of survivin in human mesothelioma cell lines and fresh tissues using reverse transcription-PCR and Western blot analysis. Our results showed that survivin was overexpressed in 7 of 8 (87.5%) mesothelioma cell lines assayed and in all (12 of 12; 100%) freshly resected mesothelioma tissues analyzed. The results show, for the first time, that survivin, an inhibitors of apoptosis protein family gene member, is highly overexpressed in malignant pleural mesothelioma. Down-regulation of survivin by a targeted antisense oligonucleotide appears to be an effective gene therapy approach to the treatment of mesothelioma. Contemporary Management of Malignant Pleural Mesothelioma E. Butchart, University Hospital of Wales, Cardiff, United Kingdom There is an urgency to achieve a consensus in the management of this tumor, which is biologically distinct from most other tumors. For patients with stage I tumors of epithelial type and good performance status, pleuropneumonectomy combined with chemotherapy and radiotherapy provides the best chance of prolonged survival, but further investigation is required to determine the optimum combination of adjuvant therapy. Debulking pleurectomy/decortication combined with adjuvant therapy is a worthwhile alternative for patients with more advanced disease, impaired performance status or tumors of less favorable histology (sarcomatous or biphasic). On currently available evidence, neither radiotherapy nor chemotherapy offer worthwhile prolonged disease control when used in isolation, although both have an important role as part of multimodality therapy. Research into immunotherapy and gene therapy suggests that these newer approaches may have a place if tumor volume is small. Consensus in mesothelioma management currently remains elusive but it seems clear that the way forward will involve striving for much earlier diagnosis, the use of multimodality therapy and collaboration between centers with special expertise in mesothelioma treatment to organize multicenter trials. Survival after conservative management of pleural malignant mesothelioma N Merritt, C. Blewett, J. Miller, W. Bennett, J. Young, J. Urschel, McMaster University, Hamilton, Ontario, Canada There were 101 patients. Mean age was 65. Symptoms of disease were present for a median time of 5 months before the diagnosis was established. The most common presenting symptoms were dyspnea, chest pain, and weight loss. Sixty-eight patients had a history of asbestos exposure. Mesothelioma subtypes included epithelial, sarcomatous, mixed, desmoplastic and unspecified . All 101 patients were treated with palliative intent. Talc pleurodesis was performed in 70 patients. At the time of analysis, 90 patients had died and 11 remained alive. Median survival was 213 days. Survival for the three major histological subtypes was significantly different. Histological subtype was the only significant independent prognostic factor. Patients with epithelial mesothelioma survive longer than those with other histological subtypes. Conservatively managed patients with pleural malignant mesothelioma have a median survival of approximately 7 months. These data from conservatively treated patients can serve as baseline information for future studies of experimental treatments.