Tratamiento del mesotelioma maligno
At the Montefiore Einstein Comprehensive Cancer Center, you can access compassionate care for malignant mesothelioma. This rare type of cancer starts in the mesothelium, the thin tissue covering the outer surface of the lungs, stomach, chest and heart.
We believe each person is unique, and no two cancers are alike. For each person we serve, our team develops an individualized treatment plan designed to achieve the best possible outcome. Depending on the type of mesothelioma you have and its stage and location, we combine therapies in radiation, medical oncology, surgery and targeted therapy.
Our cancer center was one of first NCI-designated in the world, and—for more than 50 years—we’ve been a leader in the research, diagnosis and treatment of over 200 types of cancer. We treat patients throughout the region and from across the country.
Our researchers are passionate about uncovering the latest diagnostic approaches and treatments that can help alleviate symptoms and improve outcomes. As an academic health system, you’ll have access to specialists in medical, surgical and radiation oncology. To provide you with the most advanced care, these experts will collaborate with critical care and nuclear medicine specialists, nutritionists, pathologists, and psychosocial oncology and thoracic cancer care navigators. You’ll find the care you need in our state-of-the-art facilities.
When you trust us with your care, you can expect compassionate, personalized care that meets the highest standards for quality and safety. Montefiore Einstein Comprehensive Cancer Center has one of the most comprehensive cancer programs in the nation. We’re committed to whole person care and offer patients a full choice of support services and palliative care programs to meet the complex medical, emotional and spiritual needs of our patients and their families.
When you need malignant mesothelioma care, turn to our providers who are passionate about ending cancer and addressing your whole health needs.
El Montefiore Einstein Comprehensive Cancer Center, designado como centro integral del cáncer por el National Cancer Institute (NCI), apoya la misión y las normas del NCI. La siguiente información sobre los tipos de cáncer, prevención y tratamientos ha sido facilitada por el NCI.
Malignant Mesothelioma Treatment (PDQ®)–Patient Version
General Information About Malignant Mesothelioma
Puntos clave
- Malignant mesothelioma is a type of cancer that forms in the thin layer of tissue that covers organs in the chest or abdomen.
- Being exposed to asbestos can increase the risk of malignant mesothelioma.
- Signs and symptoms of malignant mesothelioma include shortness of breath and pain under the rib cage.
- Tests that examine the inside of the chest and abdomen are used to diagnose malignant mesothelioma.
- After malignant mesothelioma has been diagnosed, tests are done to find out if cancer cells have spread to other parts of the body.
- Algunas personas deciden buscar una segunda opinión.
- Hay ciertos factores que afectan al pronóstico (probabilidad de recuperación) y a las opciones de tratamiento.
Malignant mesothelioma is a type of cancer that forms in the thin layer of tissue that covers organs in the chest or abdomen.
Malignant mesothelioma may be found in one or more of the following:
- the pleura, a thin layer of tissue that lines the chest cavity and covers the lungs
- the peritoneum, a thin layer of tissue that lines the abdomen and covers most of the organs in the abdomen
- the pericardium, a thin layer of tissue that surrounds the heart
Malignant mesothelioma may also form in the heart or testicles, but this is rare.
Malignant mesothelioma forms in the tissue that lines the chest or abdomen, including the pleura (the tissue that lines the chest cavity and covers the lungs) and the peritoneum (the tissue that lines the abdomen and covers most of the organs in the abdomen). Malignant mesothelioma may also form in the pericardium (the tissue that surrounds the heart) or the testicles, but this is rare.
Being exposed to asbestos can increase the risk of malignant mesothelioma.
Malignant mesothelioma is caused by certain changes to the way the cells that line the organs function, especially how they grow and divide into new cells. Often, the exact cause of the cell change is unknown. Learn more about how cancer develops at What Is Cancer?
A risk factor is anything that increases the chance of getting a disease. Most people with malignant mesothelioma have worked or lived in places where they inhaled or swallowed asbestos, which has been used in the building and textile industries. After being exposed to asbestos, it usually takes a long time for malignant mesothelioma to form. Living with a person who works near asbestos is also a risk factor for malignant mesothelioma. Not every person with one or more of these risk factors will develop malignant mesothelioma. And it can develop in some people who don't have any known risk factors.
Talk to your doctor if you think you may be at risk.
Signs and symptoms of malignant mesothelioma include shortness of breath and pain under the rib cage.
Sometimes the cancer causes fluid to collect in the chest or in the abdomen. Signs and symptoms may be caused by the fluid, malignant mesothelioma, or other conditions. Check with your doctor if you have any of the following:
- dificultad para respirar
- Tos
- pain under the rib cage
- dolor o hinchazón en el abdomen
- Bultos en el abdomen
- Constipación
- problems with blood clots (clots form when they shouldn't)
- Pérdida de peso sin causa aparente
- fatiga (sensación de mucho cansancio)
Tests that examine the inside of the chest and abdomen are used to diagnose malignant mesothelioma.
Sometimes it is hard to tell the difference between malignant mesothelioma in the chest and lung cancer. If you have symptoms that suggest mesothelioma, the doctor will need to find out if these are due to cancer or to another problem. The doctor will ask when the symptoms started and how often you have been having them. They will also ask about your personal and family health history and do a physical exam. Depending on these results, they may recommend other tests. If you are diagnosed with mesothelioma, the results of these tests will help you and your doctor plan treatment.
The tests and procedures used to diagnose mesothelioma may include:
- Radiografía de tórax Es un tipo de radiación que puede atravesar el cuerpo y crear imágenes de los órganos y huesos dentro del tórax.
Una radiografía de tórax se utiliza para obtener imágenes de las estructuras y órganos dentro del tórax. Los rayos X atraviesan el cuerpo del paciente y se proyectan sobre una película o una computadora.
- La tomografía computarizada (TC) utiliza una computadora conectada a un equipo de rayos X para generar una serie de imágenes detalladas del interior del cuerpo. Las imágenes se toman desde diferentes ángulos y se utilizan para crear vistas tridimensionales de tejidos y órganos. Se puede inyectar un tinte en una vena o pedir al paciente que ingiera dicho tinte para que los órganos o tejidos se visualicen con mayor claridad. Este procedimiento también se denomina tomografía computadorizada o tomografía axial computarizada. Para obtener más información, consulte Tomografía computarizada para el cáncer.
- Biopsia is the removal of cells or tissues from the pleura or peritoneum so that a patólogo can view it under a microscope to check for signs of cancer.
Procedures used to collect the cells or tissues include:
- Fine-needle (FNA) aspiration biopsy of the lung uses a thin needle to remove tissue or fluid. An procedimiento de imagen Se utiliza para localizar tejido o líquido anormal en el pulmón. Un pequeño incisión may be made in the skin where the biopsy needle is inserted into the abnormal tissue or fluid, and a sample is removed.
Biopsia por aspiración con aguja fina del pulmón. El paciente se recuesta sobre una mesa que se desliza a través de la máquina de tomografía computarizada (TC), la cual toma imágenes de rayos X del interior del cuerpo. Las imágenes de rayos X ayudan al médico a ver dónde se encuentra el tejido anómalo en el pulmón. Se inserta una aguja de biopsia a través de la pared torácica y en el área del tejido pulmonar anómalo. Se extrae un pequeño fragmento de tejido a través de la aguja y se examina con un microscopio para detectar signos de cáncer.
- Thoracoscopy is surgery to look at the organs inside the chest to check for abnormal areas. An incision (cut) is made between two ribs, and a thoracoscope (a thin, tube-like instrument with a light and a lens for viewing) is inserted into the chest.
- Thoracotomy is surgery to look inside the chest. An incision (cut) is made between two ribs to check inside the chest for signs of disease.
- Peritoneoscopy is surgery to look inside the abdomen. An incision (cut) is made in the abdominal wall, and a peritoneoscope (a thin, tube-like instrument with a light and a lens for viewing) is inserted into the abdomen to check for signs of disease.
- Open biopsy is surgery to remove abnormal tissues so a pathologist can check it under a microscope for signs of disease. An incision (cut) is made through the skin to expose and remove the tissues.
The following tests may be done on the cells and tissue samples that are taken:
- A cytologic exam is a laboratory test to view cells under a microscope to check for anything abnormal. For mesothelioma, fluid is taken from the chest or the abdomen. A pathologist checks the fluid for signs of cancer.
- Immunohistochemistry is a laboratory test that uses antibodies to check for certain antigens (markers) in a sample of a patient's tissue. The antibodies are usually linked to an enzyme or a fluorescent dye. After the antibodies bind to a specific antigen in the tissue sample, the enzyme or dye is activated, and the antigen can then be seen under a microscope. This type of test is used to help diagnose cancer and to help tell one type of cancer from another type of cancer.
- Electron microscopy is a laboratory test in which cells in a sample of tissue are viewed under a high-powered microscope to look for certain changes in the cells. An electron microscope shows tiny details better than other types of microscopes.
- Fine-needle (FNA) aspiration biopsy of the lung uses a thin needle to remove tissue or fluid. An procedimiento de imagen Se utiliza para localizar tejido o líquido anormal en el pulmón. Un pequeño incisión may be made in the skin where the biopsy needle is inserted into the abnormal tissue or fluid, and a sample is removed.
After malignant mesothelioma has been diagnosed, tests are done to find out if cancer cells have spread to other parts of the body.
The process used to find out if cancer has spread outside the pleura or peritoneum is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know whether the cancer has spread in order to plan treatment.
The following tests and procedures may be used in the staging process:
- CT scan (CAT scan) uses a computer linked to an x-ray machine to make a series of detailed pictures of areas inside the body, such as the chest and abdomen. The pictures are taken from different angles and are used to create 3-D views of tissues and organs. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. Learn more at Computed Tomography (CT) Scans and Cancer.
- PET scan (positron emission tomography scan) uses a small amount of radioactive sugar that is injected into a vein. The PET scanner rotates around the body to make detailed, computerized pictures of areas inside the body where the glucose is taken up. Because cancer cells often take up more glucose than normal cells, the pictures can be used to find cancer cells in the body.
- La resonancia magnética ( RM ) utiliza un imán, ondas de radio y una computadora para crear una serie de imágenes detalladas de áreas internas del cuerpo. Este procedimiento también se conoce como resonancia magnética nuclear (RMN).
- Endoscopic ultrasound (EUS) is a procedure in which an endoscope is inserted into the body. An endoscope is a thin, tube-like instrument with a light and a lente for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves (ecografía) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. This procedure is also called endosonography. EUS may be used to guide Biopsia por aspiración con aguja fina (biopsia por PAAF) of the lung, ganglios linfáticos, or other areas.
Biopsia aspirativa con aguja fina guiada por ultrasonido endoscópico. Se inserta un endoscopio que tiene una sonda de ultrasonido y una aguja de biopsia a través de la boca hasta el esófago. La sonda hace rebotar ondas de sonido en los tejidos del cuerpo para producir ecos que forman una ecografía (imagen de computadora) de los ganglios linfáticos cerca del esófago. La ecografía ayuda al médico a ver dónde colocar la aguja de biopsia para extraer tejido de los ganglios linfáticos. Este tejido se examina bajo un microscopio para detectar signos de cáncer.
- Laparoscopy is surgery to look at the organs inside the abdomen to check for signs of disease. Small incisions (cuts) are made in the wall of the abdomen, and a laparoscope (a thin, lighted tube) is inserted into one of the incisions. Other instruments may be inserted through the same or other incisions to perform procedures such as taking tissue samples to be checked under a microscope for signs of disease.
- Lymph node biopsy is the removal of all or part of a lymph node. A pathologist views the lymph node tissue under a microscope to check for cancer cells.
- Mediastinoscopy is surgery to look at the organs, tissues, and lymph nodes between the lungs for abnormal areas. An incision (cut) is made at the top of the breastbone, and a mediastinoscope is inserted into the chest. A mediastinoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer.
Algunas personas deciden buscar una segunda opinión.
Es posible que desee obtener una segunda opinión para confirmar su diagnóstico de cáncer y su plan de tratamiento. Si busca una segunda opinión, deberá obtener los resultados de las pruebas médicas y los informes del primer médico para compartirlos con el segundo. Este último revisará el informe patológico, las diapositivas y las exploraciones. Puede que esté de acuerdo con el primero, sugiera cambios u otro enfoque de tratamiento, o le dé más información sobre su cáncer.
Para obtener más información sobre cómo elegir un médico y obtener una segunda opinión, visite la sección «Cómo encontrar atención oncológica» . Puede comunicarse con el Servicio de Información Oncológica del NCI por chat, correo electrónico o teléfono (en inglés y español) para obtener ayuda para encontrar un médico, un hospital o una segunda opinión. Para preguntas que pueda hacer durante sus citas, visite la sección «Preguntas para hacerle a su médico sobre el cáncer» .
Hay ciertos factores que afectan al pronóstico (probabilidad de recuperación) y a las opciones de tratamiento.
El pronóstico y las opciones de tratamiento dependen de los siguientes factores:
- El estadio del cáncer
- the size of the tumor
- whether the tumor can be removed completely by surgery
- the amount of fluid in the chest or abdomen
- la edad del paciente
- the patient's activity level
- the patient's general health, including lung and heart health
- the type of mesothelioma cells and how they look under a microscope
- the number of white blood cells and how much hemoglobin is in the blood
- whether the patient is male or female
- ya sea que el cáncer haya sido diagnosticado recientemente o haya reaparecido (regresado)
Stages of Malignant Mesothelioma
Puntos clave
- La etapa del cáncer describe la extensión del cáncer en el cuerpo.
- The following stages are used for malignant mesothelioma of the lung:
- Stage I (also called stage 1) malignant mesothelioma
- Stage II (also called stage 2) malignant mesothelioma
- Stage III (also called stage 3) malignant mesothelioma
- Stage IV (also called stage 4) malignant mesothelioma
- Malignant mesothelioma can recur (come back) after it has been treated.
La etapa del cáncer describe la extensión del cáncer en el cuerpo.
Cancer stage describes the extent of cancer in the body, such as the size of the tumor, whether it has spread, and how far it has spread from where it first formed. It is important to know the stage of mesothelioma to plan the best treatment.
There are several staging systems for cancer that describe the extent of the cancer. Malignant mesothelioma staging usually uses the TNM staging system. The cancer may be described by this staging system in your pathology report. Based on the TNM results, a stage (I, II, III, or IV, also written as 1, 2, 3, or 4) is assigned to your cancer. When talking to you about your diagnosis, your doctor may describe the cancer as one of these stages.
Learn about tests to stage mesothelioma. Learn more about Cancer Staging.
The following stages are used for malignant mesothelioma of the lung:
Stage I (also called stage 1) malignant mesothelioma
Stage I is divided into stages IA and IB:
- In stage IA, cancer is found in the inside lining of the pared torácica on one side of the chest. On the same side of the chest, cancer may also be found in one or more of the following:
- In stage IB, cancer is found in the inside lining of the chest wall, and in each of the thin layers of tissue that cover the lung, the organs between the lungs, and the top of the diaphragm on one side of the chest. On the same side of the chest, cancer has also spread into one or more of the following:
- Diafragma
- lung tissue
- tissue between the ribs and the inside lining of the chest wall
- fat in the area between the lungs
- soft tissues of the chest wall
- sac around the heart
Stage II (also called stage 2) malignant mesothelioma
In stage II, cancer is found in the inside lining of the chest wall on one side of the chest. On the same side of the chest, cancer may also be found in one or more of the following:
- the thin layer of tissue that covers the lung
- the thin layer of tissue that covers the organs between the lungs
- the thin layer of tissue that covers the top of the diaphragm
Cancer has spread to lymph nodes along the center of the chest on the same side of the chest as the tumor.
o
Cancer is found in the inside lining of the chest wall, and in each of the thin layers of tissue that cover the lung, the organs between the lungs, and the top of the diaphragm on one side of the chest. On the same side of the chest, cancer has also spread into one or both of the following:
- Diafragma
- lung tissue
Cancer has spread to lymph nodes along the center of the chest on the same side of the chest as the tumor.
Stage III (also called stage 3) malignant mesothelioma
El estadio III se divide en estadios IIIA y IIIB.
- In stage IIIA, cancer is found in the inside lining of the pared torácica, and in each of the thin layers of tissue that cover the lung, the organs between the lungs, and the top of the Diafragma on one side of the chest. On the same side of the chest, cancer has also spread into one or more of the following:
- tissue between the ribs and the inside lining of the chest wall
- fat in the area between the lungs
- soft tissues of the chest wall
- sac around the heart
Cancer has spread to lymph nodes along the center of the chest on the same side of the chest as the tumor.
- In stage IIIB, cancer is found in the inside lining of the chest wall, and may also be found in the thin layers of tissue that cover the lung, the organs between the lungs, and/or the top of the diaphragm on one side of the chest. On the same side of the chest, cancer may have also spread into one or more of the following:
- Diafragma
- lung tissue
- tissue between the ribs and the inside lining of the chest wall
- fat in the area between the lungs
- soft tissues of the chest wall
- sac around the heart
Cancer has spread to lymph nodes above the collarbone on either side of the chest or cancer has spread to lymph nodes along the center of the chest on the opposite side of the chest as the tumor.
o
Cancer is found in the inside lining of the chest wall, and in each of the thin layers of tissue that cover the lung, the organs between the lungs, and the top of the diaphragm on one side of the chest. Cancer has also spread to one or more of the following:
- the chest wall and may be found in the rib
- through the diaphragm into the peritoneum
- the tissue lining the chest on the opposite side of the body as the tumor
- the organs in the area between the lungs (esophagus, trachea, thymus, blood vessels)
- the spine
- through the sac around the heart or into the heart muscle
Cancer may have spread to lymph nodes.
Stage IV (also called stage 4) malignant mesothelioma
In stage IV, cancer has spread to the tissue covering the lung or the lung on the opposite side of the chest, peritoneum, bones, liver, lymph nodes outside the chest, or to other parts of the body.
Stage IV malignant mesothelioma is also called metastatic mesothelioma. Metastatic cancer happens when cancer cells travel through the lymphatic system or blood and form tumors in other parts of the body. The metastatic tumor is the same type of cancer as the primary tumor. For example, if malignant mesothelioma spreads to the liver, the cancer cells in the liver are actually malignant mesothelioma cells. The disease is called metastatic mesothelioma, not liver cancer. Learn more in Metastatic Cancer: When Cancer Spreads.
Malignant mesothelioma can recur (come back) after it has been treated.
Recurrent malignant mesothelioma is cancer that has come back after it has been treated. If mesothelioma comes back, it may come back in the chest or in other parts of the body, such as the liver, lungs, or both. Tests will be done to help determine where the cancer has returned. The type of treatment for recurrent mesothelioma will depend on where it has come back.
Para obtener más información, consulte Cáncer recurrente: cáncer que regresa.
Descripción general de las opciones de tratamiento
Puntos clave
- There are different types of treatment for patients with malignant mesothelioma.
- Se utilizan los siguientes tipos de tratamiento:
- Cirugía
- Radioterapia
- Quimioterapia
- Inmunoterapia
- Terapia dirigida
- Se están probando nuevos tipos de tratamiento en ensayos clínicos.
- Treatment for malignant mesothelioma may cause side effects.
- Es posible que se necesiten cuidados de seguimiento.
There are different types of treatment for patients with malignant mesothelioma.
Different types of treatments are available for malignant mesothelioma. You and your cancer care team will work together to decide your treatment plan, which may include more than one type of treatment. Many factors will be considered, such as the stage of the cancer, your overall health, and your preferences. Your plan will include information about your cancer, the goals of treatment, your treatment options and the possible side effects, and the expected length of treatment.
Antes de comenzar el tratamiento, le será útil hablar con su equipo de atención médica del cáncer sobre qué esperar. Le conviene saber qué debe hacer antes de comenzar el tratamiento, cómo se sentirá mientras dure y qué tipo de ayuda necesitará. Para obtener más información, visite Preguntas para el médico sobre el tratamiento.
Se utilizan los siguientes tipos de tratamiento:
Cirugía
The following surgical treatments may be used for malignant mesothelioma in the chest:
- Wide local excision is surgery to remove the cancer and some of the healthy tissue around it. The amount of healthy tissue removed depends on how deep or how large the tumor being removed is.
- Pleurectomy and decortication is surgery to remove part of the covering of the lungs and lining of the chest and part of the outside surface of the lungs.
- Extrapleural pneumonectomy is surgery to remove one whole lung and part of the lining of the chest, the diaphragm, and the lining of the sac around the heart.
- Pleurodesis is surgery that uses chemicals or drugs to make a scar in the space between the layers of the pleura. Fluid is first drained from the space using a catheter or chest tube and the chemical or drug is put into the space. The scarring stops the build-up of fluid in the pleural cavity.
After the doctor removes all the cancer that can be seen at the time of the surgery, some people may receive chemotherapy or radiation therapy to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
Radioterapia
Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer. It may also be used as palliative care to relieve symptoms and improve quality of life.
Quimioterapia
Chemotherapy (also called chemo) uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Combination chemotherapy is the use of more than one anticancer drug.
Systemic chemotherapy is when chemotherapy is taken by mouth or injected into a vein or muscle. When given this way, the drugs enter the bloodstream and can reach cancer cells throughout the body.
Regional chemotherapy is when chemotherapy is placed directly into an organ or a body cavity, such as the chest or peritoneum. When given this way, the drugs mainly affect cancer cells in those areas. Hyperthermic intraperitoneal chemotherapy (HIPEC) is a type of regional chemotherapy used to treat malignant mesothelioma:
- HIPEC may be used to treat mesothelioma that has spread to the peritoneum (tissue that lines the abdomen and covers most of the organs in the abdomen). After the surgeon removes all the cancer that can be seen, a solution containing anticancer drugs is heated and pumped into and out of the abdomen to kill cancer cells that remain. Heating the anticancer drugs may kill more cancer cells.
La forma en que se administra la quimioterapia depende del tipo y estadio del cáncer que se esté tratando.
Para obtener más información sobre cómo funciona la quimioterapia, cómo se administra, los efectos secundarios comunes y mucho más, visite Quimioterapia para tratar el cáncer y Quimioterapia y usted: Apoyo para personas con cáncer .
Visit Drugs Approved for Malignant Mesothelioma for more information.
Inmunoterapia
La inmunoterapia ayuda al sistema inmunitario a combatir el cáncer. Su médico podría sugerirle pruebas de biomarcadores para predecir su respuesta a ciertos medicamentos de inmunoterapia. Obtenga más información sobre las pruebas de biomarcadores para el tratamiento del cáncer.
Immunotherapy drugs used to treat advanced mesothelioma include:
Other immunotherapy drugs, such as durvalumab, are being studied in malignant mesothelioma.
Obtenga más información sobre la inmunoterapia para el tratamiento del cáncer .
Terapia dirigida
Targeted therapy uses drugs or other substances to identify and attack specific cancer cells. Bevacizumab is a targeted therapy drug used to treat malignant mesothelioma.
Other targeted therapies, such as ramucirumab, are being studied in malignant mesothelioma.
Obtenga más información en Terapia dirigida para tratar el cáncer.
Se están probando nuevos tipos de tratamiento en ensayos clínicos.
Joining a clinical trial may be an option. There are different types of clinical trials for people with mesothelioma. For example, a treatment trial tests new treatments or new ways of using existing treatments. Supportive care and palliative care trials look at ways to improve quality of life, especially for those who have side effects from cancer and its treatment.
Puedes usar el buscador de ensayos clínicos para encontrar ensayos clínicos oncológicos financiados por el NCI que estén aceptando participantes. Este buscador te permite filtrar los ensayos según el tipo de cáncer, tu edad y la ubicación donde se realizan. Los ensayos clínicos financiados por otras organizaciones se pueden encontrar en el sitio web ClinicalTrials.gov .
Learn more about clinical trials at Clinical Trials Information for Patients and Caregivers.
Treatment for malignant mesothelioma may cause side effects.
Para obtener información sobre los efectos secundarios causados por el tratamiento para el cáncer, visite la página de efectos secundarios.
Es posible que se necesiten cuidados de seguimiento.
A medida que avanza el tratamiento, se le realizarán pruebas o controles de seguimiento. Es posible que se repitan algunas pruebas para diagnosticar o estadificar el cáncer con el fin de evaluar cómo está funcionando el tratamiento. Las decisiones sobre si continuar, modificar o suspender el tratamiento pueden basarse en los resultados de estas pruebas.
Algunas pruebas seguirán realizándose de manera periódica después de terminar el tratamiento. Los resultados pueden indicar si su afección ha cambiado o si el cáncer ha redicivado (regresado).
Treatment of Localized Malignant Mesothelioma (Stage I)
If stage I malignant mesothelioma is in one part of the chest lining, treatment may include surgery to remove the cancer and the tissue around it.
Treatment of stage I intracavitary mesothelioma may include:
- a surgery called extrapleural pneumonectomy
- palliative surgery with pleurectomy and decortication, which may be followed by radiation therapy, to relieve symptoms and improve quality of life
- palliative radiation therapy to relieve symptoms and improve quality of life
Obtenga más información sobre estos tratamientos en la sección Descripción general de las opciones de tratamiento .
Puede utilizar la búsqueda de ensayos clínicos y encontrar ensayos clínicos sobre cáncer patrocinados por el NCI que acepten participantes. La búsqueda le permite filtrar los ensayos según el tipo de cáncer, la edad y el lugar donde se realizan los ensayos. También encontrará información general sobre los ensayos clínicos.
Treatment of Advanced Malignant Mesothelioma (Stages II, III, and IV)
If stage II, stage III, or stage IV malignant mesothelioma is found in the chest, treatment may include:
- immunotherapy (nivolumab and ipilimumab)
- combination chemotherapy with or without targeted therapy (bevacizumab)
- combination chemotherapy and palliative care, which may be followed by maintenance chemotherapy
- palliative care, which may include draining fluid from the chest, a procedure to prevent fluid from collecting in the chest (pleurodesis), surgery, or radiation therapy, to relieve symptoms and improve quality of life
- chemotherapy placed directly into the chest or abdominal cavity to shrink the tumors and keep fluid from building up
If stage II, stage III, or stage IV malignant mesothelioma is found in the peritoneum, treatment may include:
- surgery to remove the tumor followed by hyperthermic intraperitoneal chemotherapy
- Quimioterapia
Obtenga más información sobre estos tratamientos en la sección Descripción general de las opciones de tratamiento .
Puede utilizar la búsqueda de ensayos clínicos y encontrar ensayos clínicos sobre cáncer patrocinados por el NCI que acepten participantes. La búsqueda le permite filtrar los ensayos según el tipo de cáncer, la edad y el lugar donde se realizan los ensayos. También encontrará información general sobre los ensayos clínicos.
Treatment of Recurrent Malignant Mesothelioma
When malignant mesothelioma recurs (comes back), the treatment strategy often involves options that weren’t used in the initial treatment. If you haven’t received systemic therapy before, treatment may include:
- Quimioterapia
- a combination of chemotherapy and immunotherapy (nivolumab)
- immunotherapy alone
If you have received systemic therapy, treatment might include the following, given alone or in combination:
- Quimioterapia
- Inmunoterapia
For certain people with locally recurrent cancer, surgery to remove the affected part of the chest wall may be an option.
Obtenga más información sobre estos tratamientos en la sección Descripción general de las opciones de tratamiento .
Puede utilizar la búsqueda de ensayos clínicos y encontrar ensayos clínicos sobre cáncer patrocinados por el NCI que acepten participantes. La búsqueda le permite filtrar los ensayos según el tipo de cáncer, la edad y el lugar donde se realizan los ensayos. También encontrará información general sobre los ensayos clínicos.
To Learn More About Malignant Mesothelioma
For more from the National Cancer Institute about malignant mesothelioma, see the following:
- Malignant Mesothelioma Home Page
- Drugs Approved for Malignant Mesothelioma
- Asbestos Exposure and Cancer Risk
Para obtener información general sobre el cáncer y otros recursos del National Cancer Institute, consulte los siguientes sitios web:
Sobre este resumen del PDQ
Acerca del PDQ
El Physician Data Query (PDQ) es la base de datos integral sobre el cáncer del National Cancer Institute (NCI). La base de datos del PDQ contiene resúmenes con la última información publicada sobre prevención, detección, genética, tratamiento, atención médica de apoyo y medicina complementaria y alternativa relacionada con el cáncer. La mayoría de los resúmenes se presentan en dos versiones. Las versiones para profesionales de la salud contienen información detallada escrita en lenguaje técnico. Las versiones para pacientes están escritas en un lenguaje fácil de entender y no tan técnico. Ambas versiones contienen información precisa y actualizada sobre el cáncer. La mayoría de las versiones también están disponibles en español.
El PDQ es un servicio del NCI. El NCI es parte de los Institutos Nacionales de Salud (NIH), que son el centro de investigación biomédica del Gobierno federal. Los resúmenes del PDQ se basan en una revisión independiente de la literatura médica. No son declaraciones de políticas del NCI ni de los NIH.
Propósito de este resumen
This PDQ cancer information summary has current information about the treatment of adult malignant mesothelioma. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
Revisores y actualizaciones
Los comités editoriales escriben los resúmenes de información sobre el cáncer del PDQ y los mantienen actualizados. Estos comités están formados por equipos de especialistas en el tratamiento del cáncer y otras especialidades relacionadas con esta enfermedad. Los resúmenes se revisan periódicamente y se modifican cuando hay información nueva. La fecha de actualización al pie de cada resumen indica cuándo se realizó el cambio más reciente.
La información de este resumen para pacientes procede de la versión para profesionales de la salud, la cual es revisada y actualizada por el comité editorial del PDQ sobre el tratamiento para adultos.
Información sobre ensayos clínicos
Un ensayo clínico es un estudio para responder a una pregunta científica como, por ejemplo, si un tratamiento es mejor que otro. Los ensayos se basan en estudios anteriores y en lo aprendido en el laboratorio. Cada ensayo responde a determinadas preguntas científicas que permiten encontrar nuevas y mejores formas de ayudar a los pacientes con cáncer. Durante los ensayos clínicos de tratamiento, se recopila información sobre los efectos de un nuevo tratamiento y su eficacia. Si un ensayo clínico demuestra que un nuevo tratamiento es mejor que uno que se utiliza actualmente, el nuevo tratamiento puede convertirse en “estándar”. Los pacientes pueden valorar la posibilidad de participar en un ensayo clínico. Algunos ensayos clínicos solo están abiertos a pacientes que no hayan iniciado el tratamiento.
Los ensayos clínicos se pueden encontrar en línea en el sitio web del NCI. Para obtener más información, llame al Servicio de Información sobre el Cáncer (CIS, por sus siglas en inglés), el centro de contacto del NCI, al 1-800-4-CANCER (1-800-422-6237).
Permiso de uso de este resumen
Physician Data Query (PDQ) es una marca registrada. Se autoriza el libre uso del contenido de los documentos del PDQ como texto. Sin embargo, no se podrá identificar como un resumen de información sobre cáncer del PDQ del NCI, salvo que se reproduzca en su totalidad y se actualice con regularidad. Por otra parte, se permite que los autores incluyan una oración como “en el resumen del PDQ del NCI sobre la prevención del cáncer de mama se describen, de manera concisa, los siguientes riesgos: [incluir fragmento del resumen]”.
La forma recomendada para citar este resumen del PDQ es:
PDQ® Adult Treatment Editorial Board. PDQ Malignant Mesothelioma Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/types/mesothelioma/patient/mesothelioma-treatment-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389166]
Las imágenes de este resumen se utilizan con el permiso del autor, artista y/o editorial para uso exclusivo en los resúmenes del PDQ. Si desea usar una imagen de un resumen del PDQ sin incluir el resumen completo, debe obtener autorización del propietario. El National Cancer Institute no puede otorgar dicho permiso. Para obtener más información sobre el uso de las imágenes de este resumen o de otras ilustraciones relacionadas con el cáncer, consulte Visuals Online, una colección de más de 3,000 imágenes científicas.
Descargo de responsabilidad
La información de estos resúmenes no debe utilizarse para tomar decisiones sobre reembolsos de seguros. Puede encontrar más información sobre la cobertura de seguros en Cancer.gov en el sitio Manejo de la atención del cáncer.
Contáctenos
Puede encontrar más información sobre cómo contactarnos o recibir ayuda en el sitio web Cancer.gov en la página Comuníquese con el NCI. También puede enviar sus preguntas a Cancer.gov en el apartado Escríbanos del sitio web.
Actualizado:
Source URL: https://www.cancer.gov/node/5338/syndication
Agencia de origen: National Cancer Institute (NCI)
Captured Date: 2013-09-14 09:02:47.0