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What Causes Recurrent Mesothelioma?

Posted on Thu, 2 Jun 2016

Question: Hello...my husband has a recurrence of mesothelioma. He has undergone chemotherapy, but that had to be discontinued because of severe side effects culminating in acute kidney failure. He is now participating in a clinical trial for Keytruda, he had the first treatment a week ago. Ever since the recurrence of the mesothelioma nausea has been a relentless problem, and one after another medications have been tried. He seemed to get relief from Motillium, 3 times a day, since February, but it doesn't seem to be helping any more, and he vomits or dry retches at random times during most days. He has now been found to have Atrial Flutter, and is booked to have a TOE and Zap procedure tomorrow. Whether this is contributing to the nausea or not we don't know. Do you have any suggestions for nausea control. We do all the basic recommended things like eating a little between meals, not allowing an empty stomach, keeping constipation under controletc.

Answered by Dr. Prashant Sharma (3 hours later)

Brief Answer:
All side effects have to be reported to observer

Detailed Answer:
hi madam.
I can understand your problem.
Some times nausea is very troublesome, and because of it our food intake decreases and hence leading to weight loss and weakness.
But I should tell you that there are drugs like ondensetron or aprepitant which may be of benefit to him. You can ask your treating doctor about them and get them prescribed.
As your husband is under a trial, all the problems are to be reported to the observer and you should follow his advice.
Let me inform you that recurrent mesothelioma has poor outcomes and a lot needs to be known about its character and treatment options.
I pray for your husband's good health.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prashant Sharma (21 hours later)

I don't know if my last question got through.......my husband had the TOE and heart zap procedure today, and got on well. However, the doctor noticed an area at the base of his wound from the extra pleural pneumonectomy operation, 18 months ago, which is very red and inflamed looking. It hasn't ever looked like this before. She asked if we had changed shower gel, which we may have, but it looks worse than that. It is very red, and hot, looks tight, and there are lumps around the scar. The area beneath the scar also feels hot, but isn't red. It is not painful, but the whole area has always been numb since the operation. He doesn't have a temperature. The latest CT scan, only a week ago, wasn't much different to the one a month before, which showed a growth about 23mm X 28mm. I am scared that this is a fast regrowth of the mesothelioma. Is this possible, or likely, or is it probably just a skin irritation?

Answered by Dr. Prashant Sharma (3 hours later)

Brief Answer:
Examination by an expert is needed.

Detailed Answer:
hi madam. thanks for your question.
it's very difficult to comment on your question without examination of patient.
I would like to know, since when the redness is there, a photograph of the local site will help me.
the numbness is due to the nerve injury occurred in surgery, this is a usual phenomena.
as you described the local situation, redness with lumps around, this indicates towards recurrence.
a guided biopsy from the mass seen in CT scan will help in confirmation.
and as it is a localized tumor we may think of radiotherapy, or repeat surgery.
these are treatment related sensitive issues, can't be commented upon without examination.
so please consult your treating doctor and follow her/ his advice.
feel free to ask more.

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Above answer was peer-reviewed by : Dr. Yogesh D