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Mesothelioma Chemotherapy

Literally meaning “chemical therapy,” the term ‘chemotherapy” refers to the treatment of any disease with some sort of drug or “chemical”. However, it is better known specifically as a way to treat cancer. It is often recommended for the treatment of pleural mesothelioma, either by itself, before or after surgery, or along with radiation therapy.

Simply put, chemotherapy works to stop the multiplication of cancer cells by killing them. Cancer cells, unlike healthy cells, grow out of control and not in a logical order. The chemotherapy drugs are all designed to stop this rampant growth.

For pleural mesothelioma patients, some chemotherapy drugs work better than others though there are more than 100 such drugs currently on the market. Chemotherapy generally does not offer a cure for mesothelioma patients, though scientists continue to invent new drugs that are indeed increasing the life span of those with pleural mesothelioma.

The mention of the word “chemotherapy,” however, elicits fear in most cancer patients as the treatment can sometimes be far worse than the disease. Those who are candidates for palliative chemotherapy will need to consider these implications carefully and make a decision as to whether to go ahead with treatment.

Process of Chemotherapy

Chemotherapy may be suggested as the primary treatment for some pleural mesothelioma patients, especially those that are not candidates for surgery. For those who are able to undergo surgery, it may be used beforehand to shrink tumors as much as possible or afterward to kills any remaining cancer cells. The stage of the disease and the patient’s overall health will help determine how chemotherapy is used.

Chemotherapy medicine may be delivered intravenously (through a vein) or in pill form. Your doctor will determine which is right for you. Administering chemotherapy in these forms represents “systemic” chemotherapy, which means the medicine travels throughout the body in search of cancer cells that it can destroy. The biggest concern with systemic chemotherapy is that it also kills healthy cells, resulting in the severe compromise of the immune system and other side effects.

To reduce the toxic effects of chemotherapy and to better target specific tumors, doctors have developed new ways to deliver chemotherapy medicines. Pleural mesothelioma patients, for example, may be candidates for intrapleural chemotherapy, which injects the chemotherapeutic drug directly into the pleura at the site of the tumor. Such targeted therapy spares healthy cells.

Chemotherapy and Pleural Mesothelioma

Chemotherapy medicines are often administered in pairs. Currently, the most widely used chemotherapy drug for the treatment of pleural mesothelioma is pemetrexed (Alimta®), the only FDA-approved drug specifically designed for the treatment of pleural mesothelioma. It is generally used in combination with cisplatin, a platinum chemotherapeutic agent.

Experts note that folic acid and vitamin B12 must be given when this combination is used as pemetrexed interferes with the normal metabolism of these vital nutrients. Other chemotherapy drugs most commonly used in the treatment of pleural mesothelioma include:

• Gemcitabine
• Vinorelbine
• Mitomycin
• Raltitrexed
• Onconase

Your doctor will determine which are most appropriate for you. If you do not tolerate a particular drug, a switch can usually be made. Effectiveness of any of these drugs will depend on a variety of factors including the stage of the cancer and your overall health. New chemotherapy drugs are constantly being developed and many are showing promise in the fight against pleural mesothelioma.

Side Effects of Chemotherapy for Pleural Mesothelioma

As previously mentioned, the side effects of chemotherapy can be numerous though these have been lessened with newer drugs. Nevertheless, it’s a difficult therapy to tolerate and patients need to be closely monitored by their doctor in order to avoid any life-threatening consequences. Most side effects of chemotherapy will cease when the therapy is complete, but others may take longer to disappear or may be permanent. Many can be addressed with medications. Common side effects include:

• Nausea
• Vomiting
• Low white blood cell count (leaving the patient prone to infection)
• Loss of appetite
• Constipation
• Diarrhea
• Extreme fatigue
• Fever and chills
• Hair loss
• Low platelet count and clotting concerns
• Generalized achy feeling
• Tingling hands and feet
• Rash
• Depression or anxiety

All side effects should be reported to your doctor, especially the development of a high fever, signs of infection, or the presence of blood in the urine. Decreased ability to eat because of side effects should also be noted as it is important for chemotherapy patients to maintain as healthy a diet as possible.

Sources:

1. http://www.mayoclinic.com/health/mesothelioma/DS00779/DSECTION=treatments-and-drugs
2. http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Chemotherapy_29.asp?sitearea=
3. Pass, I., Vogelzang, N., Carbone, M. Malignant Mesothelioma: Advances in Pathogenesis, Diagnosis, and Transitional Therapies. Springer: New York. 2005.