The vast majority of mesothelioma patients undergo chemotherapy either as a standalone treatment or as part of a multimodal approach. Certain chemotherapy drug combinations have shown promising survival results in patients of all stages of mesothelioma, and medical oncologists continue to research the best chemotherapy approaches for treating mesothelioma.
Mesothelioma Chemotherapy Overview
Chemotherapy is a critical component of mesothelioma treatment. It’s a non-invasive therapy that can help delay and slow the progress of mesothelioma.
If your specialist has suggested chemotherapy for mesothelioma, here is what you need to know about this standard treatment option:
- Chemotherapy is a class of potent anti-cancer drugs designed to kill abnormal cells like mesothelioma cells
- There are several different kinds of chemotherapy drugs for mesothelioma, including cisplatin and pemetrexed
- Chemotherapy is administered intravenously, in pill form, or directly into the abdominal or chest cavities
- Patients undergo multiple weeks of daily chemotherapy in order for it to build up in their bloodstreams
- Chemotherapy can have major side effects, which all patients should be prepared for
- Not all patients respond well to chemotherapy but many do and have had incredible results
- Chemotherapy drugs and drug combinations are currently being tested in clinical trials by specialized medical oncologists
Mesothelioma Chemotherapy Goals
Mesothelioma patients must learn about all available treatment options after their diagnosis. By understanding what treatments doctors recommend and how they each work, patients can feel more empowered to take their health decisions into their own hands.
Because chemotherapy is a standard cancer treatment offered to patients with mesothelioma, everyone affected by this disease should know how it works and why it can help. Chemotherapy may be offered to you as a treatment option at any stage, though how and why its used will differ based on how advanced your condition is when doctors develop your treatment plan.
Doctors use chemotherapy for mesothelioma for the following treatment objectives:
- Shrink tumors and eliminate the various types of mesothelioma cells prior to surgery to help improve surgical success
- Kill off remaining cancer cells left over after curative surgery
- Prevent recurrence (when the mesothelioma comes back) by administering chemotherapy directly into the body as opposed to via the bloodstream
- Alleviate painful symptoms associated with mesothelioma by reducing metastasis
Depending on the treatment goals, doctors specializing in mesothelioma may prescribe certain types of chemotherapy drugs over others. They may also prescribe a combination of drugs they feel will best accomplish the set treatment objective. Doctors always monitor patients undergoing chemotherapy to determine the length of time necessary to achieve the treatment goal.
Types of Mesothelioma Chemotherapy
Though there are different types of chemotherapy and different ways to administer the drugs, all chemotherapy operates on the same principle. Chemotherapy drugs are highly potent and highly concentrated anti-cancer medications.
Chemotherapy drugs are given in 3 possible ways:
- Injected into the bloodstream intravenously
- Taken orally in pill form
- Directly into the chest or abdomen
These drugs circulate through the bodies blood system and kill mesothelioma cells in their path.
When mesothelioma cells die, they cannot grow and divide, which slows down cancer growth, improving your prognosis. In order for chemotherapy to be most effective, it has to be administered daily for several weeks. By undergoing chemotherapy over an extended period, it allows for enough medication to build up in the bloodstream and increase its effectiveness.
Chemotherapy Drugs and Drug Combinations
Medical oncologists (chemotherapy doctors) continue to research and develop the most effective drugs, medications, and drug combinations for mesotheliomas. Studies have shown consistent results in certain chemo drug combinations that have now become somewhat standard in treating mesothelioma. However, doctors always develop treatment plans on an individual level, including tailoring chemotherapy drug plans to each patient.
Here are some of the possible chemotherapy drugs and drug combinations you may be prescribed for mesothelioma:
- Cisplatin and Alimta: As the current standard for mesothelioma chemotherapy, cisplatin and Alimta (pemetrexed)—both FDA approved drugs—have shown significant results in helping increase the prognosis for mesothelioma survival rates. Known as a “first-line chemotherapy” solution, the “cocktail” of Alimta and cisplatin are the first chemotherapy drugs patients receive until they stop responding to them. The combination has been researched over many years and was first developed in clinical trials.
- Gemcitabine: A chemotherapy drug originally developed for other diseases like breast and lung cancer, gemcitabine has been studied for its effectiveness in helping improve life expectancy in late-stage mesothelioma patients. When the first-line chemotherapy solution of Alimta and cisplatin stops working, gemcitabine can be prescribed as a second-line treatment.
There are several chemotherapy drugs that can be prescribed to mesothelioma patients. Learn more about Mesothelioma Chemotherapy Medications.
What Is Direct Chemotherapy?
Instead of taking chemotherapy orally or having it injected, doctors can use a different approach to administering chemotherapy specifically for operable patients. Direct chemotherapy involves directly apply chemotherapy drugs in solution form to the abdominal or thoracic cavities of surgery patients.
Doctors apply chemotherapy using a catheter inserted through a small cut in the chest or abdomen. When given to the chest, it’s called intrapleural chemotherapy. When given to the abdomen, it’s called intraperitoneal chemotherapy.
Though the bloodstream still absorbs the drugs, the most potent levels of drugs go directly to the mesothelioma cells themselves.
Can Direct Chemotherapy Benefit Peritoneal Mesothelioma Patients?
Another standard direct chemotherapy approach is called hyperthermic chemotherapy, which involves heating the chemotherapy drugs before directly administering them. The idea behind heated chemotherapy is that it improves the drug’s efficiency in circulating throughout the chest or abdomen. It’s much more common for heated chemotherapy to be administered intraperitoneally for peritoneal mesothelioma patients undergoing cytoreduction surgery—a treatment approach called cytoreduction with HIPEC (hyperthermic intraperitoneal chemotherapy).
Side Effects of Chemotherapy
Chemotherapy is well-known for its noticeable and difficult side effects. All chemotherapy drugs are different and affect certain patients more than others. Some drug types produce certain types of side effects while other produce minimal ones. It’s important for patients to know that chemotherapy side effects are not permanent and they do go away when therapy is finished.
Nevertheless, some patients do struggle with side effects to the point of needing to stop or change drugs. If this happens to you, know that you are not alone and that your team of medical care professionals will always put your comfort at the forefront of all treatment plans.
If you’re about to undergo chemotherapy or your doctor has recommended it, then here are some of the common side effects to expect:
- Hair Loss: An infamous chemotherapy side effects, hair loss is due to the chemotherapy drugs targeting rapidly dividing cells. Healthy hair cells grow at abnormal rates compared to other cells that form tissues. Because of how quickly hair cells grow, chemotherapy drugs attack them, as they cannot distinguish between these cells and cancer cells.
- Fatigue: Chemotherapy drugs are highly potent medications that can put the body through a lot. Medications administered over the course of several weeks can cause severe fatigue and energy loss. Undergoing chemotherapy daily for multiple weeks can really take it out of patients, and dealing with other side effects can also be draining.
- Nausea: Being potent cytotoxic drugs, chemotherapy medications can often cause nausea as the body adjusts to such powerful ingredients circulating through the body. Levels of nausea may range for certain patients from slight discomfort to full on vomiting. With nausea and vomiting often comes loss of appetite and weight loss as additional chemotherapy side effects.
- Mouth Sores: Chemotherapy drugs can affect the mouth, including the gums and teeth. One of the common chemotherapy side effects is developing mouth sores, which can be uncomfortable or even painful. Many doctors consult with their patients ahead of time about mouth sores and recommend a dentist’s visit before starting chemotherapy.
- Lowered Immune System: All patients undergoing chemotherapy should be advised of the effect that such potent drugs have on the immune system. Chemotherapy drugs by nature affect the immune system because they trigger a decrease in white blood cells. A weakened immune system leaves patients open to the risk of infection. Doctors are well prepared for this side effect, and monitor their patients to prevent illness and react to any infections that may arise.
A common practice during chemotherapy is for doctors to prescribe folic acid and B12 supplements. Supplementing with these two vitamins to take in conjunction with chemotherapy can help curb common side effects. Be sure to discuss any concerns you have about chemotherapy with your medical team. All patients are encouraged to vocalize their thoughts on chemotherapy before treatment gets started.
Learn About the Top Mesothelioma Medical Oncologists
If your doctor has diagnosed you with mesothelioma and recommended starting you on a chemotherapy drug plan, be sure to consult with a specialist before beginning treatment. Mesothelioma specialists are medical oncologists who have dedicated their careers to researching the best possible chemotherapy drug combinations for each specific type of mesothelioma.
There are a few top medical oncologists in the country who specialize in mesothelioma treatment. Two of these specialists include:
- Dr. Anne Tsao — MD Anderson Medical Center, Houston TX
- Dr. Heddy Lee Kindler — University of Chicago Medicine, Chicago IL
For more information on medical oncologists and seeing a specialist for a chemotherapy consultation, contact The Mesothelioma Justice Network today. Our Justice Support Team can answer any questions you have about chemotherapy for mesothelioma, its side effects and how it works with your treatment plan.
Don’t delay in getting the chemotherapy treatment you need to extend your life.