Chemotherapy by Mesothelioma Type
Pleural mesothelioma is the most common form of the disease, resulting from asbestos exposure that affects the lining of the pleural cavity where the lungs rest.
Did You Know?
According to the American Cancer Society, 81% of new cases fall into this category. Other types of mesothelioma may form in the linings of the abdomen, heart, or testicles.
Standard chemotherapy treatment is similar for all types of mesothelioma.
Chemotherapy for Pleural Mesothelioma
Chemotherapy is commonly used to treat patients with pleural mesothelioma either alone or in combination with surgery and/or radiation therapy. Pleural mesothelioma chemotherapy may be palliative or curative.
Since 2004, doctors have used a combination of the drugs pemetrexed and cisplatin to treat pleural mesothelioma by slowing the progression of the disease.
Pleural mesothelioma chemotherapy takes two major forms:
- Intraoperative chemotherapy: For surgical patients who receive either an extrapleural pneumonectomy (removal of the diseased lung and surrounding tissue and tumors) or pleural decortication (P/D) (removal of the diseased lining of the lung), the more localized form of chemotherapy called HITHOC has been proven to increase the length of survival.
- Systemic chemotherapy: Research shows that this systematic chemotherapy reduces tumors in 40% of patients, therefore extending the life of the receiver. Because chemotherapy can shrink tumors, it may help patients who are struggling to breathe and have fluid buildup in their lungs.
HITHOC (Hypothermic Intrathoracic Chemotherapy) is a procedure where heated chemotherapy drugs are applied directly into the pleural cavity directly after the surgeon removes all visible cancerous tumors and tissue.
The drug kills the remaining microscopic cancer cells, and the heat allows the drug to better permeate the tissue and magnifies the kill. Cisplatin is most often used in HITHOC, but also doxorubicin and mitomycin C can be used.
Chemotherapy for Peritoneal Mesothelioma
Specialists also use the combination of pemetrexed and cisplatin to treat patients with peritoneal mesothelioma.
As for pleural mesothelioma, peritoneal mesothelioma chemotherapy comes in two major forms.
Types of peritoneal mesothelioma chemotherapy include:
- Systemic chemotherapy: Administered systemically, it is the first line of defense for patients who have been diagnosed in the later stages of mesothelioma. Carboplatin can be successfully substituted for cisplatin and seems to be better tolerated by patients receiving the treatment.
- Intraoperative chemotherapy: For surgical candidates whose mesothelioma has been diagnosed in the earlier stages, the chemotherapy treatment called HIPEC (Hyperthermic (or Heated) Intraoperative Peritoneal Chemotherapy) offers promise to extend life.
Similar to HITHOC in the chest cavity, the heated chemotherapy drug is administered locally in the stomach cavity immediately after surgical removal of visible cancerous tumors and tissue.
HITHOC kills the cancer cells left behind that are invisible to the naked eye.
Survival rates for peritoneal mesothelioma patients who are surgical candidates can range from 38-92 months after the surgical/chemotherapy treatment combination.
Chemotherapy for Pericardial Mesothelioma
Pericardial mesothelioma (a cancer of the lining of the heart) is so rare that research and study on treatments lag behind those of more frequent cancers.
It is often misdiagnosed or found in the late stages with a very poor prognosis. Most cases of pericardial mesothelioma are discovered after the victim has already died.
However, the combination of pemetrexed and cisplatin has been shown to offer some benefits to slightly lengthen life for those who receive this systematic chemotherapy.
Chemotherapy for Testicular Mesothelioma
Testicular mesothelioma is the rarest form of mesothelioma, making up less than 1% of all mesothelioma cases.
Adjuvant mesothelioma chemotherapy and radiotherapy have not been clearly shown to be most effective for this type since the number of cases is so few.
However, testicular mesothelioma has a relatively high survival rate. 47% of its victims are still alive 2 years after diagnosis.
Surgical removal of the tumor can eradicate the cancer if discovered in its early stages. This is sometimes followed up with radiation and chemotherapy using pemetrexed and cisplatin.