Chemotherapy is one of the most common treatments for mesothelioma, and is sometimes used in combination with other treatments, such as radiation therapy. The treatment involves the use of anti-cancer drugs which are introduced to the bloodstream or directly to the organ. The drugs then work to kill cancer cells and prevent the cancer from spreading. This type of treatment can be used on its own, post-surgery to kill any remaining cells, or pre-surgery to reduce the size of a tumor.
Chemotherapy for Mesothelioma Overview
Chemotherapy for mesothelioma has been shown to improve survival rates and quality of life in patients. The treatment is not considered to be a cure, but rather a way to assist recovery, relieve tumor-related pain, and increase the life expectancy of mesothelioma patients.
Here’s what every mesothelioma patient should know about receiving chemotherapy treatment:
- Chemotherapy can kill mesothelioma cells and prevent them from spreading
- The treatment is a common pain relief solution for mesothelioma patients
- Chemotherapy can be administered in a non-invasive manner
- Treatment plans are formed based on the unique patient case; they are not a one-size-fits all solution
- In addition to common chemotherapeutic agents such as cisplatin and Alimta, a variety of anti-cancer drugs are being tested for their effectiveness in treating mesothelioma
Who Receives Chemotherapy for Mesothelioma?
Though chemotherapy is often used in conjunction with surgical procedures, the treatment itself is non-invasive, making it a feasible route for any patients who are not eligible for surgery. The treatment is known to have significant side effects, but the benefits typically outweigh the disadvantages.
Chemotherapy is administered to mesothelioma patients via three primary methods:
- Systemic: In systemic chemotherapy, the drugs are either injected intravenously or taken orally, in pill form.
- Intrapleurally: In intrapleural chemotherapy, chemotherapeutic agents are inserted directly into the pleural cavity of the chest.
- Intraperitoneally: In intraperitoneal chemotherapy, the drugs are inserted directly into the abdomen.
It is up to a patient’s specialist to determine which method of administration is most appropriate. The decision will depend on a variety of patient-to-patient factors, such as health history, histology, and the stage of the cancer. The treatment plan depends heavily on the patient’s current health, as this impacts how aggressive of an approach will be taken.
For example, multimodal therapy, where chemotherapy is combined with other treatment methods, is most appropriate for patients in the early stages of mesothelioma. This is because early stage patients can safely endure these high levels of treatment. Patients with later stage cancer or additional health concerns are recommended by mesothelioma specialists to undergo less aggressive chemotherapy treatments to alleviate symptoms of mesothelioma and increase comfort.
Chemotherapy is often recommended for patients with varying stages of cancer. For early-stage patients, the goal will be to eliminate the cancer. For other patients where this is an unlikely outcome, the main objective of the treatment will be to simply relieve symptoms and prolong life expectancy of mesothelioma patients.
Chemotherapy can accomplish a range of objectives for mesothelioma patients, which is why it is not only recommended for one particular patient profile. It is up to a patient’s doctor to decide whether the patient is a candidate for chemotherapy and, if so, to create a detailed treatment plan based on the individual’s subjective circumstances.
Why is Chemotherapy Used for Mesothelioma?
Chemotherapy is used for Mesothelioma in various ways, depending on the specific treatment goals for the patient.
Neoadjuvant chemotherapy, or preoperative chemotherapy, is administered in order to shrink a tumor before the patient goes into surgery.
The aim of this is to lower the scale of the surgery, reduce the invasiveness of the procedure, and allow the surgeon to better identify healthy tissue, making the surgery more straightforward on their part. As well, neoadjuvant chemotherapy can help mesothelioma patients recover quicker post-surgery.
Adjuvant chemotherapy, by contrast, is administered after surgery (or other forms of treatment) in order to prevent the cancer from returning for as long as possible.
With adjuvant chemotherapy, the treatment is given once all visible traces of cancer have been eliminated via the other treatment methods. This method is known to lower the chances of recurrence and to remove any cells that were missed in surgery or radiation therapy.
How is Chemotherapy Administered?
Chemotherapy for mesothelioma is administered in a cyclical format. While the exact schedule can vary by case, a common approach is to begin with three to four treatments spaced three weeks apart on average. The treatments are spaced this way to allow for recovery time.
During the treatments, patients are supervised by a chemotherapy nurse and may have to undergo additional blood tests to make sure the treatments are as effective as possible. Each treatment can last as little as half an hour, but some may take several hours.
Once a round of treatments ends, patients will have follow up appointments with their doctor. At this point in time, the doctor will assess the effectiveness and success of the treatment and determine whether further treatments are necessary. This is also an optimal time for the patient to have questions answered.
Chemotherapy can be administered differently in terms of scheduling and method (intravenous vs. pill form). However, it can also be vary in how it is given in relation to other forms of treatment during multimodal therapy — specifically, whether it is given before or after surgery.
As we know, chemotherapy is even more effective when it is combined with surgery. However, multimodal therapy can still vary from patient to patient. Whether chemotherapy is administered adjuvantly, neoadjuvantly, or intraoperatively will depend on the circumstances of the patient.
Adjuvant chemotherapy describes when chemotherapy is given to a patient after surgery. The objective of adjuvant chemotherapy is to kill any remaining mesothelioma cells after surgery is done. It can also prevent or delay the return of the mesothelioma later on.
Neoadjuvant chemotherapy refers to chemotherapy that is given before surgery takes place. Doctors give neoadjuvant chemotherapy when they want to shrink the mesothelioma tumor before operating. This allows for easier removal of the tumor during surgery.
Intraoperative chemotherapy is chemotherapy that is administered during the operation itself. HIPEC (Hyperthermic Intraperitoneal Chemotherapy) is one form of intraoperative chemotherapy. It is a more direct method, as the chemotherapy drugs are applied in a solution directly to the site of the tumor. This allows for a higher concentration of the drugs to be given safely. In the case of HIPEC, the warmth of the solution allows the body to absorb the drugs better. With this method, chemotherapy is given right after the removal of the tumor and before reconstruction. That way, any microscopic cancer cells remaining after tumor removal can be killed by the drugs.
First Line and Second Line Chemotherapy
Chemotherapy administration is commonly divided into “first-line” and “second-line” treatments. First-line chemotherapy refers to the most commonly effective mesothelioma drugs being given as a standard first approach. If these fail to show the intended results, the second-line treatment may involve the use of the same or different drugs.
Mesothelioma patients can receive chemotherapy directly into the tumor site or have the medicine injected into a vein. With the former method, the drugs are administered with tubes into the pleural cavity of the lung for pleural mesothelioma, or directly into the abdomen of patients with peritoneal mesothelioma. The latter intravenous method is used to circulate the chemotherapeutic agents through the blood system where they can kill any cancer cells encountered.
There are various cytotoxic agents (chemotherapy medications) used in chemotherapy for Mesothelioma. Many of these are platinum-based antineoplastic drugs (platins), including cisplatin and carboplatin. Alimta is used in combination with platins and is the standard drug involved in the treatment of pleural Mesothelioma.
A Gemcitabine-Cisplatin combination is also approved by the FDA for treatment of malignant Mesothelioma. Combining chemotherapy drugs can prevent cancer cells from becoming resistant.
Other drugs sometimes considered for mesothelioma chemotherapy include:
- Ranpirnase (Onconase)
- Vinorelbine (Navelbine)
Because chemotherapy utilizes chemotherapeutic agents that are cytotoxic, there can be some damage to healthy cells as well as cancerous ones. Chemotherapy has the biggest impact on cells that are growing and dividing at a fast pace, so cancer cells are more likely to be targeted by the drugs.
These drugs do have the potential to impact normal cells, resulting in several potential side effects for the patient. These can include:
- Digestion issues
- Sore gums and teeth
- Hair loss
- Low white blood cell, red blood cell, and platelet counts
- Flu symptoms
- Changes in weight and appetite
- Lowered immunity
Due to patients’ lowered immunity during chemotherapy treatments, patients should avoid situations where contracting a cold or virus could be more likely. Patients who experience unusual or unexpectedly severe side effects should consult a medical professional immediately.
Seeking Chemotherapy Treatment for Mesothelioma
Chemotherapy has been shown to positively impact the survival rates and well-being of Mesothelioma patients and to increase the effectiveness of supplementary treatments. While the treatment can be applied to a vast variety of patient objectives, many specifics are involved in determining an optimal treatment plan. A patient’s individual circumstances will determine what type of anti-cancer drugs are used, what the treatment schedule will be, whether multimodal therapy will be used, how the drugs will be taken, and much more.
Choosing the right route requires in-depth decision making that requires expertise from someone who knows your health history. Talk to a doctor today about your chemotherapy options so that you can stay informed and feel confident moving forward with your treatment.
To get connected with the right mesothelioma doctor and discuss your chemotherapy treatment options, contact our Patient Advocates. We’ll answer any of your questions about chemotherapy resources and help you locate a qualified mesothelioma specialist to oversee your treatment. Call us at 888-381-0695.