Chemotherapy provides no cure for mesothelioma but can go a long way in providing relief from the horrendous symptoms of the disease. As researchers continue to test different combinations of chemotherapy drugs, patients continue to benefit from their findings, and someday, chemo may go a lot further in prolonging the life of a mesothelioma victim.
Chemotherapy is given in pill form or injected. In the case of mesothelioma patients, the drugs are given intrapleurally (into the chest cavity) or intraperitoneally (into the abdominal cavity). Doctors usually combine two drugs for the best result. Currently, the preferred combination is Alimta© (pemetrexed) and Cisplatin, but other drugs are used in tandem if deemed preferable for a specific patient. In some cases, patients can only tolerate a single drug so only one is used for treatment.
Other drugs are given to the patient to combat the unpleasant side effects of chemo, such as medication to relieve nausea and vomiting or vitamins to replace essential ones lost during chemotherapy.
Some patients decide that the side effects of chemotherapy are too severe and opt not to receive this treatment.
How Does Chemotherapy Help?
Quite simply, chemotherapy - treatment with a specific cancer drug or combination of drugs - kills cancer cells. Unlike surgery and radiation therapy, which can destroy cancer cells in one particular location, chemotherapy can be used to destroy cells that have metastasized - or spread to other parts of the body.
There are currently about 100 chemotherapy drugs on the market. Though single chemo drugs are sometimes used to treat a particular type of cancer, more often a few of these drugs are used in tandem. This is called combination chemotherapy. Some combinations have proved more helpful than others in fighting mesothelioma and its troublesome symptoms. Because all of these drugs work a bit differently, your oncologist will determine which are best suited to treating your disease. The doctor will also be able to determine the length of your course of treatment as well as the frequency of treatments.
What to Expect
Chemotherapy is not a miracle drug, especially where mesothelioma is concerned, so it’s necessary to be patient when dealing with the treatment. Most patients receiving chemotherapy for the first time will be especially concerned about side effects. Different chemo drugs have different side effects, but your doctor should be able to tell you what to expect.
Because your doctor has experience with specific chemo drugs, he/she may also be able to tell you when to expect the side effects, how long they’ll last, and what to do about them. These days, there are many options available to help minimize or avoid these side effects so the chemotherapy of today is much different than that of decades or even years ago. Remember, also, that most of these side effects will disappear when the treatment has ended.
Types of Chemotherapy
Chemotherapy is received either by means of a pill or intravenously via a needle in the vein. Chemotherapy drugs may be administered 1) systemically - which means that the drugs are carried through the blood stream; or 2) intrapleurally - injected directly into the site of the tumor, with in the case of mesothelioma is usually the pleura, the lining of the lung. Doctors have had some success with both methods.
Chemo and Mesothelioma
Mesothelioma is a very aggressive form of cancer, so doctors treat it as aggressively as possible. That includes the use of highly toxic chemo drugs that will, hopefully, help destroy cancer cells while also providing some relief from the bothersome side affects of the disease, such as coughing, shortness of breath, and chest pain.
Years ago, doctors opted for single chemotherapy treatments for the disease. Unfortunately, they yielded little more than approximately a 15% success rate, providing minimal relief to the mesothelioma patient. More recently, oncologists and research scientists have determined that the best way to fight mesothelioma is through combination chemotherapy.
Currently, the drugs of choice are a newer drug, Alimta (pemetrexed), combined with Cisplatin, which has been on the market for some time. As a matter of fact, Alimta, when given with cisplatin, is the first and only chemotherapy drug to be approved by the Food and Drug Administration (FDA) for the treatment of patients with malignant pleural mesothelioma when surgery is not an option.
Other common chemotherapy drugs used to treat mesothelioma include gemcitabine, vinorelbine, and onconase. Researchers continue to experiment with new drugs and new combinations of chemotherapy medications in hopes that they can find the best available to treat the disease and its symptoms.
The most common chemotherapy side effects include:
Nausea
Vomiting
Low white blood cell count (which leaves you prone to infection)
Loss of appetite
Constipation
Fatigue
Fever and chills
Low platelet count (which may cause problems with clotting)
Generalized achy-ness
Tingling hands and feet
Rash
Depression
It’s important to tell your doctor about any side effects you might experience, even if they are noted as “common” side effects of your chemotherapy. High fever, inability to eat or drink, blood in the stool or urine, and signs of infection should be addressed immediately. Your doctor will inform you about other side effects which he/she considers life-threatening.
