Chemotherapy is a combination of different anti-cancer drugs that is administered to the patient. These drugs attack any cancer cells that are dividing quickly, thereby interrupting the division process and stunting their growth. In addition to destroying cancer cells, it can also decrease the size of existing tumors.

Chemotherapy is a traditional treatment option for mesothelioma that is designed to improve lifespan and decrease symptoms to help patients have a better quality of life. While it may be an performed alone, it is often recommended as part of a treatment plan that includes surgery and radiation therapy (this is known as adjuvant therapy). In fact, an Italian study found that 78% of patients diagnosed with stage 1-3 pleural mesothelioma who had surgery along with chemotherapy and radiation therapy lived for over a year after their treatment1.

Chemotherapy is a common treatment for mesothelioma.
Chemotherapy is a common treatment for mesothelioma.

Chemotherapy may be given before surgery (neoadjuvant therapy) or after surgery. When given before, its primary purpose is to decrease the number of cancer cells and lower the risk of them spreading. When given after, its purpose is to destroy cancer cells that may not have been seen or reached by the surgeon and limit their growth, so that new tumors are less able to grow back.

Mesothelioma drugs

There are a variety of drugs that can be used in chemotherapy for mesothelioma. Only one (single agent) may be prescribed, or more (combination) if necessary:
  • Pemetrexed (Alimta®)
  • Cisplatin
  • Carboplatin
  • Gemcitabine (Gemzar®)
  • Methotrexate
  • Navelbine
  • Onconase
  • Vinorelbine
  • Mitomycin
  • Doxorubicin (Adriamycin®)

Statistics show a better outcome from combination therapy.

Two methods of chemotherapy treatment

Chemotherapy can be administered in two ways, both of which follow a series of treatments scheduled over three to four weeks, with a period of rest after each series.

Systemic: This type of chemotherapy administers the drugs into the patient’s vein, so that it can travel throughout the body by the bloodstream to reach cancer cells.

Intrapleural or intraperitoneal: This type places the drugs directly into the area of the body affected, whether it is in the chest (intrapleural) or the abdomen (intraperitoneal). The drugs are administered using a small tube that is inserted into the affected area through a small incision. The majority of the drugs are absorbed into the affected area, while some are carried away by the bloodstream, where they’ll also eventually reach cancer cells. Heating the drugs may make them more effective (hyperthermic chemotherapy). The drugs may also be administered during surgery, immediately after cancerous tissue has been removed.

Risks and side effects

Chemotherapy is associated with a number of side effects, all of which are considered temporary. For this reason, it may not be recommended for some patients who are in a weakened state. These side effects include hair loss, appetite loss, nausea, vomiting, diarrhea, increase rate of infection, bruising, bleeding, aches, rash, fever and fatigue. Some side effects can be controlled with other medications.

Risks of chemotherapy include infection, hearing loss and nerve damage.

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