Chemotherapy

Chemotherapy is the medical term for treatment with anti-cancer drugs. Chemotherapy uses potent, specialized drugs to kill cancer cells and prevent them from multiplying.

Chemotherapy is most often used to treat mesothelioma when surgery is not an option. It may also be used together with surgery and/or radiation as part of a multimodality treatment. Researchers have recently had some success with chemotherapy as a preoperative treatment for early-stage pleural mesothelioma, followed by an extrapleural pneumonectomy, and postoperative radiation therapy.

Traditional chemotherapy using only a single anti-cancer drug has shown limited positive results. However, doctors have had better results by using a combination of two or more drugs. Currently, the only combination approved by the Food and Drug Administration (FDA) to treat mesothelioma is Alimta (also known as Pemetrexed), together with Cisplatin. Nevertheless, doctors may also prescribe a number of other anti-cancer drugs such as Carboplatin, Raltitrexed, Oxaliplatin, and Gemicitabine, either alone or in combination. Carboplatin is often prescribed along with Alimta/Pemetrexed for patients who are unable to tolerate Cisplatin.

Researchers continue to experiment with new drugs and new combinations of drugs in hopes that they can find new and better methods for treating mesothelioma with chemotherapy. Some of this research is happening here at the Cancer Research Center of Hawai’i. A number of anti-cancer drugs and drug combinations are currently being tested in clinical trials.

What to Expect

Most drugs used to treat mesothelioma are given by injection into a vein (intravenous, or IV). Chemotherapy can also be taken orally as a pill. In addition, doctors are studying the effectiveness of putting chemotherapy drugs directly into the chest or abdomen through a small incision. This is known as intracavity chemotherapy.

Doctors hope that the intracavity approach will allow them to administer higher doses of chemotherapy directly to the tumor while limiting the side effects to the rest of the body. Some doctors also believe that the chemotherapy drugs may be more effective if they are heated first, which is called hyperthermic chemotherapy.

Unfortunately, while the drugs used for chemotherapy can be effective in destroying the cancer cells, they are highly toxic to healthy cells as well. The side effects of chemotherapy can be extremely unpleasant. Fortunately, these side effects are usually short-term and go away after treatment is finished.

The most common side effects include:

  • Nausea
  • Vomiting
  • Fatigue
  • Loss of appetite
  • Constipation
  • Fever
  • Rash

In addition, Alimta/Pemetrexed, the drug which is most commonly used to treat mesothelioma, interferes with your body’s levels of folic acid and vitamin B12. Thus, it is important to take vitamin supplements to avoid certain additional side effects.

Sources

Pass, H., Vogelzang, N., Carbone, M., ed., Malignant Mesothelioma: Advances in Pathogenesis, Diagnosis, and Transitional Therapies. Springer: New York. 2005.

National Cancer Institute. Malignant Mesothelioma Treatment.http://www.cancer.gov/cancertopics/pdq/treatment/malignantmesothelioma/Patient/page4

American Cancer Society. Detailed Guide: Malignant Mesothelioma Chemotherapy.http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Chemotherapy_29.asp?rnav=cri