Chemotherapy is one of the most effective and most commonly-applied medical protocols for the treatment of malignant mesothelioma. Though most people are familiar with the side effects associated with chemotherapy, they do not fully understand what it is or how it works. Chemotherapeutic drugs attack fast-growing cancer cells, killing them and slowing their spread to other areas of the body. When used in combination with other protocols such as surgery and radiation therapy, it can have a significant impact on the overall survival and life expectancy for a patient diagnosed with this rare and fatal form of cancer.
Most chemotherapy is provided in medical facilities via I.V., though some drug companies have been able to formulate the drugs into a more easily-taken pill form. There are a number of benefits to delivering the medication orally, as it eliminates the need to have the toxic chemicals contained in the drug pass and impact healthy cells on its way to the cancer. It is this impact that results in the familiar loss of hair that many chemotherapy patients experience, as well as rapidly dropping blood counts, nausea, and fatigue. In the case of patients who have been diagnosed with malignant mesothelioma, there are other methods of getting the drug into direct contact with the cancer without having it enter the rest of the body. One of these is via intrapleural chemotherapy which is delivered into the chest area via a catheter; physicians have also had success with a process called HIPEC that delivers a heated chemotherapy solution directly into the peritoneal cavity following surgery to remove cancerous tumors for peritoneal mesothelioma.
The History of Chemotherapy Use in Mesothelioma
Though chemotherapy has long been used for the treatment of mesothelioma, it was originally administered as a single type of medicine that had a very low rate of success. As more has been learned about the disease and new drugs have been developed, oncologists have introduced combinations of chemotherapy drugs that they have found to be far more effective. Chemotherapy has proven to be a valuable tool in the fight against the disease. Though it is most frequently used when patients are seeking curative treatment, it has also proven helpful in providing palliative treatments that relieve symptoms. With a variety of chemotherapy drugs now available, mesothelioma physicians have many more options and can choose the drug combination and multimodality approach that best suits a mesothelioma patient’s individual condition.
The four most popular chemotherapy drugs that are being used in the treatment of malignant mesothelioma are
- Alimta – This is the gold standard of mesothelioma treatment, and is used more frequently than any other drug. It is used in treatment of patients through the most advanced stages of the disease, including those whose condition is so advanced that they are beyond being candidates for surgery. Alimta does have some uncomfortable side effects, so its manufacturer Eli Lilly and company recommends that patients also take supplements including B12 and folic acid, as well as a number of vitamins. Some patients have benefitted from taking corticosteroids at the same time as their Alimta treatment, as it helps offset the impact of the medication on the skin.
- Carboplatin – Though this medication is most frequently used to treat patients suffering from cancer of the lungs, ovaries, head, or neck, it has been found to be an effective treatment for mesothelioma as well. Carboplatin is delivered intravenously, and because it can have such a strong impact on a patient’s immune system patients are often administered the drug as inpatients to prevent them from being exposed to colds, viruses, and infection. Carboplatin is dosed and administered over multiple sessions.
- Cisplatin – Cisplatin has proven to be most effective when it is administered in combination with another form of chemotherapy such as Alimta or doxorubicin. It is administered every three weeks via I.V. When these methodologies are successful, a patient’s mesothelioma goes into a short period of remission instead of progressing unabated.
- Onconase – Onconase has proven to be a popular chemotherapy drug for those who are in relatively good health. The advantage of the drug is that its side effects are much more manageable while it still targets cancer. The drug is dosed on a weekly basis via I.V., and the process generally takes about half an hour.
Side Effects of Chemotherapy
It is well known that chemotherapy causes patients to become fatigued, to lose their hair, and to feel nauseous. There are a number of other side effects that mesothelioma patients receiving chemotherapy treatment may experience, including:
- Mouth sores and ulcers
- Bruising or risk of bleeding excessively as a result of a loss of platelets
- Low white blood cell count which increases risk of infections
Patients experience these symptoms because chemotherapy affects healthy cells at the same time that it kills cancer cells. The drug does not distinguish between the two, and specifically targets fast-growing cells such as those found in the mouth, the intestines, and the hair. For most patients, these uncomfortable side effects of chemotherapy drugs are temporary, and worthwhile when combined with a cancer remission. Additionally, physicians are able to offer coping mechanisms and medications to help offset these side effects.
Patients who undergo chemotherapy are cautioned to be vigilant regarding their health and their symptoms and told to advise their physicians if they experience a sensation of pain or burning in the hands and feet or sensitivity to heat and cold, as they may be indications of nerve damage. They are also urged to carefully monitor their health for fever or signs of infection. The more aware a patient is of their own symptoms and experience, the more effective and palatable a chemotherapy regimen can be.
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