Chemotherapy Treatment Goals
The primary goal of chemotherapy is to target and kill off mesothelioma cells so they cannot spread throughout the body. Inhibiting cancer cell growth also helps to shrink tumors and reduce painful symptoms associated with tumor growth.
Chemotherapy can be used as first- or second-line treatment. It can either serve as a patient’s primary treatment or it can play a supportive role with other mesothelioma treatments like surgery and palliative therapy.
How is Chemotherapy Administered?
Mesothelioma patients receive chemotherapy either intravenously or directly into the tumor site. Chemotherapy drugs are injected directly into a vein during intravenous administration. This allows the drugs to circulate throughout the body and destroy cancer cells along the way.
Intravenous chemotherapy is administered at an oncology clinic in three- to four-week cycles. One cycle involves multiple sessions of chemotherapy and can last anywhere from 30 minutes to four hours. Some patients undergo multiple sessions per week. After the cycle is complete, patients are given a break to let them recover.
When chemotherapy is administered directly into the tumor site, doctors use tubes (catheters) to allow the drugs to circulate into the tumor.
Chemotherapy drugs may also be heated beforehand which increases their effectiveness. This method can be administered directly into the chest for pleural mesothelioma or into the abdomen for peritoneal mesothelioma. Chemotherapy administration into the abdomen is called hyperthermic intraperitoneal chemotherapy (HIPEC).
Chemotherapy Administration Methods
When chemotherapy is administered before surgery (neoadjuvant), its goal is to shrink the tumors. This makes it easier for surgeons to remove them, improving the likelihood of success.
Chemotherapy can also be administered after surgery (adjuvant) with the goal of killing the remaining cancer cells that could not be removed surgically.
When chemotherapy is administered during surgery, it shrinks tumors and kills cancer cells by injecting the drugs directly into the tumors.
Chemotherapy Drug Types for Mesothelioma
There are several chemotherapy drugs available. Doctors will select the most effective drugs or drug combinations depending on your particular case of mesothelioma.
Here are common chemotherapy drugs:
- Pemetrexed (Alimta®)
- Doxorubicin (Adriamycin®)
- Gemcitabine (Gemzar®)
Doctors commonly prescribe cisplatin and pemetrexed as a combination drug treatment. This combination is only used if the patient is healthy enough to receive two different drug types.
Chemotherapy Side Effects and Precautions
By nature, chemotherapy is designed to kill cells that are dividing quickly. This means that it may also attack healthy cells that divide quickly too, such as hair cells.
Chemotherapy side effects can include:
- Hair loss
- Mouth sores
- Loss of appetite
Doctors anticipate this and prescribe drugs to help reduce side effects. Chemotherapy side effects stop once treatment has finished.
New chemotherapy drug developments are continuously improving the effectiveness of this mesothelioma treatment for patients. Research on chemotherapy administration methods is also helping doctors better understand how to best use chemotherapy as part of an overall mesothelioma treatment plan.