Chemotherapy is a form of cancer treatment that uses drugs to target and eliminate cells that grow and divide quickly, such as cancer cells. For individuals diagnosed with mesothelioma, a cancer affecting the lining of the lungs and other organs, this treatment is a component of their medical care. The primary objective of chemotherapy in this context is to shrink tumors, alleviate symptoms, and enhance the patient’s quality of life. It functions by disrupting the rapid division process of cancer cells, thereby slowing the progression of the disease.
The treatment can be applied with different intentions depending on the patient’s specific situation. It may be used as a therapeutic measure with the goal of improving health and extending survival. In other cases, it serves a palliative purpose, focusing on managing symptoms and making the patient more comfortable.
Common Chemotherapy Drugs
The standard initial chemotherapy regimen for pleural mesothelioma involves a combination of two drugs. One of these is Pemetrexed, often known by its brand name, Alimta. This drug works by interfering with the metabolic pathways that cancer cells need to replicate and grow. The second drug is a platinum-based compound, either Cisplatin or Carboplatin, which functions by causing damage to the DNA of cancer cells, preventing them from dividing and leading to their destruction.
Combining these drugs yields better results than a single drug alone because this dual-agent approach targets cancer cells through two different mechanisms. Studies have indicated that patients treated with the combination of Pemetrexed and Cisplatin have a median survival of 12 to 16 months following treatment.
If the initial treatment proves ineffective or the cancer returns after remission, oncologists may use second-line treatments. Drugs such as Gemcitabine or Vinorelbine may be used in these situations. The selection of these alternative drugs depends on the patient’s overall health and previous response to treatment.
Chemotherapy Administration and Cycles
The delivery of chemotherapy for mesothelioma is done intravenously, meaning the drugs are infused directly into a vein. This method allows the medication to circulate throughout the bloodstream, reaching cancer cells throughout the body. The infusion process itself can last for several hours and is conducted in a clinical setting under medical supervision.
Treatment is organized into a series of “cycles.” A cycle consists of a period of active treatment followed by a designated rest period. A typical example involves receiving the drug infusion on the first day, followed by a 21-day rest phase. This rest period is important as it gives the body time to recover from the effects of the drugs before the next treatment begins.
A complete course of chemotherapy usually comprises multiple cycles, often between four and six. The total duration of treatment is determined by the patient’s oncologist and is based on how the cancer responds to the drugs and how well the patient tolerates the side effects.
Managing Chemotherapy Side Effects
Patients undergoing chemotherapy for mesothelioma may experience a range of side effects. Among the most common are fatigue, nausea, and vomiting. To counteract nausea, doctors often prescribe anti-emetic medications to be taken before and after infusions. Eating small, frequent meals rather than large ones can also help soothe the stomach.
Fatigue is another prevalent side effect, and it is best managed by finding a balance between rest and light physical activity. While rest is necessary, gentle exercise, such as short walks, can help maintain energy levels and improve overall well-being.
Other potential side effects include hair thinning, mouth sores, and a decrease in blood cell counts. Lowered white blood cell levels can increase the risk of infection, so patients are advised to be vigilant for signs like a fever over 38°C and to contact their medical team immediately if one develops. For mouth sores, maintaining good oral hygiene and using prescribed rinses can provide relief.
Some individuals might also notice changes in their cognitive function, sometimes referred to as “chemo brain,” which can manifest as short-term memory loss or difficulty concentrating. These cognitive effects are usually temporary and tend to improve once the treatment course is completed.
Chemotherapy in Multimodal Treatment Plans
Chemotherapy for mesothelioma is frequently integrated into a larger, comprehensive treatment strategy known as a multimodal plan. This approach combines chemotherapy with other treatments like surgery or radiation to enhance overall effectiveness.
When chemotherapy is administered before surgery, it is called neoadjuvant chemotherapy. The primary goal of this approach is to shrink tumors, making them easier and safer for surgeons to remove. By reducing the size of the cancer, neoadjuvant chemotherapy can improve the chances of a successful surgical outcome.
Conversely, when chemotherapy is given after surgery, it is referred to as adjuvant chemotherapy. The purpose of adjuvant treatment is to eliminate any microscopic cancer cells that may have been left behind after the surgical procedure. This helps to reduce the risk of the cancer recurring at a later time.
In some cases, chemotherapy is also used in conjunction with radiation therapy. This combination can make cancer cells more sensitive to the effects of radiation, increasing the treatment’s potency.