How Chemotherapy Fights Mesothelioma?

Chemotherapy is a common treatment for mesothelioma. While the recommended mesothelioma treatment will vary depending on the patient’s specific circumstances and condition, the most widely used form of cancer treatment is chemotherapy, often referred to as chemo.

Dealing with the idea of chemotherapy can be equally as frightening as the initial diagnosis of mesothelioma. Chemo conjures up thoughts of unpleasant side effects that can leave the patient feeling worse than if they had no treatment at all. However, because of advances in chemotherapy drugs and medications intended to lessen chemo’s side effects, patients should remain open to the idea of undergoing this type of treatment and consider all options doctors may present them with.

How Chemotherapy Fights Mesothelioma

Chemotherapy kills cancer cells. Unlike surgery and radiation therapy, which can destroy cancer cells in one particular location, chemotherapy can be used to destroy cells that have metastasized (i.e., spread to other parts of the body).

Mesothelioma is a very aggressive form of cancer, so doctors treat it as aggressively as possible. That includes the use of highly toxic chemo drugs that will, hopefully, help destroy cancer cells while also providing some relief from the bothersome side effects of the disease, such as coughing, shortness of breath, and chest pain.

Years ago, doctors opted for single chemotherapy treatments for the disease. Unfortunately, they yielded little more than approximately a 15% success rate, providing minimal relief to the mesothelioma patient. More recently, oncologists and research scientists have determined that the best way to fight mesothelioma is by administering several chemo drugs in tandem – known as combination chemotherapy.

What to Expect During Chemotherapy Treatment

Chemotherapy is not a miracle drug, especially where mesothelioma is concerned, so it’s necessary to be patient when dealing with the treatment. Most patients receiving chemotherapy for the first time will be especially concerned about side effects. Different chemotherapy drugs have different side effects, but your doctor should be able to tell you what to expect.

Because your doctor has experience with specific chemotherapy drugs, he/she may also be able to tell you when to expect the side effects, how long they’ll last, and what to do about them. These days, there are many options available to help minimize or avoid these side effects so the chemotherapy of today is much different than that of decades or even years ago. Remember, also, that most of these side effects will disappear when the treatment has ended. Doctors can also advise patients on clinical trials experimenting with trial-phase drugs.

How is Chemotherapy Administered?

Chemotherapy is received either by means of a pill or intravenously via a needle in the vein. Chemotherapy drugs may be administered in two ways:

• Systemically – Drugs are carried through the bloodstream
• Intrapleurally or intraperitoneally – Drugs are injected directly into the site of the tumor, which in the case of mesothelioma is usually the pleura, the lining of the lung, or the peritoneum, the abdominal cavity.

Doctors have had some success with both methods.

Side Effects of Chemotherapy

The most common chemotherapy side effects include:

It’s important to tell your doctor about any side effects you might experience, even if they are noted as “common” side effects of your chemotherapy. High fever, inability to eat or drink, blood in the stool or urine, and signs of infection should be addressed immediately. Your doctor will inform you about other side effects which he/she considers life-threatening.
Read More Here: Side Effects of Chemotherapy

Types of Chemotherapy Drugs

There are currently about 100 chemotherapy drugs on the market. For mesothelioma, combination chemotherapy treatment is often used. Currently, the chemotherapy drugs Alimta (pemetrexed) and Cisplatin are an effective and often utilized combination to treat malignant pleural mesothelioma. Because all of the chemotherapy drugs work a bit differently, your oncologist will determine which are best suited to treating your disease. The doctor will also be able to determine the length of your course of treatment as well as the frequency of treatments.

Other common chemotherapy drugs used to treat mesothelioma include gemcitabine, vinorelbine, and onconase. Researchers continue to experiment with new drugs and new combinations of chemotherapy medications in hopes that they can find the best available to treat the disease and its symptoms.

Alimta

Alimta (pemetrexed) holds the distinction of being the only FDA approved chemotherapy regimen for the treatment of malignant pleural mesothelioma. Alimta is administered systemically in 21-day cycles and is typically used in conjunction with a platinum agent, such as cisplatin.

Carboplatin

Originally designed for patients undergoing treatment for lung, ovarian, head, and neck cancers, Carboplatin has been used in patients undergoing mesothelioma chemotherapy treatment. Carboplatin is an alkalizing agent, with its parent drug, cisplatin, being more popular in mesothelioma treatments. Carboplatin can be used as an alternative to cisplatin, as carboplatin is known to carry fewer unpleasant side effects than cisplatin. Carboplatin is most often utilized in a combination therapy with chemotherapy drug Gemzar (gemcitabine).

Cisplatin

Cisplatin, approved by the FDA in the late 1970s, is what is known as a platinum compound or alkalizing agent. Alkalizing agents are most often used in conjunction with other chemotherapy drugs, maximizing the primary drug’s efficacy while limiting side effects. Cisplatin for mesothelioma is most commonly combined with Alimta (pemetrexed). The combination of these two drugs represents the only FDA-approved chemotherapy regimen for the treatment of malignant pleural mesothelioma.

Gemcitabine

Gemcitabine is what is known as an anti-metabolite, a classification given to agents which can prevent cell growth and slow tumor spread. Gemcitabine is often used in a combination therapy with carboplatin.

Navelbine

Navelbine (vinorelbine) is a type of chemotherapy drug that is classified as a plant alkaloid. These types of drugs prevent cells from separating to form to new cells, thus slowing cancer cell production and spread. Navelbine is administered through an IV or orally, and is often combined with cisplatin.

Onconase

Onconase (ranpirnase) is produced by the Alfacell Corporation and is a ribonuclease protein that is intended to be taken in conjunction with more traditional chemotherapy drugs. Ribonuclease proteins enhance the cancer-defeating capacities of traditional drugs in smaller dosages, thus limiting side effects. Lower toxicity levels will usually equate to a milder set of side effects associated with mesothelioma chemotherapy drugs such as Alimta.

Sources:
1 Alimta. Malignant Pleural Mesothelioma Therapy Guide.
2 American Cancer Society. Chemotherapy.
3 American Cancer Society. Chemotherapy for malignant mesothelioma.
4 American Cancer Society. Chemotherapy for malignant mesothelioma.
5 Cancer Research UK. Cisplatin.
6 Cancer Research UK. Caroboplatin.
7 Cancer Research UK. Gemcitabine (Gemzar).
8 Cancer Research UK. Mesothelioma Research.
9 Cancer Research UK. Navelbine.
10 National Cancer Institute. General Information About Malignant Mesothelioma Treatment.

11 https://www.maacenter.org/treatment/chemotherapy/

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