Chemotherapy for Mesothelioma

Chemotherapy is standard treatment following virtually any form of cancer surgery.  Cancerous cells are rogue cells: they morph from normal cells and then multiply in a random, out-of-control fashion.  Chemotherapy is meant to destroy those cells that have been left behind by surgery.

A typical chemotherapy treatment will involve administration of the medication every week or two for an extended period.  In the case of mesothelioma, many physicians have experimented with a combination of chemotherapy drugs, trying to induce the hoped-for response.

The side effects of chemotherapy are well known and universally disliked.  They usually include severe nausea immediately following treatment along with the destruction of hair follicles, resulting in hair loss.  Less obvious but perhaps more serious side effects may include impact on the kidneys, the liver, bone marrow and the gastrointestinal system.

Drugs in Use

In 2004 the FDA issued its first approval for a drug meant specifically for the treatment of malignant mesothelioma.  That drug is pemetrexed, known also under its brand name Alimta.  It is generally used in combination with a platinum compound known as cisplatin.  Both drugs attack the growth of cancerous cells and seem to work well together.  Pemetrexed cuts off the supply of certain enzymes to cancer cells, while cisplatin has a miniscule amount of platinum at its core - which is toxic to cancerous cells.

Pemetrexed is considered a primary chemotherapy choice with patients for whom surgery is not an option.  Drug manufacturer Eli Lilly conducted a study with patients in stage III - IV that showed that when combined with cisplatin, pemetrexed provided an average increase in survival time among patients from nine months to a little over twelve months.  Pemetrexed also provided notable relief from mesothelioma symptoms of the disease including shortness of breath and chest pain.

Physicians use chemotherapy drugs in combinations which are dictated by the type of cancer, the location and its degree of advancement.  Other mesothelioma treatments nclude:

• Carboplatin, another of the platinum drugs that does damage to cancer cells.
• Vinorelbine is used to treat breast cancer and non-small cell lung cancer.  It was developed from the periwinkle plant, or "vinca."  This drug stops cancer cells from dividing into two cells and thus growing the malignancy.
• Mitomycin C is a chemotherapy drug that accomplished the same goal as vinorelbine but by a different method.  Motimycin C impacts the DNA strand in the cancer cell, effectively making it impossible for the cell to divide.
• Gemcitabine can also be used with cisplatin.  It was developed to fight pancreatic cancer and non-small cell lung cancer.  This drug is one of a family of drugs called anti-metabolites.  Anti-metabolites replace cells used during DNA replication, effectively halting the reproduction process in cancerous cells.
• Ranpirnase (Onconase) is described in medical terms as a cytotoxic ribonuclease.  What that means is that the drug can selectively attack malignant cells and inhibit protein growth.  The unique ability to be selective in the cells it impacts keeps side effects down and provides promise for selective targeting of cancerous cells.

This is a sampler of medications used with mesothelioma.  It is important that your doctor provide a clear explanation of the goal with chemotherapy treatment, along with the side effects that may accompany it.

Chemotherapy Side Effects

Chemotherapy introduces cell-killing medication into the body; that fact can lead to a wide range of side effects ranging from moderate to severe.  Many times, chemotherapy will be accompanied by treatment for side effects.  For instance, in the case of pemetrexed the patient is given a vitamin supplementation of B12 by injection during the week prior to treatment and folic acid by mouth daily. In addition an oral steroid medication is usually applied in order to avoid skin rash.

Loss of appetite is a common side effect, along with the nausea and hair loss mentioned above.  Anemia is also something the doctor will watch carefully with periodic blood tests to check the red and white blood cell counts.  A general loss of energy is also common and may continue through the cycle of chemotherapy.