Mesothelioma Chemotherapy

Chemotherapy has been used for decades as a treatment for malignant mesothelioma, an asbestos-related cancer. For a patient who has mesothelioma, chemotherapy drugs can be given orally or they can be injected into the body. Although chemotherapy cannot cure mesothelioma, it has helped some mesothelioma patients live longer.

Uses of Mesothelioma Chemotherapy

The purpose of chemotherapy is to kill cancer cells or at least stop their spread and growth. The preferred and most aggressive approach to mesothelioma treatment is surgical removal of the tumor(s) and malignant tissue or as much of it as possible followed by a program that incorporates both chemotherapy and radiotherapy. Patients who have been diagnosed with an advanced stage of mesothelioma or who cannot physically withstand the rigors of major surgery may receive chemotherapy and radiation therapy treatments without initial surgical activity.

For mesothelioma chemotherapy may be used:

  • Before surgery to shrink a tumor
  • After surgery to help destroy any cancer cells that couldn't be removed with surgery
  • To strengthen the effects of radiation therapy
  • To help destroy cancer that has spread from the original site (metastasized)
  • To destroy cancer that has recurred

Traditional chemotherapy is called a systemic treatment because the chemotherapy drugs enter the patient's bloodstream, circulating throughout the body's entire circulatory system. As an alternative the drugs (it's usually more than one drug) can be injected into a vein, or into the chest for intrapleural chemotherapy, or into the abdominal space called the peritoneum.

The systemic use of chemotherapy is what causes the miserable side effects. Direct application has proven to reduce side effects and to be a more powerful use of anti-cancer chemicals. The combination of surgery and intraperitoneal hyperthermic (heated) chemotherapy proved to be extremely successful in treating peritoneal mesothelioma.

Mesothelioma Chemotherapy Side Effects

Mesothelioma chemotherapy drugs attack cancer cells, but they may also damage some of the body's normal cells. The drugs can hurt the cells in the bone marrow that produce blood cells, leaving a patient with low blood cell counts. This can lead to:

  • Fatigue
  • Shortness of breath
  • Bleeding
  • Bruising
  • Increased risk of infection

Other side effects of mesothelioma chemotherapy, usually temporary, are:

  • Loss of appetite
  • Hair loss
  • Nausea and vomiting
  • Mouth sores

Mesothelioma Chemotherapy Drug Research

Many anticancer drugs have been used for mesothelioma chemotherapy. In most cases, two or more anticancer drugs are administered together to increase their effectiveness. New chemotherapy drugs are also being tested as treatments for mesothelioma. One such drug, pemetrexed, has been approved by the U.S. Food and Drug Administration (FDA) for use in mesothelioma chemotherapy when it is used with cisplatin, a well-studied anticancer drug. The two drugs have proven to be much more effective in a Phase III clinical trial with the addition of pemetrexed as opposed to the use of cisplatin as a single medication.

There are close to one hundred clinical trials underway as of July 2010 for mesothelioma treatments. Some of them involve surgical innovations but many involve the use of new chemotherapy drugs, or new combinations of chemotherapy drugs that involve pemetrexed or cisplatin. Oncanase, a drug manufactured from a protein taken from the leopard frog, has been in Phase III clinical trials for mesothelioma treatment for many years. The FDA continues to request additional trials; manufacturer Alfacell continues to comply while entering into Phase I/II studies for treatment of other forms of cancer.

It's not often these days that chemotherapy is given as the sole treatment for mesothelioma. Even so, research continues into the benefits of new and better forms of chemotherapy for all cancers (including mesothelioma), and chemotherapy can be of significant benefit to many mesothelioma patients, whether it's administered alone or as an adjuvant therapy.

Sources:

  1. Treatment of Peritoneal Mesothelioma, SurgicalOncology.com, Sugarbaker, http://www.surgicaloncology.com/meso.htm
  2. Newer Issues in Mesothelioma Chemotherapy, Journal of Thoracic Oncology, Vogelzang et al, February 2006, http://journals.lww.com/jto/Fulltext/2006/02000/Newer_Issues_in_Mesothelioma_Chemotherapy.15.aspx
  3. Clinical Trials Database, ClinicalTrials.gov, http://clinicaltrials.gov/ct2/results?term=%22malignant+mesothelioma%22&pg=2

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