Mesothelioma Treatments: Chemotherapy

Mesothelioma is a deadly type of cancer that affects the mesothelium, the membrane that surrounds the body’s vital organs. Most commonly, mesothelioma affects the area around the lungs, called the pleura, but can spread to other areas. Unlike other cancers, mesothelioma spreads to other parts of the body by way of small tumors instead of a single, solid mass.

Currently there is no cure for mesothelioma. However, there are treatments available to maximize life expectancy and decrease the pain of the individual. Many of these treatments are based off of other cancer treatments, however many specialized treatments are currently being developed.

Common forms of treatment include surgery, if diagnosed in early stages, and radiation therapy. However, one of the main forms of mesothelioma treatment, as with most forms of cancer, is chemotherapy.

Chemotherapy is the use of drugs and other chemical agents to fight and slow the spread of cancer. Because most cases of mesothelioma are diagnosed in its later stages, surgery is not an option for safety reasons. This makes chemotherapy one of the most common cancer treatment approaches and is the most common mesothelioma treatment approach. It is very successful in treating many types of cancer and has had the most success slowing the progression of mesothelioma.

The main goal of most chemotherapy treatments is to slow or stop the division of the rapidly dividing cancer cells. One of the main characteristics of cancer is that mitosis of the unhealthy cells happens incredibly fast, taking over healthy cells in other areas of the body.

The current standard of care for pleural mesothelioma is the use of the chemotherapy drugs pemetrexed and cisplatin.

Pemetrexed, administered intravenously, inhibits the productions of enzymes that allow cancer cells to spread. The dosage of pemetrexed is determined by the patient’s height, weight, and current health condition. Other vitamins and medications may be added at a doctor’s discretion depending on the specific situation.

Pemetrexed was introduced in 2004 and is currently manufactured by Eli Lily under the trade name Alimta.

Cisplatin, also administered intravenously, is a platinum containing compound that slows or stops the growth of cancer cells. Also, it is an alkylating agent, meaning that during the resting phase of cell division, it makes it impossible for the cancer cell to replicate the harmful DNA to form another cell.

These drugs are most successful when used in conjunction. They are administered to the patient every 21 days. If a second chemotherapy treatment is found necessary, then pemetrexed may be used by itself.

Other chemotherapy drugs exist and may be used in certain cases. The combination of pemetrexed and cisplatin is currently used as the first line of treatment in pleural mesothelioma.

Though chemotherapy is currently the most effective treatment plan for mesothelioma, some side effects can occur.

Possible side effects for pemetrexed and cisplatin can include:

• Low white or red blood cell counts
• Low platelet counts
• Fatigue
• Gastrointestinal issues
• Rash
• Thinned hair and hair loss
• Loss of weight
• Loss of appetite
• Diarrhea
• Vomiting
• Numbness and tingling of fingertips and toes

Other chemotherapy drugs may exhibit other side effects. These effects will be monitored and treated by the patient’s medical care providers on an individual basis.

Before starting something as important as chemotherapy, there are several questions that an individual may want to ask his or her medical care providers.

1. How many treatments will I be given? – This will vary depending on the individual case.
2. What drugs will be used? – It will likely be pemetrexed and cisplatin, but other drugs may also be used.
3. How will the treatments be given? – Drugs can be given either intravenously or in a pill form depending on the specific chemotherapy drug in question.
4. What side effects are likely to occur? – It is important to be aware of all possible risks before beginning the treatment regimen. There may be other medications or methods to relieve these possible side effects.
5. Where will these treatments be given? – Many times these treatments will be given in a hospital, but some separate chemotherapy centers exist.
6. Who can I contact in case of an emergency? – Finding all possible contact information for your medical care specialists can be very beneficial.

Keeping an open line with medical care specialists can greatly improve this trying experience. As medications are introduced and treatments change, it is important to stay knowledgeable about the best treatment plan for the individual patient.