Surgery a commonly used treatment method for patients with mesothelioma. It is often used in combination with radiation treatments and surgery to improve life expectancy or improve quality of life.
Chemotherapy can be a successfully mesothelioma treatment method. It can be used to improve life expectancy when combined with surgery. It can also be used as a palliative treatment to reduce symptoms and increase quality of life.
Chemotherapy at Different Mesothelioma Stages
Chemotherapy is one of the three major treatment methods available for mesothelioma patients. When used in earlier stages, it can help to increase life expectancy, if combined with other treatments. In later stages of mesothelioma, chemotherapy may help to relieve symptoms and improve patient quality of life.
Chemotherapy is an effective treatment option for mesothelioma and may have benefits such as:
- Improved life expectancy – chemotherapy may improve mesothelioma prognosis and may increase life expectancy.
- Decreased pain and discomfort – chemotherapy may be used to shrink tumors and prevent additional growth. This may reduce symptom severity and improve quality of life.
- Individualized therapy – there are a number of chemotherapeutic medications available and the treatment plan may be individualized for each patient depending upon type, location and goals of therapy.
- Reduced cancer spread – chemotherapy may help to cancer spread when used in combination with surgery. Chemotherapy is used to ensure that no viable cells remain after tumors have been surgically removed.
About Chemotherapy for Mesothelioma
Chemotherapy is prescribed by a medical oncologist, ideally by or in consultation with a mesothelioma specialist. Chemotherapy is a standard treatment method for mesothelioma that is designed to:
- Kill mesothelioma cancer cells
- Shrink mesothelioma tumors
- Prevent mesothelioma cancer cells from spreading
- Increasing effectiveness of other treatments methods such as radiation or surgery
- Decreasing the difficulty of surgery
- Reducing severity of symptoms caused by large tumors
Though there are traditional approaches to chemotherapy for mesothelioma, each case is unique and oncologists may individualize the regimen for a particular patient based on:
- Type of mesothelioma
- Location of tumors
- Cell type
- Patient medical health
- Other specific factors
The regimen may be tailored to a specific patient based on drugs chosen, length and frequency of medication administration and coordination with other treatment methods.
Chemotherapy may be used on its own as a palliative measure but when seeking curative treatment to increase life expectancy, it is most commonly used in conjunction with surgery. Radiation may also be used as part of a multimodal treatment plan with chemotherapy.
When used in combination with surgery for curative treatment, it may be given as”
Neoadjuvant therapy – chemotherapy given prior to surgery to reduce tumor size and make surgical removal of the tumor(s) easier.
Adjuvant therapy – chemotherapy given after surgery to ensure that any remaining cancer cells are killed. Cancer cells left behind after surgery are not visible except under microscopic examination.
Intraoperative therapy – chemotherapeutic medications can be applied directly to tumors during surgery. This allows for higher concentrations of medications with less potential for side effects.
In addition to direct application during surgery, chemotherapeutic medications may also be given for mesothelioma by tablet or capsule, intravenous injection or infusion. It may also be given through a “port” which is a semi-permanent tube that has been temporarily implanted in a large internal blood vessel that extends from the body, generally the chest, and is capped by a rubber membrane, allowing for repeated injections.
Medications used for Mesothelioma Chemotherapy
As mesothelioma is a very rare type of cancer and involves several “types”, no medications have been actually approved for use. This does not mean that medications are not effective, simply that the FDA has not been asked to address their use. Oncologists and other physicians are allowed to prescribe medications that are known to be effective even if they have not been officially approved.
Despite the lack of approved chemotherapy medications, a number of agents are in use. The most common medications used for mesothelioma chemotherapy include:
- Carboplatin (Paraplatin)
- Cisplatin (Platinol)
- Cyclophosphamide (Cytoxan)
- Doxorubicin (Adriamycin)
- Vinorelbine (Navelbine)
- Ranpirnase (Onconase)
- Paclitaxel (Abraxane, Onxal, Taxol)
- Pemetrexed (Alimta)
In many cases, a chemotherapy regimen will include more than one medication. Chemotherapy sessions may be given one or more days a week for several weeks. This regimen may also be repeated one or more times if appropriate.
Though these medications are the most common, other chemotherapy medicines may be used as well. Mesothelioma research is being conducted on a continuing basis and scientists are constantly seeking more effective treatments and treatment methods.
As part of the efforts that scientists are making to develop more effective treatments for mesothelioma, investigational studies and clinical trials are conducted on a routine basis. Each study is designed to examine the effectiveness of various regimens for different types of mesothelioma.
Investigational trials may include clinical trials on:
- Different combinations of medications already in use
- Different dosages of various medications
- Additional medications that have not been commonly used
- Medications used along with other treatment methods
- New treatment procedures
Depending on the stage, type and other mesothelioma specifics, along with consideration of other patient characteristics such as general health, some patients may be eligible for participation in clinical trials. Not all patients will qualify and not every trial is appropriate for each patient but investigational studies may help to increase the life expectancy of patients who are eligible.
In addition to investigating alternative ways to give known medications, newer medications are in development. Some of these may include immunomodulators which may increase the mesothelioma cancer cell’s susceptibility to being eradicated by the immune system or by other chemotherapy medications. Targeted therapy medications may be more effective for certain patients with a particular DNA profile. Other medications may be in development to increase cancer cell susceptibility to radiotherapy, making radiation treatments more successful while still others may act as “protectants” to healthy tissue so that higher radiation doses are possible.
With all investigational trials, the outcome is unknown and success is not guaranteed but clinical studies may offer additional choices for those who qualify.
Mesothelioma is a very a rare type of cancer that many physicians, oncologists or surgeons do not have experience in treating. It is important that patients diagnosed with mesothelioma seek advice or treatment from a mesothelioma specialist. These specialists are often the best source of information regarding new treatment options, including investigational treatments which can increase life expectancy and improve quality of life.