How Is Chemotherapy Used to Treat Mesothelioma?

Can Mesothelioma be Treated With Chemotherapy?

The human body is made up of billions of cells. Cancer cells divide and replicate much faster than normal cells, creating growths or tumors. Chemotherapy drugs are used to treat cancer by dramatically slowing or stopping cancer cells from dividing. Some types of chemotherapy destroy individual cells, while others disrupt the cell-dividing process. Chemotherapy drugs may be administered as a standalone treatment but are generally used as part of a multimodal treatment program, combined with other mesothelioma medications, radiation and, if necessary, surgery. Chemotherapy treatments can be administered in two ways: systemically (throughout the entire body) or intraoperatively (during surgery).

Systemic Chemotherapy for Mesothelioma

Patients either receive chemotherapy intravenously or in pill form. This allows the drugs to enter the bloodstream and kill cancer cells throughout the body. Systemic treatments destroy both cancerous and healthy cells and, as a result, tend to cause more side effects. Most side effects are due to it targeting cells that divide rapidly, like bone marrow, hair, and the gastrointestinal tract. This causes common side effects like low bone marrow, hair loss, nausea, vomiting, and diarrhea.

Intraoperative Chemotherapy for Mesothelioma

After removing any visible tumors, a surgeon may deliver chemotherapy drugs directly to the affected part of the body. In some cases, this method helps negate some of the side effects that patients experience. Intrapleural chemotherapy and heated intraperitoneal chemotherapy — also called HIPEC — are the two most common examples of intraoperative chemotherapy. Administration of local chemotherapy is thought to kill cancer cells directly but it can also cause local inflammation in the pleural or peritoneal cavity.

Oncologists prescribe a combination of drugs for each case. The goal: to find an effective dose that kills cancer cell types and works to prevent new ones from developing while balancing the potentially serious side effects, such as nausea, bone marrow suppression, hair loss, etc.

Multimodal Treatment for Mesothelioma

Patients may receive chemotherapy drugs as a standalone treatment, or as part of a multimodal treatment program, combined with radiation and, if necessary, surgery.

Neoadjuvant Therapy

A course of chemotherapy to help shrink tumors before the patient undergoes surgery.

Adjuvant Therapy

Treatment used after surgery to destroy any microscopic cancer cells that may be left behind. This is more like sterilizing the body from any leftover cells that couldn’t be seen and removed or escaped the surgical site and hiding somewhere else in the body.

Chemotherapy Drugs That Target Mesothelioma

In 2004, after reviewing the results of several studies, the Food and Drug Administration approved the combination of ALIMTA® (pemetrexed) and cisplatin for the treatment of mesothelioma. Patients who received this combination of drugs lived several months longer than those who received cisplatin alone. This treatment is administered intravenously, and the dose and number of mesothelioma treatments will vary depending on the patient’s needs. Pemetrexed may also be combined with carboplatin. You will work directly with your oncologist to determine the types and duration of chemotherapy.

Chemotherapy Drugs Used to Treat Mesothelioma

• Bevacizumab (Avastin®)
• Carboplatin
• Cisplatin (Platinol®)
• Doxorubicin
• Gemcitabine
• Methotrexate
• Mitomycin
• Pemetrexed (ALIMTA®)
• Vinorelbine (Navelbine®)

Oncologists may use combinations of these medications or administer single doses for patients who have trouble tolerating more than one drug. Your oncologist may also offer you an experimental treatment or chemotherapy.

HIPEC Procedure – Hyperthermic Intraperitoneal Chemotherapy Option

Hyperthermic intraperitoneal chemotherapy is a targeted treatment for peritoneal mesothelioma. Patients receive a dose of heated chemotherapy drugs directly into the abdomen during or after surgery to destroy any microscopic cancer cells that may have remained after surgery. This procedure, often called “heated chemotherapy,” is used after a surgeon has removed all visible lesions and tumors. HIPEC is administered for approximately 30 minutes at a temperature of roughly 109 degrees Fahrenheit. The heat has been shown to increase the absorption of drugs by the tumor. A surgeon moves the patient back and forth on the operating table for two hours to distribute the drugs and reach all affected areas.

Compared to traditional chemo, HIPEC has several benefits: it’s a single course of treatment instead of one that lasts several weeks; it allows for a more concentrated dose of chemo; and because the drugs remain within the abdominal walls, patients report fewer overall side effects. Digestive issues can develop and last for a few weeks after HIPEC. Patients should talk to an oncologist at a proper cancer medical center to learn more about this treatment and whether it is an option. Some patients may not be eligible for this treatment due to advanced disease or specific type of mesothelioma.

An oncologist will determine the length of treatment and type of drugs based on an individual’s mesothelioma diagnosis. When it comes to treating mesothelioma, each patient has a different path and faces different challenges, but preparing for treatment can reduce stress and help improve recovery time. Here are some general guidelines to ensure the body and mind are ready.

Before Chemo Treatment

• Schedule Screenings: Doctors and oncologists will run a series of tests before treatment, assessing the heart, lungs, and kidneys function to ensure the patient is healthy enough to begin chemotherapy. These screenings will also help determine the appropriate drug type and dosage. Chemo drug shortages are also reported, so calling ahead is always wise.
• See the dentist: A dental exam will ensure your teeth and gums are healthy and don’t have any signs of infection. Chemotherapy drugs are used to kill cancer cells, but they can also damage healthy cells in the mouth. Side effects include a swollen or blistered tongue, pain in the gums, and decreased saliva. These symptoms can worsen if there is a preexisting oral infection. A dentist will not only examine and clean your teeth, but he or she can also provide tips or prescribe supplements to keep your mouth healthy during treatment.
• Rest and relax: Arrive at the doctor’s office as rested and relaxed as possible. While the idea of treatment is stressful for many patients, consider it a positive part of the healing process. Maintaining a positive outlook will help to improve mental health support and the process as a whole.
• Ask for help: Certain side effects, like nausea and vomiting, may mean patients will have to stay close to home or in bed during recovery. Having a few family members or close friends around can be helpful to run errands and assist with basic household chores. There are also companies that offer services such as dog walking and grocery and meal delivery for a fee.

Common Side Effects of Chemotherapy

While receiving chemotherapy treatments, most patients will experience some side effects. Different drugs and dosages can affect patient health in various ways. Common side effects include:

• Nausea
• Vomiting
• Diarrhea
• Body bruises and mouth sores
• Fever
• Fatigue
• Diminished appetite
• Changes in taste
• Numbness or tingling in hands or feet

Late-Stage Side Effects

Depending on the type of chemotherapy drugs, specific side effects may not appear for months or even years after treatment.

• Heart or lung damage
• Infertility
• Nerve problems
• Kidney disease

While these side effects are common during chemotherapy treatments, they don’t have to disrupt daily life completely. Talk to your doctor about medications and emerging treatments that can help alleviate symptoms.

How Effective is Chemo for Mesothelioma?

Chemotherapy is a powerful tool against mesothelioma, targets fast-growing cancer cells to slow down or halt tumor growth. This essential treatment works alongside radiation and surgery for a comprehensive approach, whether given systemically or during surgery. Although side effects may occur, advancements in medical care and personalized dosing aim to minimize discomfort while maximizing effectiveness. Remember, you’re not alone in this journey—lean on your loved ones and medical team for support. Stay positive and take care of yourself throughout the process. Download our free guide to learn more and access additional resources for your mesothelioma battle.”

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