Chemotherapy
Broadly speaking, the word chemotherapy can apply to drugs that treat disease by killing cells, but most often, it is used to describe drugs used in cancer treatment.
Most chemotherapy drugs work by targeting specific metabolic processes in cells that are dividing rapidly, and work by preventing cell division or killing these cells. The method of action of these drugs means cancer cells—which are constantly and rapidly dividing—are killed by mesothelioma chemotherapy drugs.
The drawback, however, is that these drugs are not specific. Rather than specifically targeting cancer cells, they target all cells that are dividing rapidly. This means that cells involved in hair growth and cells of the immune system may also be killed when a person undergoes chemotherapy. Furthermore, this means a person undergoing chemotherapy may lose their hair, and is also highly vulnerable to infections.
There are seven chemotherapeutic drugs that are most commonly used to treat mesothelioma. Most of these drugs cause side effects such as nausea, vomiting, and loss of appetite, as well as hair loss and come with a higher risk of developing infections.
Deciding which chemotherapy option is best depends on factors such as the type of mesothelioma , the stage of development, and whether you have any other treatment options. Overall physical health is also important.
Alimta (AKA Premextred): This drug is usually used in conjunction with Cisplatin to treat people with pleural mesothelioma. In most cases, people who receive this treatment are not good candidates for surgery. Treatment is administered every three weeks, and each session usually lasts around two hours. People receiving these chemotherapy drugs must take B vitamins and folate (also a B vitamin) supplements to help counteract side effects.
Cisplatin: This chemotherapy drug is used in the treatment of several types of cancer in addition to ">mesothelioma. When used to treat mesothelioma it is usually used in conjunction with Alimta, as combining the two drugs makes them both more potent. Treatments are administered in two hour sessions every three weeks. Patients must take supplements of folate and other B vitamins to counteract side effects.
Carboplatin: This drug is a modified version of Cisplatin that has reduced side effects and is generally used in conjunction with non-chemotherapy mesothelioma treatments. For example, it is often administered following surgery to kill any remaining cancer cells. Cisplatin is commonly administered every 28 days, but may be given more frequently in some cases.
People with impaired liver or kidney function are not usually considered candidates to receive Carboplatin treatment due to toxicity issues and side effects.
Gemcitabine: While this drug is most often used in the treatment of lung, breast, pancreatic, and bladder cancer, it is also a treatment for pleural mesothelioma. In people with pleural mesothelioma, Gemcitabine is usually used after surgery. The surgery is carried out to remove as much of the cancer as possible, and chemotherapy treatment follows this to kill residual cancer cells the surgery could not remove.
Patients may receive Gemcitabine as often as once a week, for up to seven weeks. Depending on the circumstances some patients may be treated for more than seven weeks. A session of treatment usually takes around 30 minutes. As with Carboplatin, this drug is not safe for people who have impaired kidney or liver function.
Navelbine: This relatively new chemotherapy drug is a semi-synthetic drug derived from the Periwinkle plant. Navelbine is usually administered once a week for several weeks, depending on the individual. This drug has produced positive results for many people with mesothelioma, and has actually been shown to slow the spread of the cancer temporarily. Most people suffer fewer unpleasant side effects when being treated with Navelbine.
Onconase: This is another new semi-synthetic chemotherapy drug that is derived from an unusual source—the eggs and embryos of the leopard frog. Onconase has been used to treat a wide range of cancers, including mesothelioma. Clinical trials have shown promising results. Many mesothelioma patients have had increased survival times, some up to two years. The drug is administered once per week for several weeks, and each session lasts for around 30 minutes.
Heated Chemotherapy: This type of chemotherapy treatment is very different from others. While most chemotherapy treatments are administered intravenously, heated chemotherapy is administered during surgical procedures carried out on people with peritoneal mesothelioma (this type of chemotherapy is not an option for any other types of mesothelioma).
Heated chemotherapy proceeds following surgery, which aims to remove the bulk of cancerous tumors from the peritoneal cavity. During the chemotherapy treatment the cavity is perfused with chemotherapy drugs that have been heated slightly above body temperature. The increased heat allows the drugs to penetrate deeper into the tissues. This type of treatment is particularly advantageous in patients for this reason, and because patients experience fewer side effects due to the site-specific delivery of the drugs.