The term “chemotherapy” means, literally, “chemical therapy.” It refers, in general, to the treatment of a disease with some form of drug, but in the last 50 to 60 years has become a term that is most closely identified with the treatment of all types of cancer. Indeed, chemotherapy is often the first course of treatment for those with a variety of kinds of cancers, and because mesothelioma is usually diagnosed in its later stages, surgery is rarely an option and chemotherapy is almost always suggested. It can be used by itself or in tandem with other treatments, including radiation therapy.
Unfortunately, coping with the idea of having chemotherapy can be as frightening as dealing with the disease itself. Everyone has heard horror stories about the side effects of chemotherapy drugs and some patients opt not to follow a course of treatment that involves chemotherapy, preferring instead to maintain quality of life, especially if they have only a short time left to live. However, with the advent of newer chemo drugs as well as other medications to treat side effects, chemotherapy is becoming less of a trial for many cancer patients, and its use is adding some significant time to the life span of mesothelioma victims.
Normal cells within a body grow and divide in a controlled pattern. Cancer cells, however, do not. They are out of control and grow in an illogical order. Chemotherapy drugs, of which there are more than 100 on the market, work to stop the multiplication of these cancer cells by killing them. Unlike radiation or even surgery, chemotherapy can work on cancer that has metastasized because it can kill these rapidly dividing cells in more than one location.
Each chemotherapy medication is a little different and some work better with certain kinds of cancer than with others. Currently, a medication manufactured by Eli Lilly Company, known as Alimta®, is the chemotherapy drug of choice for the treatment of mesothelioma. In fact, it is the first and only drug approved by the FDA specifically for the treatment of malignant pleural mesothelioma where surgery is not an option. When combined with a platinum agent such as Cisplatin, Alimta has forged great strides in the treatment of the disease and has – for many people – resulted in the addition of several months to their lives. Other chemotherapy medications commonly used in the treatment of malignant mesothelioma include gemcitabine, vinorelbine, carboplatin and onconase.
Chemotherapy can be administered in a few different ways. The most common ways are either intravenously (through a vein) or in pill form. Sometimes, the doctor will install a “port” to make intravenous administration easier and to avoid multiple needle sticks, keeping the patient more comfortable.
Chemotherapy can also be administered directly into the affected area. For example, people with peritoneal mesothelioma often receive intra-peritoneal chemotherapy. This is generally done after surgery to remove tumors. Also known as a chemotherapy wash, the drugs are heated and stay in the peritoneum for a few hours and are then drained. This puts medications in direct contact with the affected site and the heating of the drugs to body temperature, doctors say, increase the chemical’s ability to penetrate affected tissues.
Anyone who has received chemotherapeutic treatment will tell you that it’s no walk in the park. However, it is an essential treatment for most individuals with mesothelioma and is the treatment that has shown the most promise in fighting the disease.
An oncologist experienced in the treatment of mesothelioma will be able to choose the most efficient drugs for the treatment of this type of cancer and should be able to inform the patient as to what types of side effects to expect. Every chemotherapeutic medication is different and everyone reacts differently to treatment. Side effects can range from mild to severe, but any side effects should be reported to the doctor, even if deemed “common.” Things like high fever, signs of infection, blood in the urine, or the prolonged inability to eat or drink need to be reported immediately as these may be life threatening.
The most common chemotherapy side effects include:
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