Mesothelioma Guide’s registered nurse, Karen Ritter, has created a list of questions for those fighting mesothelioma cancer to ask their doctor about chemotherapy. For more information about mesothelioma or questions about treatment options, please contact Karen at karen@mesotheliomaguide.com.
Chemotherapy for mesothelioma is an FDA-approved treatment. In 2004, the FDA approved the combination of chemotherapy drugs pemetrexed (Alimta) and cisplatin to treat mesothelioma.
Many people diagnosed with mesothelioma are not eligible for surgery, which makes chemotherapy one of the first options considered for treatment. There are also many questions about the therapy, most notably about the side effects associated with it and whether it is possible to maintain a good quality of life during and after the treatment.
Mesothelioma Guide recommends patients and caregivers ask their doctor these important questions when considering chemotherapy as a treatment option for their mesothelioma.
What Chemotherapy Drugs Are Approved to Treat Mesothelioma?
Chemotherapy has been a standard of care for the treatment of mesothelioma for years. The FDA approved a chemotherapy treatment using the combination of pemetrexed and cisplatin, and studies have shown this combination therapy to be effective in improving survival and reducing the symptoms of mesothelioma.
There are occasions when cisplatin is not well-tolerated. In these cases, cisplatin is replaced with carboplatin (another platinum-based chemotherapy drug). The choice to use chemotherapy to treat mesothelioma can depend on many factors, such as the patient’s overall health, stage of cancer and specific type of mesothelioma.
Talk to your mesothelioma doctor to find out what treatment options are right for you and your specific type of mesothelioma.
How Often Will I Receive Treatment for Mesothelioma?
Chemotherapy treatments are typically given in cycles with a rest period in between the treatment sessions. The medical oncologist determines the number of treatment cycles and the specific chemotherapy medications to use. These decisions depend on your specific type of mesothelioma and the extent of the disease.
Chemotherapy is an aggressive treatment approach, often associated with difficult side effects that can impact the patient’s health and their ability to fight off infection. The rest periods between the chemotherapy cycles are necessary to give the body time to recover and rebuild healthy blood cells – ensuring the patient is ready for the next treatment.
What Is the Goal of Chemotherapy Treatment for Mesothelioma?
When fighting mesothelioma, the goal of chemotherapy often depends on the stage of the disease and the overall treatment plan.
Chemotherapy is a first-line treatment option and a standard of care for the treatment of mesothelioma. This treatment has been widely used and is scientifically proven from clinical trials and other medical studies.
The goal of mesothelioma chemotherapy is to control the spread of the disease, shrink tumors, and improve survival. Chemotherapy has also been found to diminish the symptoms of mesothelioma and improve quality of life. Treatment goals are individualized and may depend on the patient’s specific type of mesothelioma, overall health and extent of the disease.
What Are the Potential Side Effects of Chemotherapy for Mesothelioma?
Chemotherapy is an aggressive treatment to fight mesothelioma. The drugs circulate throughout the body and target cells that replicate and grow quickly. This is why chemotherapy is effective in killing cancers like mesothelioma that have cancer cells replicating and dividing fast.
There are normal cells in the body that also divide and replicate quickly, and chemotherapy may attack these healthy cells – resulting in side effects. Despite the side effects, chemotherapy is often a treatment of choice to combat mesothelioma.
The potential side effects of chemotherapy for mesothelioma include:
- Fatigue
- Nausea
- Vomiting
- Diarrhea
- Mouth sores
- Low blood counts
Mesothelioma patients should discuss the potential side effects of chemotherapy with their doctor. It is important to understand what to expect and how the doctor plans to manage adverse effects.
How Will We Know if Chemotherapy Is Working?
Evaluating the therapeutic effects of chemotherapy on mesothelioma involves regular monitoring and physical exams by the doctor.
Periodic testing and evaluations during the treatment cycles and at the completion of the treatment rounds will be performed. It is important to evaluate the effectiveness of the chemotherapy on the mesothelioma tumors. The doctor will monitor any changes in tumor size or progression of the disease using imaging tests like CT scans, MRI scans and PET scans.
Blood tests, including tumor markers and mesothelin levels, are also often used to monitor progress and are compared to previous results. Additionally, doctors assess changes in symptoms and the patient’s overall health. It’s crucial that the physicians evaluate the whole patient and not just the test results.
The testing and physical exams will provide a benchmark to help doctors determine if the chemotherapy has provided effective results or if changes to the treatment plan are needed.
Does the Treatment Improve Survival?
Mesothelioma is often difficult to treat. The recent advancements in treatment options have given mesothelioma patients hope of extended survival and improved quality of life.
Studies show chemotherapy is an effective treatment option for fighting mesothelioma. Chemotherapy’s goal is to stop the progression of the disease, shrink tumors, and help prevent the spread of mesothelioma to other parts of the body. This is especially true for patients who are not candidates for surgery.
Without mesothelioma treatment, the median survival is 4-12 months.
With treatment, some patients may achieve survival rates of:
- 12-24 months with chemotherapy alone
- 18-36 months with multimodal (combined) therapies
Longer survival has been seen in some patients who have had an early diagnosis and exceptional responses to their treatments.
It is also important to understand that survival outcomes vary greatly depending on the stage of disease at the time of diagnosis, the patient’s overall health status, and the type of mesothelioma.
What Is the Success Rate of Chemotherapy for Mesothelioma?
At this time, there is no known cure for mesothelioma, but chemotherapy is a proven treatment option to help people fight this rare cancer and extend their survival.
Mesothelioma patients treated with chemotherapy – FDA-approved pemetrexed and cisplatin – have seen an average tumor response (tumor shrinkage or no new tumor growth) of approximately 40% and an average survival of 12-17 months.
While chemotherapy alone can extend survival and improve symptoms, the introduction of advanced treatment combinations using chemotherapy with other therapies (like surgery or immunotherapy) have led to improved results:
- 16 months median survival for systemic chemotherapy before or after pleural mesothelioma surgery
- 22 months median survival for intraoperative chemotherapy with surgery for pleural mesothelioma
- 35 months median survival for surgery, photodynamic therapy and systemic chemotherapy for pleural mesothelioma
- 53 months median survival and 47% 5-year survival rate for intraoperative chemotherapy with surgery for peritoneal mesothelioma
Results vary depending on the stage of disease, patient’s overall health, patient’s age, and type of mesothelioma. Chemotherapy for mesothelioma has shown to improve survival, reduce tumor size, and alleviate symptoms. With continued research there is hope for advancements and improvements in mesothelioma treatments.
Is IV (Intravenous) Chemotherapy the Only Form Used for Mesothelioma?
The most common type of chemotherapy for mesothelioma is intravenous, or IV chemotherapy. It is considered a systemic treatment, which means it is something that can affect the entire body. Systemic chemotherapy is most often given through an IV. The drugs travel through the bloodstream to find and kill cancer cells.
Another form of chemotherapy used to treat mesothelioma is intraoperative chemotherapy. This is a localized treatment where a liquid chemotherapy solution is delivered directly into the affected area, such as the chest for pleural mesothelioma or the abdominal cavity for peritoneal mesothelioma.
Mesothelioma patients should maintain open and honest communications with their treatment team regarding chemotherapy. Discuss treatment options, goals, potential side effects, and expectations with your doctor. Taking an active role in the decisions regarding your treatment plan will help you navigate your mesothelioma journey with confidence.
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