One of the most popular mesothelioma treatment options is chemotherapy, which involves treating the disease through targeting cancerous cells with anti-cancer drugs. Sometimes a patient’s health or cancer type, or stage prevents more direct procedures, like surgery, and chemotherapy becomes the main treatment option. Chemotherapy may then be the sole treatment, or be used in conjunction with radiation therapy. Although chemotherapy may succeed in slowing the progression of mesothelioma, it is rare for it to succeed as a curative measure on its own.    

Chemotherapy Types

The anti-cancer drugs used in chemotherapy may be given to patients in two different ways. For systemic therapy, patients either swallow the medication in a pill form or have it injected into a vein. Both methods allow it to enter the bloodstream, where it can circulate throughout the body to target cancer cells wherever they are.

The other technique of administering chemotherapy involves inserting the drugs directly into the body where the cancer resides. These are given either intrapleurally, directly into the chest cavity, or intraperitoneally, into the abdominal cavity. A catheter is used to transport the drugs through a small incision in the affected area of the body. Although this method of giving patients chemotherapy still allows the drugs to be absorbed into the bloodstream, higher concentrations of the drugs go directly to the diseased locations. Using this chemotherapy approach allows doctors to give higher doses of these drugs to the tumor while also limiting unfavorable side effects.

Chemotherapy drugs administered directly into the tumor site are also sometimes heated first, called hyperthermic chemotherapy. There is evidence that first heating these drugs may increase their effectiveness. This treatment is also sometimes given to patients once right after surgery to remove cancerous tissue. This use after surgery, called adjuvant therapy, helps eliminate any cancerous tissue doctors may have missed due to their small size. This treatment may help prevent or delay the return of cancer. However, chemotherapy may also be given before mesothelioma surgery, called neoadjuvant therapy, in order to shrink the cancer and decrease its chances of spreading.

Treatment Variables

This treatment can involve the use of different drug combinations, which depend on several factors. These factors include the type of mesothelioma cancer being treated, the stage, and any other treatments the patient is simultaneously receiving. Furthermore, the age and general health of the patient must be taken into account before this treatment is administered, though unlike other treatments, older patients may still be eligible.

When administering chemotherapy, doctors generally do so in cycles, with a rest period following each treatment period, allowing the patient’s body to recover. Generally given in cycles lasting three to four weeks, several chemotherapy drugs have been used in the treatment of mesothelioma. Today most doctors use pemetrexed and cisplatin, though pemetrexed lowers folic acid and B12 levels, necessitating their replenishment. In addition, several other chemotherapy drugs are used to treat mesothelioma patients and they are usually given in combinations of two or more. However, for some patients too weak to tolerate a combination of medications, one drug may be used. Currently, several additional drugs are being studied for use in the fight against mesothelioma. The current list of chemotherapy drugs used to treat patients includes the following:

• Carboplatin
• Cyclophosphamide
• Doxorubicin
• Epirubicin
• Gemcitabine
• Ifosfamide
• Methotrexate
• Mitomycin
• Vinblastine
• Vincristine

Chemotherapy Side Effects 

Unfortunately, these chemicals do not only kill rapidly-dividing cancer cells, but healthy ones as well.  These healthy cells that are attacked include those located in bone marrow, the intestines and the lining of the mouth, as well as hair follicles. This further weakens patients who may have already been fighting the natural fatigue of disease. Other common side effects of chemotherapy include nausea, vomiting, loss of appetite, hair loss, diarrhea and easy bruising or bleeding. In addition to taxing one’s energy level, chemotherapy drugs also make patients more susceptible to infections or other ailments.   

Although the side effects of these drugs are generally short term, going away after treatment ends, patients can still lessen their effects. Methods to improve comfort during treatment include taking other medications to help fight nausea and vomiting.