There are three traditional kinds of treatment for patients with malignant mesothelioma: Surgery (taking out the cancer), chemotherapy (using drugs to fight the cancer), and radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells). This article focuses on the use of chemotherapy to treat mesothelioma.
Generally, chemotherapy drugs work by targeting specific processes in cells that are undergoing rapid division and growth, preventing cell division, resulting in the death of the cancerous cells. Because in the past surgery alone has failed to effect a cure, or even to help prolong life for any extended period of time, it is currently being combined with traditional chemotherapy and/or radiation, or other new approaches such as gene therapy, immunotherapy or photodynamic therapy.
Since chemotherapy for mesothelioma is not considered "curative", the goal is to control the cancer by stopping its spread or slowing its growth. The most common use for chemotherapy in mesothelioma patients is as an option for those who are not surgical candidates. However, cancer centers are conducting trials using the neoadjuvant approach (giving chemotherapy before surgery).
The most common way to administer chemotherapy is intravenously, or through a vein. Intraperitoneal chemotherapy may also be delivered through a catheter or a port. In general, chemotherapy treatment is administered in "cycles". A "cycle" being defined as a period of treatment followed by a period of rest. The number of treatment cycles, or the length of time between the beginning and end of chemotherapy may vary. In general, 3 to 4 cycles of treatment are given before response is evaluated and 2 to 3 cycles are considered a minimum to assess for effectiveness.
After response to the treatment has been determined, the following criteria will be used to decide whether chemotherapy should continue:
1. If there is shrinkage of the tumor, or the disease is kept stable, chemotherapy may be continued for as long as it can be tolerated and there is no disease progression.
2. If there is continued disease progression, chemotherapy will be stopped, and the patient will be given alternative options.
One of the most common side effects, and one your doctor will monitor carefully, is a chemotherapy-induced low white blood cell count (neutropenia) which means your immune system is weakened, therefore leaving you more prone to infection. While this side effect is anticipated when someone is undergoing chemotherapy, it can cause delays in your treatment schedule, or changes in the dosage of the drugs you will receive. Most chemotherapy drugs have specific side effects such as nausea, vomiting, loss of appetite, hair loss, and increased vulnerability to infection.
Understanding the various chemotherapy options and available treatments often helps patients and their loved ones make the best decision for their personal situation. Deciding which chemotherapy option is the best treatment for specific mesothelioma cases depends on a number of factors, including the type of mesothelioma, the stage of the disease, and other treatment being administered. Factors such as overall physical health and age are also taken into consideration when detailing a chemotherapy treatment plan. Many mesothelioma patients will consider chemotherapy as a treatment option.
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