Mesothelioma Chemotherapy-A Basic Overview

Chemotherapy is one of the commonly used conventional treatments for mesothelioma cancer. Chemotherapy is cancer treatment with anti-cancer drugs. There are 2 main ways that anti cancer drugs can be administered:

1- Chemotherapy can be given systematically. In systemic therapy, the anti cancer drugs are swallowed in pill form or injected into a vein. The drug enters the bloodstream and circulates throughout the body to get to the cancer cells wherever they may be and kill them.

2-Chemotherapy can also be administered locally. In this form of delivery, the chemotherapy drugs may be given intrapleurally (directly into the chest cavity) or intraperitoneally (into the abdominal cavity) through a small incision in the chest or abdominal wall. This approach may allow doctors to give higher doses of chemotherapy to the tumor while limiting the side effects to the rest of the body. Chemotherapy drugs given this way may be heated first (hyperthermic chemotherapy), which may help them work better.

Chemotherapy may be given as an addition to surgery; it could be administered before or after the surgery. When it is given before the surgery it is referred to as neoadjuvant therapy and when it is given after surgery it is referred to as adjuvant therapy.

For advanced tumors that are not operable, chemotherapy can be used as the main form of treatment (alone or along with radiation therapy). Chemotherapy may slow the progression of the disease, but it is very unlikely to give a total cure.

Chemotherapy is given in cycles, with each period of treatment followed by a rest period to allow the body time to recover. Chemotherapy cycles generally last about 3 to 4 weeks. Chemotherapy is often not recommended for patients in poor health, but advanced age by itself is not a barrier to getting chemotherapy.

Several chemotherapy drugs have been used to treat mesothelioma. The most commonly used chemo combination to treat mesothelioma is the combination of pemetrexed (Alimta) and cisplatin. Pemetrexed interferes with levels of folic acid and vitamin B12 in the body, so these must also be given to avoid certain side effects.

Other chemotherapy drugs used to treat mesothelioma include:
• gemcitabine
• carboplatin
• methotrexate
• vincristine
• vinblastine
• mitomycin
• doxorubicin
• epirubicin
• cyclophosphamide
• ifosfamide
These drugs are usually given in combinations of 2 or more, but single drugs can be used in people who may not be able to tolerate combinations of drugs. Several other drugs are also being studied to determine their effectiveness in treating mesothelioma.

Side effects of chemotherapy drugs

The mode of action of chemotherapy drugs is to attack rapidly diving cancer cells in the tumor growth, but in doing so they also attack other normal rapidly diving cells of the body like those in the bone marrow, the lining of the mouth and intestines, and in the hair follicles. These cells are also likely to be affected by chemotherapy, which can lead to the development of side effects.

The side effects of chemotherapy depend on the type and dose of drugs you are given and on how long they are used for. These side effects can include:
• hair loss known medically as alopecia
• mouth sores
• loss of appetite also known medically as anorexia
• nausea and vomiting
• increased chance of infections (due to low white blood cell counts)
• easy bruising or bleeding (due to low blood platelet counts)
• fatigue (due to low red blood cell counts)

These side effects are usually temporary and usually disappear once treatment is over. There are often ways to lessen these side effects. For example, there are drugs that can be given to help prevent or reduce nausea and vomiting. Be sure to ask your doctor or nurse about medicines to help reduce side effects, and let him or her know when you do have side effects so they can be managed effectively.

Some of these chemotherapy drugs also have side effects that are peculiar to them. For example, cisplatin can cause nerve damage. This nerve damage can sometimes lead to hearing loss or abnormal sensations in the hands and feet such as pain, burning or tingling sensations, hypersensitivity to cold or heat, or weakness. (This is called peripheral neuropathy.) In most cases this goes away once treatment is stopped, but it may last a long time in some people.

All side effects should be promptly reported to your health team once they are noticed when you are on chemotherapy so that they can be dealt with promptly. Sometimes the dosage of the drugs will have to be reduced or treatment will have to be temporarily stopped or delayed to prevent the side effects from getting worse.

About the Author: Bello kamorudeen.


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