Chemotherapy can be used in all stages of treatment. It is commonly used on its own, but it is also used in conjunction with radiation and surgery.
Chemotherapy Advances in Mesothelioma
Advances in Chemotherapy
Pre-surgery reduction of tumors, making surgery more efficient and successful. This is known as neoadjuvant chemotherapy.
Post-surgery eradication of mesothelioma cells, leading to longer life expectancies and survival. This is known as adjuvant chemotherapy.
Chemotherapy has significantly increased survival times, especially when used in a multimodal approach. Patients are now living longer than ever.
Patients who aren’t eligible for surgical procedures are still given chemotherapy. Patients with cancer that has spread to the lymph nodes and other organs are usually ineligible for surgery. Chemotherapy is still administered because it can provide pain relief and may shrink tumors.
Delivery methods for administering chemotherapy include:
- Intravenous delivery – most common
- Chemotherapy port – used in patients who receive many infusions
- Oral delivery – most convenient, still in development
Neoadjuvant chemotherapy is administered prior to surgery being performed. Doctors may prescribe chemotherapy before surgery in an attempt to shrink the existing tumors. This can make surgery more effective.One study done by Dr. Walter Weder, a thoracic surgeon in Switzerland, shows patients who receive neoadjuvant chemotherapy before an extrapleural pneumonectomy have a 32% response rate.
The response rate measures the percentage of patients who experienced a shrinking or disappearing tumor following treatment. This is compared to 21% in those who did not receive neoadjuvant chemotherapy. The same study shows median survival time increased from 13 months to 23 months after surgery.
Intraoperative chemotherapy is commonly used in patients with mesothelioma during surgical procedures. In patients with pleural mesothelioma, “heated chemo” is directly administered to the exposed area to kill any remaining cancer cells missed during the surgery. Studies show that cancerous cells cannot withstand the hot (107 degrees) medication and break up when exposed to it.
Patients with peritoneal mesothelioma are given a heated chemotherapy “bath”. Hyperthermic intraoperative chemotherapy (HIPEC) is coated over the organs to kill the left over cancer cells after a cytoreduction (removal of the abdomen lining). The abdominal cavity is filled with the HIPEC liquid and left for 90 minutes. The chemotherapy drugs are then suctioned from the abdominal cavity.
Dr. David Sugarbaker is one of the top mesothelioma doctors using intraoperative chemotherapy. He has demonstrated phenomenal survival rates among his patients using this method after surgery. Learn more about intraoperative chemotherapy in our free Mesothelioma Survivor Guide.
Adjuvant chemotherapy is used on patients following surgery. It is used as a follow up to destroy any remaining cancer cells. Researchers have found that after surgery the combination of cisplatin and Alimta have had the greatest results in extending life expectancy in patients.
Most oncologists recommend waiting two to eight weeks after surgery to start adjuvant chemotherapy. This allows ample time for the post-surgical recovery prior to any additional treatments. Adjuvant chemotherapy may also be used after radiation therapy as well.
Chemotherapy can also be used for pain relief purposes. Cancerous tumors grow quickly and may cause discomfort in patients. By shrinking the tumor, chemotherapy shrinks the tumor and relieves the pain, while also killing the cancerous cells.