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

Methods for administering chemotherapy are being studied constantly. Over the past few decades, chemotherapy has improved survival rates by leaps and bounds. Seeing a mesothelioma specialist is essential to receive the best treatment possible.

Advances in Chemotherapy

  • Pre-Surgery Chemotherapy

    Pre-surgery reduction of tumors, making surgery more efficient and successful. This is known as neoadjuvant chemotherapy.

  • Post-Surgery Chemotherapy

    Post-surgery eradication of mesothelioma cells, leading to longer life expectancies and survival. This is known as adjuvant chemotherapy.

  • Improving Survival

    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

Chemotherapy Types

  • Neoadjuvant Chemotherapy

    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

    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

    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.

Delivery Methods

Patients who receive chemotherapy may be given the drug in a variety of ways. The method in which they receive the chemotherapy is based on the type of mesothelioma they have, the location of the cancer, and their overall health.

Intravenous Delivery

The most common way to administer chemotherapy is intravenously. This process can take anywhere from a few minutes to several hours. Sometimes the chemotherapy is administered through an injection directly into a vein.

Other times, the chemotherapy may be infused through a “drip” which includes an IV line into the patient’s vein. The line is attached to a plastic bag containing the liquid chemotherapy and takes longer than an injection.

Chemotherapy Port (Port-a-Cath)

Doctors may recommend a chemotherapy port (port-a-cath) for some patients. The port is a small device implanted beneath the patient’s skin. Patients who receive ports are placed under local anesthesia while their port is installed. This usually happens about a week before chemotherapy treatment begins.

Chemotherapy Port Delivery Mesothelioma TreatmentPorts are most commonly inserted through a small incision in the upper part of the chest, and sometimes they are implanted in the upper arm. A port is used in patients who receive chemotherapy for an extended period of time (usually more than 4 cycles).

A catheter is inserted from the port into an artery, which allows the chemotherapy to spread throughout the patient’s body quickly and easily. During chemotherapy, a small needle is inserted (like a shot) into the port and the chemotherapy is delivered.

No special care is needed for the ports. Patients may see a small lump on their skin where the port is placed, but clothing can hide it easily.

Oral Delivery

Chemotherapy may also be administered orally in pill form and can be taken at home. While most mesothelioma chemotherapy is delivered intravenously, there is a developing treatment option using the oral drug, Pazopanib.

In the study, the Pazopanib pill outperformed previous oral chemotherapy tests and showed fewer side effects. Chemotherapy pills contain a lower dosage of chemotherapy than what is given intravenously; however, these pills must be taken every day.

Chemotherapy capsules must be taken at certain times of the day or with food, or they may not be as effective otherwise. This type of administration is gaining popularity because of its convenience.

Some oral drugs can cause nausea, vomiting, mouth sores, or skin changes. Patients should speak with their doctor immediately if they experience these side effects. Patients should also consult their doctor immediately if they are vomiting after treatment because the body isn’t absorbing the chemotherapy properly.

Which Chemotherapy Type Is Right For You?

The chemotherapy method prescribed by doctors depends on how advanced the patient’s disease is, their overall health and whether they are participating in clinical trials.

In order for patients to receive the most effective method of chemotherapy an experienced mesothelioma specialist is a must. Find a mesothelioma specialist near you with our free Doctor Match program.