Chemotherapy for pleural mesothelioma
Chemotherapy uses drugs to kill or slow the growth of cancer cells while causing the least possible damage to healthy cells.
The main chemotherapy drugs for pleural mesothelioma are pemetrexed in combination with cisplatin or carboplatin. Research shows this combination can improve quality of life and increase survival by a few months more than using a single drug.
The goals of chemotherapy are not only to increase length of life but also to shrink the cancer, reduce symptoms and improve quality of life. However, chemotherapy doesn’t work for some people.
Learn more about:
- Having chemotherapy
- Side effects of chemotherapy
- Recent advances in treating mesothelioma
- Video: What is chemotherapy?
Chemotherapy is usually administered into a vein through a drip (intravenously). The drugs travel through the bloodstream and reach the entire body. This is known as systemic chemotherapy.
You will usually have chemotherapy during day visits to your hospital or treatment centre. Each session may last for several hours followed by a rest period of several weeks. Together, the session and rest period are called a cycle. You will probably have up to six cycles. However, the length and timing of the treatment and rest days of each cycle may vary.
Most chemotherapy drugs cause side effects. Side effects depend on the type and dose of chemotherapy drugs.
Your specialist may prescribe vitamin B12 injections and low-dose folic acid, which have been shown to reduce the side effects of pemetrexed and cisplatin chemotherapy. You will also be given medicines (such as anti-nausea medicine) to help control any side effects that are likely to occur. If side effects become too difficult to manage, your oncologist can adjust the dose or type of chemotherapy.
Common side effects of chemotherapy include:
- tiredness and feeling weak (fatigue)
- nausea and/or vomiting
- bowel problems (diarrhoea or constipation caused by anti-nausea drugs)
- sore or dry mouth, or small ulcers in the mouth
- taste changes and/or loss of appetite
- increased risk of anaemia (low level of red blood cells)
- reduced kidney function
- skin rash
- numb or tingling hands or feet (peripheral neuropathy)
- ringing in the ears (tinnitus) or hearing loss
- red and itchy eyes (conjunctivitis).
Chemotherapy weakens the immune system by lowering the level of white blood cells, making it harder for your body to fight infections. If you have a temperature over 38oC, contact your doctor immediately or go to your nearest hospital emergency department.
While hair loss and scalp problems are rare with chemotherapy for mesothelioma, hair may thin. Some people have trouble thinking clearly or experience short-term memory loss after chemotherapy, but this usually improves once treatment ends.
Mesothelioma treatment has improved in recent years. There are more accurate ways to diagnose and stage the disease, better surgical techniques and post-surgery care, new evidence-based chemotherapy combinations and new radiation therapy methods.
Clinical trials are testing promising new drugs called immunotherapy for treating mesothelioma. Immunotherapy slows the growth of cancer or kills cancer cells by altering the body’s immune system response. Immunotherapy does not work for most people with mesothelioma, but some people may have good results from this treatment.
Immunotherapy for mesothelioma is still experimental and available only through a clinical trial. In NSW, some people who have responded to chemotherapy may be able to get help paying for immunotherapy through icare Dust Diseases Care. Talk to your specialist about whether immunotherapy is an option for you.
Video: What is chemotherapy?
A/Prof Brian McCaughan, Cardiothoracic Surgeon, Chris O’Brien Lifehouse, NSW; Theodora Ahilas, Principal Lawyer, Maurice Blackburn Lawyers, NSW; Prof David Ball, Director, Lung Service, Peter MacCallum Cancer Centre, VIC; Shirley Bare, Consumer; Cassandra Dickens, Clinical Nurse Consultant, Cancer Care Coordinator – Thoracic Malignancies, Sunshine Coast University Hospital, QLD; Penny Jacomos, Social Worker, Asbestos Diseases Society of South Australia, SA; A/Prof Thomas John, Medical Oncologist, Senior Clinical Research Fellow, Austin Health, and Olivia Newton-John Cancer Research Institute, VIC; Victoria Keena, Executive Officer, Asbestos Diseases Research Institute, NSW; Penny Lefeuvre, Consumer; Jocelyn McLean, Mesothelioma Support Coordinator, Asbestos Diseases Research Institute, NSW; Prof David Morris, Peritonectomy Surgeon, St George Hospital and University of New South Wales, NSW; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council Western Australia; Prof Anna Nowak, Medical Oncologist, Sir Charles Gairdner Hospital, and Professor of Medicine, School of Medicine and Pharmacology, The University of Western Australia, WA; Prof Jennifer Philip, Palliative Care Specialist, St Vincent’s Hospital, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, VIC; Nicole Taylor, Acting Lung Cancer and Mesothelioma Cancer Specialist Nurse, The Canberra Hospital, ACT. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title. Previous editions of this title and related resources were funded in part by the Heads of Asbestos Coordination Authorities and a donation from Lyall Watts.
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