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.
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The main chemotherapy drugs for pleural mesothelioma are pemetrexed in combination with cisplatin or carboplatin. Research shows that using some drugs together can give improved results compared with using just a single drug. Vinorelbine or gemcitabine may be used if mesothelioma comes back.
Chemotherapy is usually given through a drip into a vein (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 and be followed by a rest period of several weeks. Together, the session and rest period are called a cycle. You will probably have up to 6 cycles. However, the length and timing of the treatments and rest days of each cycle may vary from person to person.
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.
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.
Common side effects of chemotherapy include:
- tiredness and feeling weak (fatigue)
- nausea and/or vomiting
- bowel problems (diarrhoea or constipation may also be 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).
You will also be given medicines (such as anti-nausea drugs) 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.
While hair loss and scalp problems are rare with chemotherapy for mesothelioma, some hair thinning may occur. Some people have trouble thinking clearly or experience short-term memory loss after chemotherapy, but this usually improves once treatment ends.
Video: What is chemotherapy?
Watch this short video to learn more about chemotherapy.
Podcast: Making Treatment Decisions
Dr Anthony Linton, Medical Oncologist, Concord Cancer Centre and Concord Repatriation General Hospital, NSW; Dr Naveed Alam, Thoracic Surgeon, St Vincent’s Hospital Melbourne and Monash Medical Centre, VIC; Donatella Arnoldo, Consumer; Polly Baldwin, 13 11 20 Consultant, Cancer Council SA; Dr Melvin (Wee Loong) Chin, Medical Oncologist, Sir Charles Gairdner Hospital and National Centre for Asbestos Related Diseases, WA; Prof Kwun Fong, Thoracic and Sleep Physician and Director, UQ Thoracic Research Centre, The Prince Charles Hospital, and Professor of Medicine, The University of Queensland, QLD; Vicki Hamilton OAM, Consumer and CEO, Asbestos Council of Victoria/GARDS Inc., VIC; Dr Susan Harden, Radiation Oncologist, Peter MacCallum Cancer Centre, VIC; Penny Jacomos, Social Worker, Asbestos Diseases Society of South Australia, SA; Prof Brian Le, Director, Parkville Integrated Palliative Care Service, The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, VIC; Lung Cancer Support Nurses, Lung Foundation Australia; Jocelyn McLean, Mesothelioma Support Coordinator, Asbestos Diseases Research Institute, NSW; Prof David Morris, Peritonectomy Surgeon, St George Hospital and UNSW, NSW; Joanne Oates, Registered Occupational Therapist, Expert Witness in Dust Diseases, and Director, Evaluate, NSW; Chris Sheppard and Adam Barlow, RMB Lawyers.
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