Chemotherapy is considered one of the most effective methods for treating mesothelioma, particularly when the cancer is unresectable. There are currently more than 100 chemotherapy drugs approved for cancer treatments of all types of cancers, and of these, several may be used for mesothelioma.

Purpose of Mesothelioma Chemotherapy Treatment 

The purpose of chemotherapy treatment is to destroy mesothelioma cells or to slow the growth of cancerous cells. However, there are four ultimate goals of chemotherapy depending on the type and stage of the mesothelioma:

• Curative: The goal is to destroy the mesothelioma cells completely or to slow its metastasis (spreading)
• Neoadjuvant: The goal is to reduce the size of the mesothelioma tumors before another treatment.  This is most typically performed before surgery to make excision of tumors easier.
• Adjuvant: The goal is to destroy remaining mesothelioma cells which may not have been removed during surgery.
• Palliative: The goal is to relieve symptoms being caused by the tumor.  Palliative chemotherapy is performed when there is no likelihood that the tumor can be drastically shrunk or eliminated by chemotherapy and/or other treatments. 

In other words, chemotherapy is used to kill cancer cells in the tumor or cells that have spread to other parts of the body. By killing the cells, the cancer will either be cured or its growth will be slowed if all of the cells are not destroyed.. 

Chemotherapy has been found most effective when it is given as a combination regimen, meaning that more than one chemotherapy drug is administered during treatments.  Studies show that two chemotherapy drugs are significantly more effective in treating cancer than one sole agent used alone.  The use of three chemotherapy agents has not shown any notable benefits over the use of two drugs. However, combination therapies have only proven effective in generating higher response rates but have not improved median survival rates. That may change as genetic studies enable researchers to identify aberrant receptors in the cells of tumors.¹

There are exciting new advances in chemotherapy because of medical advances in genetics. Chemotherapy regimens for cancer are now more effective because the mixture of drugs can be designed for a particular person’s genetics. In other words, a chemotherapy drug can be designed to destroy specific cancer cells while leaving healthy cells intact. Research in the area of mesothelioma cancer has a long way to go but there are studies now being done to determine if targeted chemotherapy can improve survival rates or even eventually cure mesothelioma victims. Targeted chemotherapy agents for mesothelioma being researched include inhibitors of intracellular effectors and cancer cell growth factor receptors.²

How is Chemotherapy Administered for Mesothelioma? 

Chemotherapy drugs are most commonly administered intravenously or orally.  However, chemotherapy can be administered directly to the areas of infection.  These methods of administration can vary considerably.  For example, chemotherapy drugs can be delivered via arteries through pumps implanted between the muscle and skin.  For mesothelioma in the pleural area, chemotherapy may be administered through a chest tube into the pleural cavity.

How frequently a dosage of chemotherapy is administered will be determined on an individual basis. The treatment schedule will depend on various factors including how the patient reacts to treatment and how the mesothelioma is responding to treatment. 

Side Effects of Chemotherapy 

Chemotherapy works by destroying or slowing the growth of cells which divide rapidly.  This includes mesothelioma cells but also many other types of healthy cells. Depending on the type of chemotherapy treatment used, different cells may be affected which can produce varying side effects.  The healthy cells which are most commonly affected by chemotherapy drugs include:

• Bone marrow
• Digestive system
• Hair and skin
• Lining of the mouth

The healthy cells are typically able to repair themselves after the damage caused by chemotherapy whereas the mesothelioma cells are unable to repair themselves.  Thus, symptoms abate after chemotherapy treatment is stopped. Common side effects of chemotherapy include:

• Nausea
• Hair loss
• Anemia
• Changes to appetite
• Diarrhea/constipation
• Inflammation
• Low libido
• Pains

While it is common for patients receiving chemotherapy for mesothelioma to have side effects, not all patients have severe or any side effects.  Patients should talk to their doctors on an individual basis about what to expect from their chemotherapy treatment.

There are a number of clinical trials that are investigating chemotherapy drugs that can be tailored to the patient. As a participant, these trials give you access to the latest treatments or targeted therapies.³

¹ Pasi A. Jänne, (2008) Chemotherapy for Malignant Pleural Mesothelioma.Clinical Lung Cancer, v5:2, 98-10, doi: 10.3816/CLC.2003.n.023.

² Palumbo, C., Bei R., Procopio A. and Modesti A. (2008) Molecular targets and targeted therapies  for malignant mesothelioma. Curr Med Chem, v15:9, 855-867.

³ Chemotherapy (2011) Retrieved from The University of Chicago Medical Center at: http://www.uchospitals.edu/specialties/cancer/chemotherapy/