Chemotherapy
Chemotherapy uses anti-cancer or 'cytotoxic' drugs to destroy cancer cells. They work by disrupting the growth of cancer cells. As they circulate in the blood, they can reach cancer cells wherever they are in your body.
How is chemotherapy given?
Chemotherapy is usually given into a vein. You may be given a treatment with a single drug or several chemotherapy drugs together.
A course of chemotherapy is made up of a number of cycles. The drugs are given to you over a few days. Then you have a break of a few weeks to allow your body to recover from the effects of the chemotherapy drugs. Then another cycle begins. The number of cycles you have depends on
Which drugs you are having
The stage of your mesothelioma
The results of your tests
How the mesothelioma responds to the treatment
Most of the treatment is given in out patients, although with some drugs you may have to stay in hospital for a day or two.
Peritoneal chemotherapy
For peritoneal mesothelioma, you may be offered chemotherapy directly into your abdomen. A small incision is made in the wall of your abdomen and a tube called a catheter is put into the incision. The chemotherapy infusion is given into the abdominal cavity through the catheter. There are fewer side effects than with chemotherapy into a vein because the chemotherapy drugs stay inside the abdominal cavity. Very little gets into the blood stream. This type of treatment is not done very often. This treatment is still experimental and you may be asked to take part in a clinical trial if you are offered this treatment.
The drugs and side effects
There is no standard treatment used to treat mesothelioma and many different combinations of drugs are used. These combinations are sometimes called chemotherapy regimes or regimens. The chemotherapy drugs used include
Mitomycin C
Cisplatin
Carboplatin
Vinorelbine
Gemcitabine
Other drugs being tested include
Pemetrexed
Irinotecan
All chemotherapy drugs have side effects. Drugs affect people in different ways. Not everyone has the same side effects with the same drug. Some people have very few side effects at all. It is not possible to tell how you will react until you have had that particular drug. It is important to remember that these effects are temporary. They will go away when your treatment is finished. All the drugs have different side effects. Ask your doctor or nurse which side effects are most common with the chemotherapy drugs you will be having.
There are some side effects that are quite common with many chemotherapy drugs. These are
A fall in the number of blood cells
Feeling and being sick
Diarrhoea
Sore mouth and mouth ulcers
Hair loss or thinning
Feeling tired and run down
Pemetrexed is an experimental drug that has shown good results in trials for mesothelioma. The commonest side effects of this drug include
A drop in the number of blood cells
Feeling or being sick
Sore mouth and mouth ulcers
Pemetrexed is a type of drug known as an anti-folate. To help control the side effects, you should be given this drug with extra folic acid and vitamin B12.
A fall in the number of blood cells will increase your risk of picking up a serious infection. Because of this risk, you should make sure you know exactly how to contact the hospital or your chemotherapy nurse. You should phone the hospital or go straight to casualty if you develop any signs of infection and especially if you get a temperature of 38 degrees C (100.5 degrees F) or higher.
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