Mesothelioma Chemotherapy

Chemotherapy (literally “chemical therapy”) is the usage of certain medicines to kill cancer cells and reduce the chances of them from multiplying. A number of different chemotherapy drugs are accessible to deal with mesothelioma, although some of these drugs have actually proven to be more effective than others.

HIPEC Treatment
Defining Mesothelioma Chemotherapy

What is Mesothelioma Chemotherapy?

Chemotherapy is one of the most frequently used treatment methods for cancer. The standard first-line chemotherapy treatment for mesothelioma is pemetrexed (Alimta ®) and Cisplatin. A few recent research studies show that combining these drugs with bevacizumab (Avastin) can enhance the effectiveness of chemotherapy against mesothelioma cancer.

Chemotherapy (literally “chemical therapy”) is the usage of certain medicines to kill cancer cells and reduce the chances of them from multiplying. A number of different chemotherapy drugs are accessible to deal with mesothelioma, although some of these drugs have actually proven to be more effective than others.

Mesothelioma is a sudden and devastating form of cancer caused by asbestos exposure. This terminal disease occurs unexpectedly usually 20 to 40 or more years after asbestos exposure. Anyone can be exposed from everyday locations, such as homes, workplaces, schools, and even by direct contact with someone who has asbestos dust contamination on their clothes. Wives and children of workers that were exposed to asbestos have also been shown to be at risk of this disease as a result of personal exposure to asbestos dust on their loved one’s clothing. According to Occupational Safety and Health Administration (OSHA), the National Institute of Occupational Safety and Health (NIOSH), the Environmental Protection Agency (EPA) and the International Company for Research study on Cancer (IARC), there is no proof of any asbestos exposure level that is considered safe. In conclusion, there is not a specific level of direct exposure that can reduce your possibility of establishing the disease. Any level of asbestos exposure may result in this degenerative disease.

If you or a loved one has been exposed to asbestos and are experiencing signs such as shortness of breath, coughing, pain in chest or abdomen, seek out a mesothelioma experienced doctor as quickly as possible in order to get appropriate treatment. If medical diagnosis is early you will have access to a wider range of treatment options with more promising outcomes.

Mesothelioma Chemotherapy

How Chemotherapy Treats Mesothelioma

Chemotherapy can be used to treat mesothelioma patients in two ways. Either or both of these methods may be used in conjunction with surgery and/or radiation, depending on the treatment plan developed by the doctor and the patient.

Chemotherapy can be given intravenously or as a pill. It then travels throughout the bloodstream and reaches the entire body. Systemic chemotherapy carries the most side effects because in addition to killing cancer cells, it also kills other fast-growing cells such as hair and blood cells.

In some cases, chemotherapy can be delivered directly to the area where tumors have formed, often with fewer side effects than systemic chemotherapy. Intrapleural chemotherapy and heated intraperitoneal chemotherapy (HIPEC) have become more popular in recent years, with great results.

Intrapleural Chemotherapy
Mesothelioma Surgery Side Effects
Mesothelioma Surgery

Mesothelioma Surgeons

The doctors who operate on mesothelioma patients often specialize in the area of the body where the tumors first form. For example, thoracic surgeons – who specialize in surgeries of the chest cavity – may perform surgery on patients with pleural or pericardial mesothelioma. There are also surgical oncologists who specialize in cancer-related surgery.

Mesothelioma Chemotherapy

First-Line and Second-Line Chemotherapy

Chemotherapy treatments are often discussed as being first-line and second-line (or even third-line) treatments. These refer to the chemotherapy treatments given first, second, third, and so on, based on their effectiveness.

The most common first-line treatment for mesothelioma is a combination – often called a “cocktail” – of pemetrexed and a platinum-based drug such as cisplatin or carboplatin. This combination has been found to be the most effective in treating mesothelioma, and therefore, it is usually administered first.

If the first-line treatment does not work, a second-line treatment may be tried. There is currently no consensus within the medical community about the best second-line treatment for mesothelioma. Doctors will often make their best decision on which drugs can best treat the disease based on the patient’s specific circumstances.

Mesothelioma Chemotherapy

Mesothelioma Chemotherapy Drugs

A number of different chemotherapy drugs can be used to treat mesothelioma. The recommended chemotherapy drug will vary with each patient. Oncologists choose the drugs they believe will most benefit the patient while also taking into consideration side effects and other important issues.

Currently, the most widely used drug and the one with which doctors have had the most success is Pemetrexed (Alimta®). This drug is usually used in tandem with a platinum agent like Cisplatin and has been shown to add several months to the patient’s mesothelioma life expectancy in many cases.

Pemetrexed (Alimta®)

Pemetrexed is the most common chemotherapy drug used to treat mesothelioma, often given in conjunction with cisplatin. It is an injected drug, and patients will often be given corticosteroids and prescribed vitamin B9 (folic acid) and B12 supplements to prevent certain harmful side effects.


Cisplatin is a platinum-based chemotherapy drug administered through an IV. Along with pemetrexed, it is one of the most common mesothelioma drugs. In many cases, doctors will treat mesothelioma patients with cisplatin for unresectable tumors (i.e., when surgery is not an option).


Another platinum-based drug, carboplatin was derived from cisplatin in the 1980s. Although it typically has fewer and milder side effects than cisplatin, it can also inhibit the body’s production of blood cells, leading to an increased likelihood of fatigue and infection.

Gemcitabine (Gemzar)

Typically administered in combination with carboplatin, gemcitabine is used to treat lung, bladder, and ovarian cancers. In clinical trials, it has been shown to be a relatively effective chemotherapy treatment for mesothelioma, and is often used as a second-line treatment.

Ranpirnase (Onconase)

Granted orphan drug status by the FDA in 2007, ranpirnase is an enzyme that has been shown in clinical trials to effectively kill mesothelioma cells by breaking down their RNA. It is unique in that it does this without affecting healthy cells, which severely reduces the potential side effects of chemotherapy.

Vinorelbine (Navelbine)

Primarily used to treat non-small-cell lung cancer (NSCLC), vinorelbine has also been shown to be somewhat effective against mesothelioma. It works by triggering apoptosis (programmed cell death) in cancer cells.

Mesothelioma Chemotherapy

Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

Another option which has been proven highly effective in treating peritoneal mesothelioma that has not metastasized outside of the abdomen is Hyperthermic Intraperitoneal Chemotherapy (HIPEC). This procedure combines surgery with a concentrated dose of chemotherapy in the abdomen with minimal exposure to the rest of the body.

Following a peritonectomy and/or cytroreductive surgery to remove parts of the peritoneum and any visible tumors in the abdomen, a heated chemotherapy solution is introduced into the abdominal cavity. After the roughly 100-103 degree solution is pumped into the abdomen, it circulates for one and half to two hours reaching all exposed areas aiming to kill any cancer cells that may not have been removed during surgery. This procedure is beneficial as it allows for a more concentrated dose of chemotherapy while not subjecting the rest of the body to the potential toxic effects of the drug.

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Mesothelioma Chemotherapy

Side Effects of Chemotherapy

Chemotherapy can cause many side effects in mesothelioma patients. Most of these adverse effects are short term and will go away soon after treatment ends. Others, however, can last long time, in some cases even years after the chemotherapy has ended.

Patients or their loved ones should report all chemotherapy side effects to the patient’s medical team, even if they are deemed “common” or seem mild. This is especially important after the first treatment, when it may be difficult to predict how the patient will react to certain drugs.

Stages of Pleural Mesothelioma

Pleural Mesothelioma Stages

A doctor will also determine the stage of mesothelioma as part of the diagnostic process, which determines the origin in the lining of the lungs and describes how far it has spread from that point. This information is significant to doctors when determining potential treatment availabilities. Standard treatment options are more commonly available to patients with stage 1 or stage 2 compared to patients with the later 3 and 4 stages.

The following are the pleural mesothelioma stages:


Within Stage 1, the mesothelioma tumor is generally in one location, and the cancerous cells have not dispersed to lymph nodes or other body organs and tissues. In general, surgical treatment may be an option for eliminating the cancerous growth.



Within Stage 2, the mesothelioma tumor is larger and has probably intruded on surrounding organs, such as the lung or even diaphragm. Lymph nodes could additionally be included. In this case, surgical reapportion might still be feasible, however much more difficult depending on the scope of the growth.


Within Stage 3, mesothelioma cancer has infested a region or perhaps location. Cancer has progressively spread throughout one side of the chest, within the chest wall, esophagus, and additional lymph nodes. Surgical treatment is typically not an option as curative therapy, however various other treatment options may be attempted. 


Within Stage 4, the mesothelioma has dispersed to numerous locations, such as various other organs and tissues throughout the body. Surgical treatment is no longer an alternative, and most treatments at this stage concentrate on minimizing discomfort and pain.