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Chemotherapy| is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. The drugs work by disrupting the growth of the cancer cells.
In some people, chemotherapy may control the growth of mesothelioma for a time, reducing symptoms and giving a better quality of life. Chemotherapy may help some people with mesothelioma to live for a few months longer, but can’t usually cure it.
Chemotherapy may be given before surgery for pleural mesothelioma. This is sometimes called neoadjuvant chemotherapy. It can shrink the tumour making it easier to remove. Or, if there is a possibility that there are cancer cells elsewhere in the body, giving chemotherapy sooner rather than later may increase the chance of controlling them.
Chemotherapy can also be given after surgery to reduce the chances of the mesothelioma coming back. It aims to destroy any cancer cells that might be left behind after the operation. This is called adjuvant chemotherapy.
The effectiveness of chemotherapy in treating mesothelioma is still being researched|. There are a number of different combinations of chemotherapy drugs that may be used.
The most commonly used drugs to treat pleural mesothelioma are pemetrexed (Alimta®)| together with either cisplatin| or carboplatin|. If you have pemetrexed, you will be given the vitamins B12 and folic acid as these help to reduce side effects of treatment without reducing its effectiveness.
Other drugs that may be used include:
In peritoneal mesothelioma, pemetrexed and cisplatin is the most commonly used combination. Other drugs that can be used include:
The National Institute for Health and Clinical Excellence (NICE) has recommended pemetrexed as a treatment option for a particular group of people with mesothelioma. These are people with advanced pleural mesothelioma who can’t have surgery, but who are considered by their doctor to be fit and able to look after themselves. Other chemotherapy drugs may also be used as part of trials|. Your doctor may ask you to consider whether you’d like to take part in a trial.
Chemotherapy may be better at controlling the symptoms of mesothelioma than using other medicines to control each symptom individually. Your doctor can discuss with you the possible benefits and disadvantages of chemotherapy in your particular situation.
While chemotherapy drugs are acting on the cancer cells in your body, they also temporarily reduce the number of white cells in your blood (neutropenia). When the number of these cells is low, you are more likely to get an infection and you may tire easily. Contact your doctor or the hospital straight away if:
During chemotherapy, your blood will be tested regularly and, if necessary, you’ll be given antibiotics to treat any infection. You may be given blood transfusions if you are anaemic.
Other side effects vary according to the chemotherapy drugs being used. They may include feeling sick (nausea|), being sick (vomiting), diarrhoea| and hair loss|. Some drugs also make your mouth sore| and may cause small mouth ulcers. Using mouthwashes regularly is important and the nurses will show you how to use these properly. Medicines are also available from your doctor to help you stop feeling sick (anti-emetics).
Although they may seem hard to bear at the time, the side effects are temporary and will disappear once your treatment is over. If you lose your hair, it will start to grow back a couple of months after the treatment has finished.
Chemotherapy affects different people in different ways. Some people are able to lead a normal life during their treatment; others find they become very tired and have to take things more slowly. Just do as much as you feel like doing and try not to overtire yourself.
Our general information on chemotherapy| discusses this treatment and its side effects in more detail.
Content last reviewed: 1 May 2010
Next planned review: 2013
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© Macmillan Cancer Support 2013
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