Chemotherapy for mesothelioma

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 cannot usually cure it. Chemotherapy is usually aimed at controlling symptoms. If you've had surgery, you may be given chemotherapy afterwards.

The effectiveness of chemotherapy in treating mesothelioma is still being researched. Many different combinations of chemotherapy drugs maybe used. These combinations are sometimes called chemotherapy regimes or regimens.

Individual drugs

The drugs that can be effective in treating mesothelioma are pemetrexed (Alimta®)|, cisplatin|, carboplatin|, mitomycin C|, vinorelbine (Navelbine®)|, raltitrexed (Tomudex®)|, vinblastine (Velbe®)|, doxorubicin| and gemcitabine (Gemzar®)|.

Often cisplatin or carboplatin are combined with one or more of the other chemotherapy drugs.

The National Institute for Health and Clinical Excellence (NICE) are an independent body that were set up by the government. NICE assess medicines and treatments, and give guidance to doctors on how to use them in the NHS in England and Wales. The equivalent body in Scotland is the Scottish Medicines Consortium (SMC).

Pemetrexed is licensed for use with another chemotherapy drug called cisplatin to treat mesothelioma. It has been approved for use in Scotland by the SMC. NICE has recommended pemetrexed as a treatment option for a particular group of people with mesothelioma. These are people with advanced 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. Several research trials are taking place to find out how helpful different chemotherapy combinations could be. You may be asked by your doctor to consider whether you would like to take part.

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.

Side effects

While chemotherapy drugs are acting on the cancer cells in your body, they also temporarily reduce the number of normal cells in your blood. When the number of these cells is low, you are more likely to get an infection and you may tire easily. During chemotherapy, your blood will be tested regularly and, if necessary, you will 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. Regular mouthwashes are important and the nurses will show you how to do these properly.

If you don't feel like eating, you can supplement or replace your meals with nutritious, high-calorie drinks| that are available on prescription from your doctor. Medicines are also available from your doctor to help you stop feeling sick (anti-emetics). Our section eating well| may be helpful.

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 ended.

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 and try not to overtire yourself.

Our chemotherapy| section discusses the treatment and its side effects in more detail.