Mesothelioma medical therapy: Difference between revisions
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=== | ===Chemotherapy=== | ||
Chemotherapy is one of the main treatments for mesothelioma. Many people are not diagnosed until their mesothelioma is advanced and cannot be removed with surgery. In these cases, chemotherapy is used to treat the disease and relieve symptoms. | |||
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to treat cancer. It is usually a systemic therapy | |||
systemic therapy | |||
Treatment that travels through the bloodstream to reach cells all over the body. that circulates throughout the body and destroys cancer cells, including those that may have broken away from the primary tumour. Chemotherapy may also be a regional therapy given to specific areas of the body. Regional chemotherapy for mesothelioma may be given directly into a body cavity (intracavitary chemotherapy) that contains cancer including the: | |||
chest cavity (intrapleural chemotherapy) | |||
abdominal cavity (intraperitoneal chemotherapy) | |||
Chemotherapy may be used: | |||
as the main treatment to shrink the tumour and keep the cancer under control | |||
Chemotherapy may be used in this way for people: | |||
who cannot have surgery because their cancer is considered inoperable (unresectable) | |||
with sarcomatoid subtype of mesothelioma | |||
not well enough to tolerate surgery | |||
who decide not to have surgery | |||
to relieve pain or to control the symptoms of advanced mesothelioma (palliative chemotherapy) | |||
after surgery to destroy cancer cells left behind and to reduce the risk of the cancer recurring (adjuvant | |||
adjuvant | |||
Treatment given in addition to the first-line therapy (the first or standard treatment) to help reduce the risk of a disease (such as cancer) coming back (recurring). chemotherapy) | |||
before surgery to shrink a tumour (neoadjuvant | |||
neoadjuvant | |||
Treatment given to shrink a tumour before the first-line therapy (the first or standard treatment), which is usually surgery. chemotherapy) | |||
Drugs, doses and schedules vary from person to person. | |||
Chemotherapy drugs | |||
The most common chemotherapy drugs used to treat mesothelioma are: | |||
cisplatin (Platinol AQ) | |||
carboplatin (Paraplatin, Paraplatin AQ) | |||
an antifolate drug | |||
pemetrexed (Alimta) | |||
raltitrexed (Tomudex) | |||
gemcitabine (Gemzar) | |||
Gemcitabine may be given to people who cannot have platinum-based (cisplatin or carboplatin) combination chemotherapy. | |||
vinorelbine (Navelbine) | |||
This drug may be also given to people who cannot have platinum-based combination chemotherapy or who have been treated previously with platinum-based combination chemotherapy. | |||
Although a single drug may be used, better responses to chemotherapy occur when a combination of drugs are given for mesothelioma. The most common chemotherapy combinations used to treat mesothelioma are: | |||
cisplatin and an antifolate drug | |||
cisplatin and pemetrexed – most common combination used | |||
cisplatin and raltitrexed | |||
carboplatin (Paraplatin, Paraplatin AQ) and an antifolate drug | |||
Carboplatin may be used instead of cisplatin, especially in older adults because it causes less kidney and nerve problems than cisplatin. | |||
Drug combinations may include: | |||
carboplatin and pemetrexed | |||
carboplatin and raltitrexed | |||
cisplatin and gemcitabine | |||
carboplatin and gemcitabine | |||
These combinations of drugs are given intravenously for 3–6 cycles. In some cases, they are given until the disease progresses. | |||
Regional chemotherapy | |||
Regional (intracavitary) chemotherapy for mesothelioma may include: | |||
intrapleural chemotherapy | |||
Chemotherapy drugs are injected through a chest tube or catheter into the pleural cavity (the space between the membranes lining the lung and chest wall). | |||
It is used to treat pleural mesothelioma. | |||
Intrapleural chemotherapy can be used to control pleural effusions. | |||
intraperitoneal chemotherapy | |||
Chemotherapy drugs are injected into the peritoneal space or peritoneal cavity (space between the abdominal organs and the membrane lining the abdominal wall). | |||
This is the way chemotherapy is most often given to treat peritoneal mesothelioma. Peritoneal mesothelioma usually remains confined to the peritoneal cavity until late in the course of the disease. Giving drugs directly into the peritoneal cavity greatly enhances the concentration of drugs in that area and limiting side effects to the rest of the body. | |||
Sometimes regional chemotherapy is given right after surgery (in the operating room) or soon afterwards. | |||
Some of the drugs used as regional chemotherapy to treat mesothelioma include: | |||
cisplatin | |||
mitomycin (Mutamycin) | |||
doxorubicin (Adriamycin) | |||
Regional chemotherapy drugs are sometimes heated before they are given (hyperthermic chemotherapy) to help them work better. | |||
==References== | ==References== | ||
Revision as of 03:46, 9 February 2016
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Mesothelioma medical therapy On the Web |
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Risk calculators and risk factors for Mesothelioma medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Medical Therapy
The treatment for mesothelioma depend on various factors, which include:[1]
- Location of the mesothelioma
- Stage
- Resectability of the tumor
- Type of symptoms
- Overall health and performance status
- Performance status
- Age
The various treatment options for mesothelioma include:[1]
Treatment of Mesothelioma | |||||||||||||||||||||||||||||||||||||||||
Supportive Care | Radiotherapy | Chemotherapy | Surgery | ||||||||||||||||||||||||||||||||||||||
Supportive Care
| Concern | Supportive Care |
|---|---|
| Loss of appetite | Small amounts of high-calorie foods or fluids, having smaller, more frequent meals, and nutritional supplements can be helpful. Anti-emetic drugs can be used to control nausea and vomiting. Cold foods may be better tolerated and using plastic cutlery can help if foods have a metallic taste. When appropriate, medicines may be prescribed to help increase appetite. Cachexia can occur in people whose mesothelioma is very advanced. |
| Shortness of breath | Pleural effusion is common with pleural mesothelioma, but can also occur with some peritoneal mesothelioma. Treatment options for pleural effusion may include:
Relaxation and breathing exercises may help with problems breathing. Oxygen therapy may be ordered to help relieve difficulty breathing. |
| Ascites | Peritoneal mesothelioma can cause ascites. Paracentesis may be done to relieve symptoms. Another option is to insert catheter to drain the fluid from the abdomen. |
| Pain | People with advanced mesothelioma may experience pain because the tumor grows into surrounding nerves and organs. The amount of pain often increases as the cancer advances. Pain may be managed by:
|
| Fatigue | Poor appetite and trouble breathing can also make fatigue worse. It can be hard to cope when you are feeling very tired and don’t have a lot of energy, especially for a while after treatment or if the cancer is advanced. |
| Bowel obstruction | Bowel obstruction can occur in people with peritoneal mesothelioma. A bowel obstruction can cause abdominal pain, nausea, vomiting, and an inability to pass feces. Resting the bowel by not having anything to eat or drink, or feeding through a nasogastric tube placement may help, but surgery to remove the obstruction may be necessary. |
| Coping with advanced cancer | Mesothelioma is often diagnosed at an advanced stage. People with advanced mesothelioma are offered palliative care. This is a special type of care that focuses on making the person as comfortable as possible, relieving symptoms, providing support and improving or maintaining the person’s quality of life. |
| Financial concerns | People with mesothelioma may have financial concerns as a result of their illness. There are special services or benefits to help workers (and their families) who have developed mesothelioma from occupational exposure to asbestos. Conditions about exposure and legal processing of claims for asbestos-related cancers can differ by province or territory. |
Chemotherapy
Chemotherapy is one of the main treatments for mesothelioma. Many people are not diagnosed until their mesothelioma is advanced and cannot be removed with surgery. In these cases, chemotherapy is used to treat the disease and relieve symptoms.
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to treat cancer. It is usually a systemic therapy systemic therapy Treatment that travels through the bloodstream to reach cells all over the body. that circulates throughout the body and destroys cancer cells, including those that may have broken away from the primary tumour. Chemotherapy may also be a regional therapy given to specific areas of the body. Regional chemotherapy for mesothelioma may be given directly into a body cavity (intracavitary chemotherapy) that contains cancer including the:
chest cavity (intrapleural chemotherapy) abdominal cavity (intraperitoneal chemotherapy) Chemotherapy may be used:
as the main treatment to shrink the tumour and keep the cancer under control Chemotherapy may be used in this way for people: who cannot have surgery because their cancer is considered inoperable (unresectable) with sarcomatoid subtype of mesothelioma not well enough to tolerate surgery who decide not to have surgery to relieve pain or to control the symptoms of advanced mesothelioma (palliative chemotherapy) after surgery to destroy cancer cells left behind and to reduce the risk of the cancer recurring (adjuvant adjuvant Treatment given in addition to the first-line therapy (the first or standard treatment) to help reduce the risk of a disease (such as cancer) coming back (recurring). chemotherapy) before surgery to shrink a tumour (neoadjuvant neoadjuvant Treatment given to shrink a tumour before the first-line therapy (the first or standard treatment), which is usually surgery. chemotherapy) Drugs, doses and schedules vary from person to person.
Chemotherapy drugs
The most common chemotherapy drugs used to treat mesothelioma are:
cisplatin (Platinol AQ) carboplatin (Paraplatin, Paraplatin AQ) an antifolate drug pemetrexed (Alimta) raltitrexed (Tomudex) gemcitabine (Gemzar) Gemcitabine may be given to people who cannot have platinum-based (cisplatin or carboplatin) combination chemotherapy. vinorelbine (Navelbine) This drug may be also given to people who cannot have platinum-based combination chemotherapy or who have been treated previously with platinum-based combination chemotherapy. Although a single drug may be used, better responses to chemotherapy occur when a combination of drugs are given for mesothelioma. The most common chemotherapy combinations used to treat mesothelioma are:
cisplatin and an antifolate drug cisplatin and pemetrexed – most common combination used cisplatin and raltitrexed carboplatin (Paraplatin, Paraplatin AQ) and an antifolate drug Carboplatin may be used instead of cisplatin, especially in older adults because it causes less kidney and nerve problems than cisplatin. Drug combinations may include: carboplatin and pemetrexed carboplatin and raltitrexed cisplatin and gemcitabine carboplatin and gemcitabine These combinations of drugs are given intravenously for 3–6 cycles. In some cases, they are given until the disease progresses.
Regional chemotherapy
Regional (intracavitary) chemotherapy for mesothelioma may include:
intrapleural chemotherapy Chemotherapy drugs are injected through a chest tube or catheter into the pleural cavity (the space between the membranes lining the lung and chest wall). It is used to treat pleural mesothelioma. Intrapleural chemotherapy can be used to control pleural effusions. intraperitoneal chemotherapy Chemotherapy drugs are injected into the peritoneal space or peritoneal cavity (space between the abdominal organs and the membrane lining the abdominal wall). This is the way chemotherapy is most often given to treat peritoneal mesothelioma. Peritoneal mesothelioma usually remains confined to the peritoneal cavity until late in the course of the disease. Giving drugs directly into the peritoneal cavity greatly enhances the concentration of drugs in that area and limiting side effects to the rest of the body. Sometimes regional chemotherapy is given right after surgery (in the operating room) or soon afterwards.
Some of the drugs used as regional chemotherapy to treat mesothelioma include:
cisplatin mitomycin (Mutamycin) doxorubicin (Adriamycin) Regional chemotherapy drugs are sometimes heated before they are given (hyperthermic chemotherapy) to help them work better.
References
- ↑ 1.0 1.1 Treatment of mesothelioma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/treatment/?region=on. Accessed on February 8, 2016