I often ask people when I care for them if they had chemotherapy before having surgery for their mesothelioma. I am really not sure what the percentage is of who has had it and who hasn't, but if you had chemotherapy prior to your surgery, chances are your lymph nodes were positive during your initial biopsy. Most likely, your oncologist ordered chemotherapy to try to shrink the lymph node tumors to make your operation easier.
In pleural mesothelioma, cancer cells invade the lining of the lung as a large mass of interlocked tumors that blend in with healthy tissue making complete surgical removal difficult. As a result, after surgery, chemotherapy, sometimes combined with radiation therapy, is recommended to try to destroy any cancer cells left behind. Some chemotherapy agents have shown to improve overall survival rates. Patients can expect to achieve a partial response or at least stability with the disease, although chemotherapy is not a known cure for mesothelioma.
As you can see, chemotherapy is critical in the treatment of mesothelioma. Although many people cringe at the thought of undergoing chemotherapy due to the reputation the drugs have for causing debilitating side effects, things have changed in the chemotherapy world, and people don't suffer the side effects like in the past. Now, there are many drugs available to counteract the common side effects.
In 2004, pemetrexed became the first agent to get the U.S. Food and Drug Administration's approval for use in combination with cisplatin. Malignant pleural mesothelioma is often treated with this combination to slow or stop the growth of cancer cells in the body by inhibiting the enzyme action that is required for the cells to reproduce and spread.
The side effects of pemetrexed include fatigue, nausea, diarrhea, hair loss and skin rashes. Patients undergoing treatment of pemetrexed are usually given dexamethasone and folic acid to counteract these side effects. Dexamethasone is typically given twice a day orally after pemetrexed to lessen the impact of the side effects. Folic acid is given to patients, 400 units per day, while receiving chemotherapy to also reduce the effects of nausea and fatigue. It is suggested that vitamin supplementation be started along with folic acid a week before the chemotherapy has been initiated.
I also always suggest that mesothelioma patients try to improve their nutritional status while undergoing chemotherapy. Eat more, always try to make the right food choices, but try to put on a little weight. This extra weight could possibly help out if more therapy (surgery or radiation) is needed.
There are a variety of treatment approaches – chemotherapy, surgery and radiation – to fight mesothelioma. It is a difficult disease to conquer, but these therapies have demonstrated improved response rates for patients over other treatments. And they no longer have to negatively impact your quality of life.
If you have questions about side effects or just want to ask a question regarding your mesothelioma treatment, feel free to email me at LHyde-Barrett@mesotheliomahelp.net.
More articles by Lisa Hyde-Barrett
Lisa Hyde-Barrett has been a thoracic surgery nurse for nearly 25 years, and has the skill and knowledge to care for and support mesothelioma patients. Through her work, she has helped ease the stress of patients and their families by offering a comforting hand. She is passionate about helping the mesothelioma community.
