Search This Blog

Sunday, September 12, 2010

The Common Chemotherapy Mesothelioma Treatment Option in Use

Chemotherapy is the treatment of mesothelioma using chemical substances called drugs to fight the cancer cells. In other words, mesothelioma chemotherapy is the treatment of mesothelioma using chemical substances called drugs. Wherever cancer occurs, abnormal cells will continue to divide uncontrolled and anticancer drugs can be of help to the patients as they work to destroy cancer cells by preventing them from multiplying. Depending on the stage of the cancer at the time of diagnosis, and the age and health condition of the patient itself, chemotherapy may be used to achieve curative treatment and other different goals such as:

1. To control the cancer cells by stopping its spread or slowing its growth.
2. It is also used to shrink tumors prior to other treatments, such as surgery. This chemotherapy medical procedure is called neoadjuvant.

3. Chemotherapy also helps to destroy microscopic disease which may remain after surgery? This is also called adjuvant chemotherapy.

4. Lastly, chemotherapy is used to relieve symptoms of mesothelioma, such as pain. This is referred to as palliative chemotherapy, and palliative chemotherapy is given in a situation where drastic reduction in the tumor is not expected. Palliative chemotherapy is commonly used for chemotherapy in mesothelioma patients. It is an option for those who are not surgical candidates but these days, various cancer centres are now conducting trials using the neoadjuvant approach.

An example in case is Alimta (pemetrexed), a drug approved by the Food and Drug Administration (FDA) for use with Cisplatin in the treatment of patients with malignant pleural mesothelioma that is for the treatment of patients whose disease is either unresectable or who are not candidates for curative surgery. Alimta is the drug approved by FDA specifically for the treatment of mesothelioma and Alimta/Cisplatin chemotherapy regimen is the first Food and Drug Administration (FDA) approved drug specifically for the treatment of malignant pleural mesothelioma. This drug is currently considered the most effective first-line palliative chemotherapy treatment for mesothelioma patients who are not surgical candidates. Alimta works by blocking the enzymes necessary for DNA copying and cell division in the cancerous cells.

That fact above makes Alimta a multi-targeted antifolate drug. The good news is that during the clinical trial process, it was discovered that Alimta/Cisplatin improved median survival of pleural mesothelioma patients by approximately three months over treatment with Cisplatin as a single agent. It is however important to discuss the possibility of using Alimta with your doctor. This discussion with your doctor on the possibility of using Alimta/Cisplain should include all pertinent information regarding effectiveness, administration and possible side effects of the drug combination on you.

It is also important to begin vitamin supplementation of B12 by injection during the week prior to treatment. This is usually repeated every 9 weeks with folic acid taken by mouth daily until 21 days after the last cycle of Alimta. In most cases patients using this combination are also normally given an oral steroid medication to minimize the risk of skin rash or other possible side effects. Your doctor will have information on the correct dosages of each medication and be sure to tell your doctor of any other medications you are taking prior to the time, including non-prescription drugs so he may be aware of any adverse or interactions that may occur.

One good benefit of Alimta/Cisplatin chemotherapy is that, it can be administered to patients on an outpatient basis every 21 days. The chemotherapy treatment normally involves a 10-minute infusion of Alimta followed by a 2 hour infusion of Cisplatin. How many cycles of treatment a patient receives is determined by his or her response rate to the drug which is usually judge by the rate of regression of the tumor or halt to progression of the disease and the side effects which the patient might be experiencing.

The other good news in this drug is that the side effects of Alimta/Cisplatin are mild to moderate for most mesothelioma patients and side effects during treatments such as nausea, vomiting and fatigue are common and are usually managed by their doctors. The drugs combination side effects may however be debilitating in some patients and may require a decrease in dosage or removal from the program of some patients. It is important that every patient using Alimta/Cisplain combination discusses all side effects noticed when they start to use the combination with their doctors and no side effect should be considered as minor or negligible.

As said before, one of the common chemotherapy procedure is a combination of Alimta and Cisplatin, administered with a 10 minute infusion of Alimta followed by two hours of cisplatin and given in 21 day cycles when necessary, modifications to this schedule can be made according to what the doctor feels is appropriate in a particular patient case. In general, 3 to 4 cycles of treatment are given before response is evaluated but 2 to 3 cycles Alimta/Cisplatin are considered a minimum to assess for effectiveness. The number of treatment cycles or the length of time between the beginning and end of chemotherapy may vary.

After response to the treatment has been determined, the doctor examines the following medical factors in his patient and uses it to determine the possibility of chemotherapy for the treatment of mesothelioma, one the disease condition must be kept stable and two, there must be shrinkage in the tumor. But if there present a disease progression the chemotherapy must be discontinued and alternative treatment options should be considered. This means the patient’s immune system is weakened leaving the patient more prone to infections. If this occurs, it can cause delays in the patient mesothelioma treatment plan or make the doctor to change dosage of the drugs the patient will receive.

Presently, the widely used means of administering chemotherapy is intravenously i.e. through a vein and by the use of a thin needle that is inserted into a vein in the hand or in the lower arm. Intravenous administration allows for rapid entry into the blood stream of the administered drugs. Drugs can also be delivered via catheters or ports. What are catheters and ports? Catheters are soft, thin, flexible tubes placed into a large vein in the body and kept in place for as long as they are needed for drugs administration.

On the other hand catheter can sometimes be attached to a small round plastic or metal disc called port placed under the skin on the chest. Like catheters, ports can also be kept in place for as long as necessary. Many drugs like intraperitoneal chemotherapy can either be delivered through a catheter or a port. In this case, the catheter is inserted through the abdominal wall and through it, chemotherapy drugs can then be infused directly into the abdominal cavity. Otherwise, ports can also be placed under the skin of the abdominal wall and the catheter tunneled between the skin and muscle into the peritoneum.

As its known with all drugs that there is no chemotherapy without its own side effects no matter how small and mesothelioma chemotherapy is no exception. However, the type of side effects a patient experiences and how severe they are, depend on the type of chemotherapy one is receiving, the dosage given and how the patient body reacts to treatment being given. As its known, cancer cells grow and divide more rapidly than normal cells though some normal cells also multiply quickly, particularly those in the digestive tract, reproduction system, and hair follicles but it is the damage done to the normal cells during chemotherapy that causes side effects.

Therefore, before any chemotherapy treatment on mesothelioma begins, it is normal medical practice these days for doctors to ask their patients to sign a consent form. Before signing the form however, be sure your doctor informs you of all the facts regarding the treatment he or she will be administering, including information about the particular drug or combination of drugs to be used, the possible risks or side effects (such as nausea, vomiting and peripheral neuropathy), the number of treatments you will receive and how often, and whether it will be given during a hospital stay or on an outpatient basis. Ask as many questions as you may want. You are the one involved here.

Lastly, at the commencement of chemotherapy, how regularly you will be receiving chemotherapy will be determined by your doctor by taking into consideration certain factors like the stage of the cancer, the types of drugs you receive, the anticipated toxicities of the drugs in the body and the time necessary for your body to recover from these toxicities. It is the responsibility of the doctor also to decide whether the goal of the chemotherapy he is to be administered on you, is to control the growth of the cancer or to ease symptoms associated with the disease.

In most cases and as said before chemotherapy treatment is administered in cycles and each treatment cycle is followed by a period of rest. Each cycle rest therefore allows the cancer cells to be attacked by the drugs as well as allows the body's normal cells time to recover. Though, the combination of drugs to be used, the length of time to administer the drugs are important, how often they should be repeated and the number of cycles recommended have to be analyzed thoroughly during clinical trials also.

No comments:

Post a Comment