There are a variety of schedules and techniques used to deliver chemotherapy and a patient’s treatment largely depends upon the type of individualized treatment your doctor prescribes, based on a variety of selective factors. Chemotherapy may consist of a single drug or a combination of drugs delivered in cycles.
In general, chemotherapy can be administered orally in the form of a pill or injected into a vein (intravenous), into a body cavity (such as the bladder), into a muscle (intramuscular), or into the spinal fluid (intrathecal).
For mesothelioma, chemotherapy may be administered directly into the pleural space (intrapleurally) or site of the mesothelioma.
Currently, most chemotherapy is administered intravenously; however, oral chemotherapy drugs are gaining wider use. In some cases, it may be beneficial to administer IV chemotherapy through a venous access device (VAD), which is inserted into a major vein in the body and can remain in place for a long period of time.
Each course of chemotherapy is different, but generally consists of 4 to 6 cycles. The actual administration of some chemotherapy drugs may take only seconds or minutes, while others may take hours or even days.
Follow-up typically consists of clinical evaluation, with particular attention to symptoms and chest wall recurrence, and chest CT scans may be delivered to monitor the patient’s prognosis, as needed.
Chemotherapy drugs such as platinum analogues, doxorubicin, and some antimetabolites, such as methothrexate, raltitrexed, pemetrexed, as well as the combinations of both pemetrexed with cisplatin, and raltitrexed with cisplatin have been shown to improve survival in mesothelioma patients. The combination of pemetrexed with carboplatin has also been administered as an alternative treatment.
Chemotherapy for mesothelioma is given with a variety of aims depending on the stage. If the patient has early stage disease, he/she may be given chemotherapy after surgery to remove the mesothelioma cancer. This is called adjuvant chemotherapy. It is given to try to lower the chances of the cancer coming back.
Chemotherapy can be used to treat stage 2, 3 or 4 mesothelioma. The treatment is given to help control symptoms and to try to slow the cancer from metastisizing.
