Chemotherapy is the general term for any treatment involving the use of chemical agents to stop cancer cells from growing. Chemotherapy can be administered through a vein, injected into a body cavity, or delivered orally in the form of a pill, depending on which drug is used. Unfortunately, chemotherapy drugs cannot tell the difference between cancer cells and some healthy cells. As a result, chemotherapy often eliminates fast-growing cancer cells along with other cells in the body, such as hair and blood cells.
Chemotherapy drugs used to treat mesothelioma include: pemetrexed (Alimta), cisplatin (Platinol), carboplatin (Paraplatin), ranpirnase (Onconase), gemcitabine (Gemzar), and vinorelbina (Navelbine).
In 2004, the FDA approved Alimta in combination with cisplatin for the treatment of pleural mesothelioma. It is important to note that the FDA approval is limited to use with patients who are not candidates for surgery. Furthermore, in testing which led to its approval, the partial response rate for Alimta/cisplatin was only 41% and the increased median survival rate was only 2.8 months as compared to cisplatin alone. At this time, Alimta/cisplatin remains the only FDA approved chemotherapy for mesothelioma.
Patients who are diagnosed with mesothelioma are typically referred directly to an oncologist. The vast majority of oncologists are not surgical oncologists and, therefore, are only directly involved in the non-surgical treatment of cancer. In many cases, oncologists recommend starting a patient on chemotherapy before referring the patient for a consult with a thoracic surgeon to determine whether surgery is an option.
Because the only FDA approved chemotherapy for mesothelioma is approved only for patients who are not candidates for surgery, many oncologists believe it is prudent to refer the patient to a thoracic surgeon before starting chemotherapy. If the surgeon determines that surgery is an option, the surgeon and oncologist will work together to determine the appropriate role of chemotherapy in the patient’s treatment.
For further discussion on this topic, please see: Dr. Robert Cameron on Treating Mesothelioma: “The Argument Against Chemotherapy as a Stand-Alone Treatment for Mesothelioma”
For videos of Dr. Cameron where he discussed mesothelioma, how it is caused, how it is diagnosed and how it is treated, click here.
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