Mesothelioma Chemotherapy

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Mesothelioma Chemotherapy

Chemotherapy - the use of medications to treat cancer - has had disappointing results in the treatment of malignant mesothelioma. Some chemotherapy drugs have a partial effect in some patients. Combination chemotherapy (using more than one drug at the same time) may be given in an attempt to improve response. Some combinations have shown some promise, and some new medications are being tried.Mesothelioma treatments are divided into two categories; traditional mesothelioma treatments and new mesothelioma treatments. Chemotherapy falls into both categories. It has been used traditionally in the treatment of malignant mesothelioma and a variety of other cancers for decades. Mesothelioma research, as of late, has focused heavily on the development and implementation of new chemotherapy drugs that are based on a greater understanding of how mesothelioma metastasizes (spreads to other organs).Like radiation therapy, chemotherapy may be administered after surgery in an attempt to kill cancer cells that could not be removed during the procedure.

Chemotherapy, in its most general sense, refers to treatment of disease by chemicals that kill cells, both good and bad, but specifically those of micro-organisms or cancerous tumours. In popular usage, it refers to antineoplastic drugs used to treat cancer or the combination of these drugs into a cytotoxic standardized treatment regimen. In its non-oncological use, the term may also refer to antibiotics (antibacterial chemotherapy). In that sense, the first modern chemotherapeutic agent was Paul Ehrlich's arsphenamine, an arsenic compound discovered in 1909 and used to treat syphilis. This was later followed by sulfonamides discovered by Domagk and penicillin discovered by Alexander Fleming.

Most commonly, chemotherapy acts by killing cells that divide rapidly, one of the main properties of cancer cells. This means that it also harms cells that divide rapidly under normal circumstances: cells in the bone marrow, digestive tract and hair follicles; this results in the most common side effects of chemotherapy-myelosuppression (decreased production of blood cells), mucositis (inflammation of the lining of the digestive tract) and alopecia (hair loss).

Other uses of cytostatic chemotherapy agents (including the ones mentioned below) are the treatment of autoimmune diseases such as multiple sclerosis and rheumatoid arthritis and the suppression of transplant rejections (see immunosuppression and DMARDs). Newer anticancer drugs act directly against abnormal proteins in cancer cells; this is termed targeted therapy.

Treatment schemes

mesothelioma_chemoteraphyThere are a number of strategies in the administration of chemotherapeutic drugs used today. Chemotherapy may be given with a curative intent or it may aim to prolong life or to palliate symptoms.

Combined modality chemotherapy is the use of drugs with other cancer treatments, such as radiation therapy or surgery. Most cancers are now treated in this way. Combination chemotherapy is a similar practice that involves treating a patient with a number of different drugs simultaneously. The drugs differ in their mechanism and side effects. The biggest advantage is minimising the chances of resistance developing to any one agent.

In neoadjuvant chemotherapy (preoperative treatment) initial chemotherapy is designed to shrink the primary tumour, thereby rendering local therapy (surgery or radiotherapy) less destructive or more effective.

Adjuvant chemotherapy (postoperative treatment) can be used when there is little evidence of cancer present, but there is risk of recurrence. This can help reduce chances of developing resistance if the tumour does develop. It is also useful in killing any cancerous cells which have spread to other parts of the body. This is often effective as the newly growing tumours are fast-dividing, and therefore very susceptible.

Palliative chemotherapy is given without curative intent, but simply to decrease tumor load and increase life expectancy. For these regimens, a better toxicity profile is generally expected.

All chemotherapy regimens require that the patient be capable of undergoing the treatment. Performance status is often used as a measure to determine whether a patient can receive chemotherapy, or whether dose reduction is required. Because only a fraction of the cells in a tumor die with each treatment (fractional kill), repeated doses must be administered to continue to reduce the size of the tumor. Current chemotherapy regimens apply drug treatment in cycles, with the frequency and duration of treatments limited by toxicity to the patient.

Side-effects

The treatment can be physically exhausting for the patient. Current chemotherapeutic techniques have a range of side effects mainly affecting the fast-dividing cells of the body. The most common side effects include (dependent on the agent):

  • Pain
  • Erythema
  • Nausea
  • Diarrhea or constipation
  • Anemia
  • Malnutrition
  • Hair loss
  • Memory loss
  • Depression of the immune system, hence (potentially lethal) infections and sepsis
  • Dehydration
  • Vertigo
  • Hematoma
  • Dry mouth/ xerostomia
  • Psychosocial distress
  • Weight loss or gain
  • Hemorrhage
  • Water retention
  • Sexual impotence
  • Secondary neoplasms

Damage to specific organs may occur, with resultant symptoms:

  • Cardiotoxicity (heart damage)
  • Hepatotoxicity (liver damage)
  • Nephrotoxicity (kidney damage)
  • Ototoxicity (damage to the inner ear)

Source: www.wikipedia.org

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