Chemotherapy is the only treatment for mesothelioma that has been proven to improve survival in randomised and controlled trials. The landmark study published in 2003 by Vogelzang and colleagues compared cisplatin chemotherapy alone with a combination of cisplatin and pemetrexed (brand name Alimta) chemotherapy) in patients who had not received chemotherapy for malignant pleural mesothelioma previously and were not candidates for more aggressive "curative" surgery.[19] This trial was the first to report a survival advantage from chemotherapy in malignant pleural mesothelioma, showing a statistically significant improvement in median survival from 10 months in the patients treated with cisplatin alone to 13.3 months in the combination pemetrexed group in patients who received supplementation with folate and vitamin B12. Vitamin supplementation was given to most patients in the trial and pemetrexed related side effects were significantly less in patients receiving pemetrexed when they also received daily oral folate 500mcg and intramuscular vitamin B12 1000mcg every 9 weeks compared with patients receiving pemetrexed without vitamin supplementation. The objective response rate increased from 20% in the cisplatin group to 46% in the combination pemetrexed group. Some side effects such as nausea and vomiting, stomatitis, and diarrhoea were more common in the combination pemetrexed group but only affected a minority of patients and overall the combination of pemetrexed and cisplatin was well tolerated when patients received vitamin supplementation; both quality of life and lung function tests improved in the combination pemetrexed group. In February 2004, the United States Food and Drug Administration approved pemetrexed for treatment of malignant pleural mesothelioma. However, there are still unanswered questions about the optimal use of chemotherapy, including when to start treatment, and the optimal number of cycles to give.
Cisplatin in combination with raltitrexed has shown an improvement in survival similar to that reported for pemetrexed in combination with cisplatin, but raltitrexed is no longer commercially available for this indication. For patients unable to tolerate pemetrexed, cisplatin in combination with gemcitabine or vinorelbine is an alternative, or vinorelbine on its own, although a survival benefit has not been shown for these drugs. For patients in whom cisplatin cannot be used, carboplatin can be substituted but non-randomised data have shown lower response rates and high rates of haematological toxicity for carboplatin-based combinations, albeit with similar survival figures to patients receiving cisplatin.[20]
In January 2009, the United States FDA approved using conventional therapies such as surgery in combination with radiation and or chemotherapy on stage I or II Mesothelioma after research conducted by a nationwide study by Duke University concluded an almost 50 point increase in remission rates.
Showing posts with label Chemotheraphy. Show all posts
Showing posts with label Chemotheraphy. Show all posts
Saturday, September 5, 2009
Mesothelioma Chemotherapy - Do You Know the Schedule of Treatment and Common Side Effects?
Chemotherapy Schedules
How often you will receive chemotherapy will be determined by your doctor, taking into consideration factors such as the stage of your cancer, the types of drugs you receive, the anticipated toxicities of the drugs and the time necessary for your body to recover from these toxicities. The doctor may also consider whether the goal of the chemotherapy is to control the growth of the cancer, or to ease symptoms associated with the disease.
In general, chemotherapy treatment is administered in "cycles" - a "cycle" being defined as a period of treatment followed by a period of rest. This cycle allows the cancer cells to be attacked by the drugs, and then allows the body's normal cells time to recover. The combination of drugs used, the length of time to administer the drugs, how often they should be repeated and the number of cycles recommended have been analyzed very well in clinical trials.
For mesothelioma patients, the "standard" treatment is a combination of Alimta and cisplatin, administered IV, with a 10 minute infusion of Alimta followed by two hours of cisplatin, given in 21 day cycles. Modifications to this schedule may be made according to what your doctor feels is appropriate in your particular case.
The number of treatment cycles, or the length of time between the beginning and end of chemotherapy may vary, however in general, 3 to 4 cycles of treatment are given before response is evaluated; 2 to 3 cycles are considered a minimum to assess for effectiveness. After response to the treatment has been determined, the following criteria will be used to decide whether chemotherapy should continue:
• If there is shrinkage of the tumor, or the disease is kept stable, chemotherapy may be continued for as long as it can be tolerated and there is no disease progression.
• If there is continued disease progression, chemotherapy will be stopped, and the patient will be given alternative options.
The goal of setting a chemotherapy schedule is to make treatment as effective, timely and trouble-free as possible, but while the drugs are working to kill cancer cells, they may also affect healthy cells causing side effects.
Common Side Effects of Chemotherapy Includes:
-Fever of, or greater than 101 degrees
-Nausea
-Diarrhea or constipation
-Fatigue
-Tingling or numbness in the fingers or toes
-Ringing in the ears
-Bruises or rashes
-Sores in the mouth or throat
-Reduced white blood cell count {neutropenia} making you more prone to infections. For this reason your full blood count should be monitored closely.
Be sure you report all over-the-counter and prescribed medicines to your physician. Don't take aspirin unless it has been approved by your physician. Ask your pharmacist if aspirin is part of the drugs you want to purchase.
Stay away from people who have colds or the flu. Chemotherapy can compromise your immune system and lower your resistance to germs.
It is normal to feel sad, angry or afraid, however, letting these emotions get out of control can affect negatively your overall well-being. Look out for the help of family, friends, your doctor, a counselor or a support group.
Chemotherapy treatment should be a cooperative effort between you and your doctor. The interaction that takes place is important to your health. It will not only help you feel better, but will also address any potential problems with improper communication.
Patients should educate themselves about mesothelioma and treatment options and reach out to available resources to make coping with a mesothelioma diagnosis easier.
How often you will receive chemotherapy will be determined by your doctor, taking into consideration factors such as the stage of your cancer, the types of drugs you receive, the anticipated toxicities of the drugs and the time necessary for your body to recover from these toxicities. The doctor may also consider whether the goal of the chemotherapy is to control the growth of the cancer, or to ease symptoms associated with the disease.
In general, chemotherapy treatment is administered in "cycles" - a "cycle" being defined as a period of treatment followed by a period of rest. This cycle allows the cancer cells to be attacked by the drugs, and then allows the body's normal cells time to recover. The combination of drugs used, the length of time to administer the drugs, how often they should be repeated and the number of cycles recommended have been analyzed very well in clinical trials.
For mesothelioma patients, the "standard" treatment is a combination of Alimta and cisplatin, administered IV, with a 10 minute infusion of Alimta followed by two hours of cisplatin, given in 21 day cycles. Modifications to this schedule may be made according to what your doctor feels is appropriate in your particular case.
The number of treatment cycles, or the length of time between the beginning and end of chemotherapy may vary, however in general, 3 to 4 cycles of treatment are given before response is evaluated; 2 to 3 cycles are considered a minimum to assess for effectiveness. After response to the treatment has been determined, the following criteria will be used to decide whether chemotherapy should continue:
• If there is shrinkage of the tumor, or the disease is kept stable, chemotherapy may be continued for as long as it can be tolerated and there is no disease progression.
• If there is continued disease progression, chemotherapy will be stopped, and the patient will be given alternative options.
The goal of setting a chemotherapy schedule is to make treatment as effective, timely and trouble-free as possible, but while the drugs are working to kill cancer cells, they may also affect healthy cells causing side effects.
Common Side Effects of Chemotherapy Includes:
-Fever of, or greater than 101 degrees
-Nausea
-Diarrhea or constipation
-Fatigue
-Tingling or numbness in the fingers or toes
-Ringing in the ears
-Bruises or rashes
-Sores in the mouth or throat
-Reduced white blood cell count {neutropenia} making you more prone to infections. For this reason your full blood count should be monitored closely.
Be sure you report all over-the-counter and prescribed medicines to your physician. Don't take aspirin unless it has been approved by your physician. Ask your pharmacist if aspirin is part of the drugs you want to purchase.
Stay away from people who have colds or the flu. Chemotherapy can compromise your immune system and lower your resistance to germs.
It is normal to feel sad, angry or afraid, however, letting these emotions get out of control can affect negatively your overall well-being. Look out for the help of family, friends, your doctor, a counselor or a support group.
Chemotherapy treatment should be a cooperative effort between you and your doctor. The interaction that takes place is important to your health. It will not only help you feel better, but will also address any potential problems with improper communication.
Patients should educate themselves about mesothelioma and treatment options and reach out to available resources to make coping with a mesothelioma diagnosis easier.
Mesothelioma Chemotherapy
Chemotherapy is often one component of mesothelioma treatment that is difficult for the lay person to grasp. Part of the problem is that the literature dealing with this subject is jargon intensive. The other problem is that the science and research are ever advancing. Understanding chemotherapy is truly a moving target. As a nurse, I can assist in cutting through some of the medical jargon, but I would be remiss if I didn't inform patients at the beginning that the principle source of information should be their oncologist, or cancer specialist doctor.
Your oncology doctor is reading all the latest research, and is highly motivated to defeat your cancer, and extend your life. Ask all of your questions without holding back.
All three of the basic approaches to treating mesothelioma; surgery, radiation therapy, and chemogtherapy, are potentially frightening to a patient. Chemotherapy is perhaps a little more difficult to penetrate rationally, and weigh the risks, versus rewards. Certainly, the list of possible side effects is quite intimidating. Mesothelioma, however, is a killer and you must trust your oncologist as he will want to throw everything that he thinks can work at this disease.
If surgery is an option for you, it may be followed by radiation therapy, and/or chemotherapy in order to try to kill the microscopic cancer cells that remain in your body.
The chemotherapy agents that your doctor selects will often be a combination or recipe of drugs that when used together have better outcomes than when used by themselves.
One of the medications that you may encounter is Cisplatin. Cisplatin messes up the DNA strands inside cancer cells by crossing them during cell division and causing these abnormal DNA-crossed cells to die. Another medication , doxorubicin forms free radicals that fracture the DNA strands inside cancer cells. Pemetoexed slows or stops tumor growth by blocking cell enzymes required for the production of RNA and DNA. There are many others, and there are treatment programs that combine medications with radiation. Your treatment will be customized for your specific needs.
All chemotherapy agents have some possible side effects. Remember though, drugs affect different people differently. Fatigue affects many cancer patients, often due to anemia. You will probably be taking high potency vitamins to help combat this. Other blood changes that may occur are low platelets, affecting blood clotting, and low white blood cells, which can affect your resistance to infection. You may experience various gastrointestinal problems, such as vomiting, nausea, diarrhea, or constipation. You may also develop yeast infections, and sores in the mouth. There is also a condition known as "chemo brain". "Chemo brain" is difficulty concentrating, focusing, fuzziness, and poor memory. Side effects may cause you to make some lifestyle changes during the chemotherapy treatment. These side effects ease and go away after the round of chemo is complete.
When you are receiving chemotherapy, what is happening is that the chemo is attacking the cancer cells. Unfortunately, some of the normal cells are also affected. This is why most of the side effects occur. The normal cells that are affected are primarily the fast growing cells. Cancers themselves are fast growing cells. Normal fast growing cells are the bone marrow, where blood cells are produced, the blood cells themselves, the digestive tract including the mouth and stomach, and the hair follicles. Some drugs affect vital organs as well.
Your close relationship with your oncologist is very important. Defeating mesothelioma is a team effort, and he is your quarterback. You are the team owner, so you must play an active role.
Your oncology doctor is reading all the latest research, and is highly motivated to defeat your cancer, and extend your life. Ask all of your questions without holding back.
All three of the basic approaches to treating mesothelioma; surgery, radiation therapy, and chemogtherapy, are potentially frightening to a patient. Chemotherapy is perhaps a little more difficult to penetrate rationally, and weigh the risks, versus rewards. Certainly, the list of possible side effects is quite intimidating. Mesothelioma, however, is a killer and you must trust your oncologist as he will want to throw everything that he thinks can work at this disease.
If surgery is an option for you, it may be followed by radiation therapy, and/or chemotherapy in order to try to kill the microscopic cancer cells that remain in your body.
The chemotherapy agents that your doctor selects will often be a combination or recipe of drugs that when used together have better outcomes than when used by themselves.
One of the medications that you may encounter is Cisplatin. Cisplatin messes up the DNA strands inside cancer cells by crossing them during cell division and causing these abnormal DNA-crossed cells to die. Another medication , doxorubicin forms free radicals that fracture the DNA strands inside cancer cells. Pemetoexed slows or stops tumor growth by blocking cell enzymes required for the production of RNA and DNA. There are many others, and there are treatment programs that combine medications with radiation. Your treatment will be customized for your specific needs.
All chemotherapy agents have some possible side effects. Remember though, drugs affect different people differently. Fatigue affects many cancer patients, often due to anemia. You will probably be taking high potency vitamins to help combat this. Other blood changes that may occur are low platelets, affecting blood clotting, and low white blood cells, which can affect your resistance to infection. You may experience various gastrointestinal problems, such as vomiting, nausea, diarrhea, or constipation. You may also develop yeast infections, and sores in the mouth. There is also a condition known as "chemo brain". "Chemo brain" is difficulty concentrating, focusing, fuzziness, and poor memory. Side effects may cause you to make some lifestyle changes during the chemotherapy treatment. These side effects ease and go away after the round of chemo is complete.
When you are receiving chemotherapy, what is happening is that the chemo is attacking the cancer cells. Unfortunately, some of the normal cells are also affected. This is why most of the side effects occur. The normal cells that are affected are primarily the fast growing cells. Cancers themselves are fast growing cells. Normal fast growing cells are the bone marrow, where blood cells are produced, the blood cells themselves, the digestive tract including the mouth and stomach, and the hair follicles. Some drugs affect vital organs as well.
Your close relationship with your oncologist is very important. Defeating mesothelioma is a team effort, and he is your quarterback. You are the team owner, so you must play an active role.
Chemotherapy - Treatment For Lung Cancer
The process of destroying the cancer cells by introducing the anti cancer drugs into the body is called Chemotherapy. This method can be performed for many types of cancers like lung, ovarian, liver, abdominal, neck and brain cancers as well. Lung cancer arises as a result of the improper growth of cells in the lungs. Lungs are the important organ in our body which purifies the air we breathe. So cancer produced in lungs could be producing breathing problems for us.
The drugs purposely employed for lung cancer is; Carboplatin and Taxol, germicitabine with cisplatin, vinorelbine and cisplatin. These drugs are normally injected into the body rather than taking orally. The treatment may be performed for few days and the patient will be asked to be in rest for few weeks. The treatment performed would be based on the stage of the disease.
Performing chemotherapy brings up so many side effects. The setback of chemotherapy is the side effects. It produces a reduction in the production of the white blood corpuscles (WBC). It is the WBC which is responsible for the protection of our body against infection. Its reduction will indicate that our body is open to all sorts the infections.
As the drugs not only destroy the cancer cells but also some healthy cells, the platelets produced in the body may reduce. These platelets are responsible for the clotting of blood in our body. It may result in unstopped bleeding.
Due to destruction of healthier cells, there may be tiredness, hair loss, sore mouth, vomiting, and anemia and so on. But most of the side effects will be present at the time of treatment, and they may disappear once the treatment gets over.
The drugs purposely employed for lung cancer is; Carboplatin and Taxol, germicitabine with cisplatin, vinorelbine and cisplatin. These drugs are normally injected into the body rather than taking orally. The treatment may be performed for few days and the patient will be asked to be in rest for few weeks. The treatment performed would be based on the stage of the disease.
Performing chemotherapy brings up so many side effects. The setback of chemotherapy is the side effects. It produces a reduction in the production of the white blood corpuscles (WBC). It is the WBC which is responsible for the protection of our body against infection. Its reduction will indicate that our body is open to all sorts the infections.
As the drugs not only destroy the cancer cells but also some healthy cells, the platelets produced in the body may reduce. These platelets are responsible for the clotting of blood in our body. It may result in unstopped bleeding.
Due to destruction of healthier cells, there may be tiredness, hair loss, sore mouth, vomiting, and anemia and so on. But most of the side effects will be present at the time of treatment, and they may disappear once the treatment gets over.
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