Key takeaways: Chemotherapy is an exceptionally effective measure to treat malignant pleural mesothelioma (MPM). It is a systemic treatment, meaning it affects both cancerous and healthy cells within one’s body. Chemo seeks to control, cure, or provide palliation for cancer, meaning that it achieves different goals depending on the type, stage and spread (metastasis) of cancer. Because chemo is disruptive to all body cells, there are certain characteristic side effects of care; however, most healthy cells are able to return to normal functioning once care is complete.
What is Chemotherapy?
Chemotherapy is a systemic method of treating cancer, as it affects both the cancerous cells and the healthy cells in a patient. It is a class of drugs that has several methods of administration, including intravenously (IV), orally (through ingestion/the mouth), through injection, or topically (on top of the skin, through a gel or cream). Drugs are regarded as chemotherapeutic based on their effects on cells, which is the disruption of the cell cycle. The cell cycle is the micro life cycle of cells, which includes DNA transcription and translation (the copying of DNA to be passed to daughter cells), how quickly cells “mature,” and how quickly cells die. Chemotherapeutic drugs intervene in this process in different, micro ways. Some drugs (alkylating agents) disrupt the arrangement of DNA, which in turn makes the cellular reproduction process inert. Other drugs (topoisomerase inhibitors) intercept the enzymes that are responsible for separating DNA strands so that they can be copied for daughter cells.
Other drugs (anti-tumor antibiotics) target cancerous cells’ DNA by disrupting the normal sequence of amino acids, thus making DNA replication nearly impossible. While this isn’t an exhaustive list of the kinds of chemotherapy drugs, it gives a working impression of how they work: they disrupt, interfere with, and hinder cellular division. One characteristic of cancer–and MPM in particular–is its rapid cellular growth; cancerous cells undergo exaggerated growth. This makes chemotherapy a viable option: by slowing down the growth of all cells, cancerous cells a.) are slowed in their production; and b.) cannot use the body’s healthy tissues from which to extract nutrients and support.
Mesothelioma Chemotherapy Treatment – How it Works
- Cure When MPM is caught in a very early stage, there is an opportunity for cure. This means that the tumor(s) is completely eradicated through chemotherapy interventions; however, this does not mean that the cancer will never return.
- Control Because MPM is an aggressive form of cancer, chemotherapy will oftentimes be used to control, or curb, the further spread of cancer. This could mean preventing MPM from migrating from the pleural tissues or lungs into other parts of the body, which in turn results in an increased prognosis. When used to “control,” chemotherapy helps manage a cancer long-term–akin to treating a chronic illness.
- Palliative Care When “cure” or “control” do not apply to the staging or metastasis of MPM, chemotherapy can help to increase one’s quality of life. Palliative care via chemotherapy seeks to ease one’s pain and discomfort by either shrinking tumors or preventing further spread.
Implications of Care
Because chemotherapy interferes with the reproductive efforts of all cells, it’s important to note that there are distinct side effects associated with its use. Healthy cells that reproduce relatively quickly are impacted the most: skin cells, hair cells, cells in the digestive and reproductive tracts, and cells that create blood (located in the bone marrow of long bones). Some side effects include general fatigue, susceptibility to infection (immunosuppression), hair loss, changes in appetite and digestion, changes in mood, issues with fertility, nerve problems, and more. While the side effects are significant, the success of chemotherapy outweighs the temporary side effects. Doctors often prescribe other medications and treatments to mitigate the effects of chemotherapy on quality of life. Additionally, chemotherapy is often paired with other forms of treatment in order to successfully (and contextually) treat MPM.
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Sources:
Annals Of Cardiothoracic Surgery
