Mesothelioma Treatment - Chemotherapy - Heated Chemotherapy
Most chemotherapy agents for the treatment of mesothelioma are administered intravenously, typically once a week or once every three or four weeks, for a length of time determined by the patient's physician. There are several common chemotherapeutic agents that may be used to treat mesothelioma, including Alimta, Cisplatin, and Carboplatin.
However, a new form of chemotherapy is being tested in clinical trials involving mesothelioma patients. This treatment, called heated chemotherapy, is showing some promise for the treatment of peritoneal mesothelioma, a form of the disease which involves the protective lining around the abdomen. (Due to the nature of the treatment, it has been deemed not appropriate for pleural or pericardial mesothelioma.)
This treatment was developed by Paul Sugarbaker at the Washington Cancer Institute, and for this reason may sometimes be referred to as the Sugarbaker Technique.
Heated Chemotherapy for Peritoneal Mesothelioma Treatment
Heated chemotherapy for peritoneal mesothelioma, which is also known as Heated Intraoperative Intraperitoneal Chemotherapy, is administered in a very different fashion than most other types of chemotherapy treatment.
During the heated chemotherapy procedure, a patient is treated with chemotherapeutic drugs in liquid form that are administered directly into the peritoneum (the lining of the abdominal cavity). However, before this can occur, the patient undergoes surgery that removes as much of the tumors growing in the peritoneum as possible.
Once the surgical portion of the procedure has been completed, the chemotherapy portion can begin. During this part of the treatment, the patient's peritoneum is permeated with heated chemotherapeutic drugs in order to expose all organs and tissues within the peritoneum to the heated chemotherapeutic agents in a uniform fashion, and to ensure all affected organs receive treatment.
The chemotherapeutic drugs used in the procedure are heated to a temperature of between 44 and 46 degrees Celsius, and the intraperitoneal environment is maintained at a temperature of approximately 42 to 43 degrees Celsius. The chemotherapeutic fluid is perfused in the peritoneum for between one and two hours, and is then drained from the operation site.
Advantages of Heated Chemotherapy
There are two particularly important features of heated chemotherapy that make this a superior alternative to standard chemotherapy for suitable candidates.
First, the chemotherapeutic drugs are applied directly to the affected site. This means that the drugs come in direct contact with tissues that are affected by the mesothelioma. In traditional chemotherapy, the patient is treated with chemotherapeutic drugs intravenously and the patient's entire body is affected by the drugs. Perfusing drugs directly into the peritoneum increases the concentration of the drugs at the site where they are most needed, and also means that patients experience less serious side effects from exposure to chemotherapeutic drugs, because other body cells and organs do not come into direct contact with the drugs.
The second important feature is the fact that the drugs are heated to the approximate temperature of the human body. Heating the chemotherapeutic agents increases their ability to penetrate tissues. This is important because it is difficult for chemotherapeutic drugs to penetrate into large or dense tumors when the drugs are administered in the traditional intravenous method. In addition, the heat from the heated chemotherapeutic drugs is actually damaging in itself, especially to cancer cells.
Is Heated Chemotherapy a Good Treatment Option for You?
Again, it is important to note that heated chemotherapy is currently a treatment option only for patients with peritoneal mesothelioma. If you have mesothelioma of the pleura or pericardium, you will need to explore other treatment options with your cancer doctor.
If you are eligible for heated chemotherapy, both you and your doctor will need to discuss your treatment options extensively before determining whether this is a good option for you.
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