GENTLER CHEMOTHERAPY REGIMENS FOR OLDER MESOTHELIOMA PATIENTS

Open Forum-Faith Franz

In the world of modern medicine, there’s an unspoken idea that stronger treatment equals better results. However, that’s not always the case.

Some drugs, like doxorubicin, have a more than 90 percent chance of causing severe side effects like prolonged nausea and vomiting. Many other drugs are powerful enough to stop (or slow down) tumor growth, but severely reduce the patient’s quality of life with side effects like fatigue, digestive distress and even permanent organ toxicity.

Early-stage cancer patients in good health may be able to withstand invasive surgeries and potent medication regimens. However, elderly patients or patients with co-existing conditions may develop severe side effects without any significant gains in survival.

For these patients, gentler chemotherapy regimens may be a better option.

One study found that carboplatin was gentler than Cisplatin for older mesothelioma patients. Both platinum-based chemotherapy drugs helped reduce the cancer symptoms, but the carboplatin regimen produced slightly better tumor response. The toxicity was also lower in the carboplatin group.

Another study found a similarly gentle esophageal cancer chemotherapy regimen. The researchers compared survival rates and toxicity rates, and found that a combination of epirubicin, Cisplatin and protracted venous infusion fluorouracil was easier to tolerate than other standard combinations.

Other chemotherapy drugs that are generally “milder” and less toxic for older adults include:

  • Vinblastine
  • Methotrexate
  • Gemcitabine
  • Uracil

Not all chemotherapy drugs are appropriate for all diagnoses, however. Your oncologist will help you develop a regimen with the lowest possible toxicity risks based on your specific cancer type and stage.

Other Ways of Lowering Chemotherapy’s Toxicity

Chemotherapy is given in adjustable doses. If your initial regimen is too potent and you experience too many side effects, your doctor may be able to reduce your dose so that your body doesn’t have to process so many harsh chemicals.

If the first round of chemotherapy doesn’t produce the desired effects, your oncologist may consider changing the regimen entirely. They may opt for a different, less harsh combination of drugs, or even just a single drug. (Single-agent chemotherapy is often less likely to cause toxic complications.)

Another option is the drug Glucarpidase. This drug helps reduce toxic levels of chemotherapeutic agents in the patient’s blood stream. It can produce results in as little as 15 minutes – and the results can last as long as eight days. During this time, side effects may be negated or significantly reduced.

Several other medicines are available to help minimize the side effects of chemotherapy. Several common options include:

  • Kytil and Zyfron, anti-nausea medicines that are administered minutes before a chemotherapy infusion.
  • Dronabinol, a potent appetite stimulant that helps cancer patients prevent cachexia.
  • Fiber supplements, including natural options to help counteract chemotherapy-induced constipation.

Alternative medicines can also help patients manage their chemotherapy side effects. Yoga is a powerful anxiety reducer (and helps stimulate the appetite at the same time). Therapeutic massage can relax tense muscles and soothe patients to sleep. Food-based strategies (like high-fiber or low-fiber diets) can also provide relief for chemotherapy-related digestive issues.

You shouldn’t have to sacrifice quality of life for a shot at survival. Don’t hesitate to bring up any issues with your medical team – they’re generally more than willing to help you personalize your regimen for better results.

Faith Franz is a researcher and writer for The Mesothelioma Center. She advocates for alternative medicine and encourages patients to explore all of their treatment options.

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