Combining Surgery With Traditional Cancer Treatment

Adjuvant chemotherapy is used to destroy mesothelioma cells that doctors were unable to remove with surgery alone. This type of multimodal chemotherapy treatment is also responsible for longer survival times in mesothelioma patients.

The idea behind neoadjuvant therapy is to shrink any tumors before attempting surgery. Therefore the chemotherapy is administered with the intention of having a future surgical procedure.

Chemotherapy and radiation therapy are the most well-known and traditional treatment methods for patients with all types of cancer. These traditional treatment methods haven’t always been the most effective for mesothelioma patients, but multimodal treatment methods are changing that.

It wasn’t long ago that chemotherapy didn’t have much effect for mesothelioma patients. However, the introduction of new chemotherapy drugs a little over a decade ago has given patients and families cause for hope. Furthering the cause for hope is the way chemotherapy is being administered in addition to surgical treatment.

Neoadjuvant and Adjuvant Chemotherapy

One of the best developments in treating mesothelioma with multiple modes of therapy is the use of neoadjuvant and adjuvant chemotherapy. Neoadjuvant chemotherapy is chemotherapy that is applied prior to surgery whereas adjuvant chemotherapy is administered post-surgery.
Neoadjuvant Therapy

A study in 2004 in 16 patients in varying stages of mesothelioma who had chemotherapy prior to an extrapleural pneumonectomy resulted in several patients living over 3 years, while the median survival for this group was just under 2 years from the date of the surgery.

Adjuvant Chemotherapy
As multimodal therapy is used in essentially all patients who undergo surgery, it is up to the mesothelioma specialist to decide whether neoadjuvant or adjuvant chemotherapy is more appropriate for the patient. However, adjuvant chemotherapy is often replaced with adjuvant radiation therapy, especially in patients who had a pleurectomy with decortication or patients undergoing a trimodality approach.

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