Types of Local Chemotherapy for Mesothelioma


Mesothelioma, a form of cancer primarily caused by asbestos exposure, can affect various parts of the body, including the lining of the lungs (pleural mesothelioma) and the abdomen (peritoneal mesothelioma). Treatment strategies for mesothelioma often focus on combining surgical interventions with localized chemotherapy to directly target cancer cells in specific areas. Among the localized chemotherapy techniques, Hyperthermic Intraperitoneal Chemotherapy (HIPEC) and Hyperthermic Intrathoracic Chemotherapy (HITHOC) are noteworthy for their innovative approach to treating mesothelioma by using heated chemotherapy drugs.

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Peritoneal Mesothelioma

HIPEC is a cutting-edge treatment option specifically designed for patients with peritoneal mesothelioma, which affects the abdominal cavity. This procedure involves the surgical removal of as much of the cancer as possible, known as cytoreductive surgery (CRS), followed by the direct application of heated chemotherapy drugs into the abdominal cavity. The heat enhances the effectiveness of the chemotherapy by improving drug absorption and penetration into cancerous tissues, while also directly killing cancer cells through thermal damage.

The rationale behind using HIPEC after CRS is to eliminate microscopic cancer cells that may remain post-surgery, thereby reducing the risk of recurrence. This method has been recognized as a gold standard for treating peritoneal mesothelioma, with multiple studies highlighting its potential to significantly extend the survival rates of patients. The heat not only facilitates a better distribution of the chemotherapy drugs but also increases their cytotoxicity against cancer cells, offering a dual benefit in the treatment process.

Hyperthermic Intrathoracic Chemotherapy (HITHOC) for Pleural Mesothelioma

Similar to HIPEC, HITHOC targets mesothelioma located in the chest cavity, specifically pleural mesothelioma. This approach involves the application of heated chemotherapy directly into the thoracic cavity following surgical interventions aimed at removing tumor mass from the chest area. The principle behind HITHOC is akin to that of HIPEC, leveraging the benefits of heat to enhance the efficacy of chemotherapy drugs.

By applying chemotherapy in a heated, localized manner, HITHOC aims to destroy residual cancer cells that surgery alone might not eliminate. This technique is part of a multimodal treatment strategy, combining surgery, chemotherapy, and sometimes radiation therapy, to provide a comprehensive attack against mesothelioma.

Advantages of Localized Chemotherapy for Mesothelioma

Localized, heated chemotherapy methods like HIPEC and HITHOC offer several advantages over traditional systemic chemotherapy, including:

  • Targeted Treatment: Directly targeting the affected area allows for higher concentrations of chemotherapy drugs at the site of the tumor, which can lead to better outcomes.
  • Reduced Systemic Toxicity: By localizing the chemotherapy, there is less exposure for the rest of the body, which can reduce side effects.
  • Enhanced Effectiveness: Heating the chemotherapy drugs can enhance their ability to kill cancer cells.

These innovative treatments represent significant progress in the management of mesothelioma, providing hope for patients through potentially longer survival times and improved quality of life. However, the suitability of HIPEC or HITHOC for an individual patient depends on various factors, including the stage of the cancer, the patient’s overall health, and the specific characteristics of their mesothelioma. As research continues, these therapies are being refined to maximize their benefits for patients battling this challenging disease.

Remember these are significant surgeries and must be taken very seriously before deciding on doing either of them.