NCCN Guidelines for Patients
Malignant Pleural Mesothelioma
Part 5: Treating mesothelioma
You can receive chemotherapy either before or after
surgery. Chemotherapy given before surgery is called
neoadjuvant treatment. It is given to shrink the tumor
before it is removed from the body. Pemetrexed with
cisplatin is recommended for neoadjuvant treatment.
Chemotherapy is the use of drugs to treat cancer.
Chemotherapy stops the growth process of cells in an
active growth phase. It doesn’t work on cells in a resting
phase. Cancer cells grow fast, so chemotherapy works
well to stop new cancer cells from being made. However,
it also kills normal cells and can cause side effects. Side
effects are unplanned physical or emotional responses to
treatment. Ask your doctor for a list of side effects caused
Chemotherapy is given in cycles of treatment days
followed by days of rest. Cycles give the body a chance
to recover before the next treatment. The length of 1 cycle
of pemetrexed and cisplatin is 21 days. Pemetrexed and
cisplatin are given on Day 1 of the cycle. Both drugs are
liquids that are slowly injected into your vein.
If you receive neoadjuvant treatment, a CT scan of your
chest is recommended to check treatment results. The
CT scan can show if the tumor is smaller and where it
is still present. See page 11 for more information on CT
scans. Based on the chest CT, your doctors may want
you to have another imaging test to assess if there’s
cancer in the area between your lungs.
Treatment with surgery
Chest CT, and
Pemetrexed + cisplatin
Stage I – III epithelioid or mixed mesothelioma