MesotheliomaWeb Launches New Page on Dose-Dense Chemotherapy
Mesothelioma Web, the superbly comprehensive site that provides information, coping and lifestyle tips for victims of mesothelioma, recently posted a new offering on its website explaining the nature of what is known among cancer doctors and researchers as dose-dense chemotherapy, or DDC.
Malignant mesothelioma is a rare but devastating form of cancer whose only medically recognized cause is asbestos fibers. Unlike most cancers, mesothelioma can lie dormant for up to five decades, but when it does begin to produce definitive symptoms – and is diagnosed – the typical prognosis is about a year to live.
Dose-dense chemotherapy is simply an accelerated chemotherapy protocol. That is, instead of delivering chemotherapy drugs over an oncologist-prescribed period of time, called a LOT (length of time), and then allowing the patient to “rest” for the usual three-week period before beginning a new cycle of treatment, dose-dense therapy reduces the rest period to two weeks.
This respite period allows patients to recover from the side effects of chemotherapy, the most dangerous of which is reduced white blood cell counts. More specifically known as neutropenia, this deficiency can cause chemotherapy patients to develop serious, peripheral illnesses like pneumonia, which can be critical to patients weakened by cancer-destroying chemicals.
In dose-dense chemotherapy, administration of drugs that boost the body’s production of both white and red blood cells helps to ameliorate both the consequent anemia and the neutropenia – which in worst-case scenarios can produce a fever in excess of 104 degrees, further weakening patients. In fact, this additional blood-boosting regimen may actually reduce the prevalence of neutropenia among chemotherapy patients at large, even where rest periods are reduced as in dose-dense therapy.
Dose-dense chemotherapy, according to the site, shows greatest promise in the case of ER/PR/HER2-negative (estrogen-receptor-negative) breast cancer, but may also offer additional hope in other types of cancer, including mesothelioma.
Developed in the 1980s, this dose-dense administration protocol is based on the work of Benjamin Gompertz, who in 1825 described a pattern of cytokine behavior as related to cancer that showed a non-accelerating response in the programmed growth of tumor cells. Cytokines, by the simplest definition, are cell signalers, telling cells when to reproduce and when to die.
Researchers have since used Gompertz’s work to devise a cancer treatment protocol based on the fact that chemotherapy is most beneficial when tumor cells are dividing and multiplying quickly. This protocol was later used to develop clinical trials, one of which (in the U.S. in 2002) showed that dose-dense chemotherapy among ER/PR/HER2-negative breast cancer patients (whose tumors had spread to lymph nodes) had an increased, cancer-free survival rate of 7 percent, compared to breast cancer sufferers who had undergone conventional chemotherapy. The ER/PR/HER2-negative version of the disease represents only 25 percent of breast cancer presentations.
These results were duplicated and improved in a Phase III study in Germany, with the caveat that patients’ quality of life was decreased compared to conventional chemotherapy regimens – a not surprising result, given the statistical side effects of chemotherapy.
Dose-dense therapy has not been shown as effective in treating non-Hodgkin’s lymphoma (except for those over 61), or in cases of bone cancer. Clinical trials testing its use in ovarian and lung cancer are in progress.
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