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Mesothelioma Drug Side Effect Relieved by Surgery

783511_older coupleA team of plastic surgeons in New York have had good luck dealing with one of the bothersome side effects of the mesothelioma drug, Alimta.

Alimta (pemetrexed) is considered the gold standard chemotherapy drug for malignant pleural mesothelioma. It is often combined with the platinum-based drug cisplatin as a primary mesothelioma treatment or to help shrink mesothelioma tumors before or after surgery. It is also used to treat non-small cell lung cancer. But, like other powerful chemotherapy drugs, Alimta causes certain side effects, one of which can be swelling of the eyelids.

While not life-threatening, eyelid swelling or “edema” can impact quality of life for mesothelioma patients and others on Alimta. But a new article in Ophthalmic Plastic and Reconstructive Surgery details the case of an Alimta patient whose eyelid swelling was successfully treated with eyelid surgery.

According to her doctors, the 77-year-old female lung cancer patient developed “persistent, severe bilateral lower eyelid swelling” which lasted for several months after her chemotherapy. The problem got worse with each successive round of chemotherapy. When compresses and treatment with the antihistamine Benadryl did not help, the patient elected to have eyelid surgery.

“Elective excision was performed with good results and no recurrence after 6 months follow up,” reports study author Neeraj Mangla, BS, with the Department of Ophthalmology at Albany Medical College. Further study of the removed eyelid tissue found that the chemotherapy regimen had triggered changes in the collagen and elastin that are common in people with droopy eyelids (known as dermatochalasis).

Because mesothelioma can have a latency period that lasts for decades, most mesothelioma patients are over 65. The natural aging of the tissue around the eyelids at this age, including slower lymphatic drainage and leaky capillaries, can make older mesothelioma patients especially prone to eyelid swelling with Alimta.

Source: Mangla, N et al, “Pemetred-Associated Eyelid Edema: Effective Treatment by Excision of Lymphedematous Eyelid Tissue”, June 6, 2014, Ophthalmic Plastic & Reconstructive Surgery, Epub ahead of print

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