Treatment of peritoneal mesothelioma

Peritoneal mesothelioma is difficult to treat because it spreads quickly throughout the abdomen. Most people have advanced disease when they are diagnosed. Treatment is given to control the cancer for as long as possible, manage symptoms and improve quality of life.

The following are treatment options for peritoneal mesothelioma. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Chemotherapy is the main treatment for peritoneal mesothelioma. It is given as a regional therapy. This means that the chemotherapy drugs are put directly into the peritoneal cavity. This is called intraperitoneal chemotherapy. When the drugs are heated before they are put into the body, it is called hyperthermic intraperitoneal chemotherapy.

For people who have surgery for peritoneal mesothelioma, the chemotherapy drugs will be put into the abdominal cavity at the end of the surgery. For people who can’t have surgery, the chemotherapy drugs are put into the peritoneal cavity through a hollow tube (catheter) inserted into the abdomen.

The most common chemotherapy drugs used for intraperitoneal chemotherapy are:

• cisplatin
• mitomycin (Mutamycin)
• doxorubicin (Adriamycin)

Sometimes cisplatin is combined with either mitomycin or doxorubicin.

Surgery is usually not possible for people with peritoneal mesothelioma because the cancer has usually spread too much for it to be completely removed. Surgery is often used to relieve symptoms caused by peritoneal mesothelioma.

The surgeries used for peritoneal mesothelioma include:

• debulking surgery – removing as much of the mesothelioma as possible before using intraperitoneal chemotherapy
• paracentesis – draining fluid buildup from the abdomen

External beam radiation therapy may be used to relieve pain and control symptoms of advanced peritoneal mesothelioma. It is not used as a main treatment because many of the organs in the abdomen are sensitive to the effects of radiation.

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.

There may be a clinical trial in Canada open to people with peritoneal mesothelioma. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.