Peritoneal mesothelioma treatment

This page gives an overview of the treatment options for mesothelioma in the abdomen (tummy). There is information about

• A quick guide to what's on this page
• The main treatments
• Surgery
• Chemotherapy
• Supportive care (palliative care)

A quick guide to what's on this page

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The main treatments

The choice of treatment for peritoneal mesothelioma depends on a number of factors. These include

• The stage of your cancer
• Any other medical conditions you may have
• Your general fitness

Some people with localised abdominal mesothelioma can have surgery to try to remove all of the tumour from the abdominal cavity. 

If you have advanced mesothelioma, you may have surgery to take away as much of the tumour as possible. This type of surgery is called debulking. You may have chemotherapy on its own for advanced abdominal mesothelioma. Or you may have it before or after surgery.

Unfortunately, cancer treatments such as chemotherapy and radiotherapy do not always work well for mesothelioma. Doctors and researchers are working to improve mesothelioma treatment all the time. You may be offered treatment as part of a clinical trial. The results of the trials will be used to improve treatment in the future. We have information about taking part in clinical trials.

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Surgery

Surgery is not often possible for peritoneal mesothelioma as you need to be very fit for this type of major operation. If surgery is possible, the operation is called a peritonectomy. This means removing the part of the peritoneum (the lining of the abdomen) in which the mesothelioma is growing. This aims to reduce symptoms.

You may have a technique known as cytoreductive surgery. This involves the surgeon carrying out a total peritonectomy procedures, to remove as much of the cancer as possible. At the same time as the surgery, and afterwards, heated chemotherapy is given straight into the peritoneal cavity. Doctors have achieved some promising results using these techniques.

Read more detailed information about surgery for mesothelioma. 

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Chemotherapy

Some people with peritoneal mesothelioma may have chemotherapy (anti cancer drugs) injected into a vein. Depending on the type of chemotherapy drugs used, this treatment can be given weekly or every two to three weeks. Usually the treatment is given as an outpatient. It aims to shrink the mesothelioma and keep it under control for as long as possible. But chemotherapy given like this does not work very well for many people with mesothelioma. Research is continuing to try to find better ways of using chemotherapy.

For people who are fit and have early stage peritoneal mesothelioma, chemotherapy may be given directly into the abdomen at the same time as cytoreductive surgery, or soon afterwards. The doctor makes a small cut in the wall of your abdomen. Then they put a tube called a catheter through the opening and into your tummy (abdomen). The chemotherapy is given into your abdominal cavity through the catheter. It is usually heated to a few degrees above body temperature first. This is called hyperthermic intraoperative intraperitoneal chemotherapy (HIIC). A study looking at how well this treatment works found that about half of people who had this treatment were alive at 5 years. 

Read more detailed information about chemotherapy for mesothelioma. 

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Supportive care (palliative care)

Unfortunately peritoneal mesothelioma is often diagnosed when it is quite advanced. Some people may be too ill to cope with intensive chemotherapy. But you can still have treatment to try to relieve symptoms such as pain, weight loss and fluid in the abdomen.

With peritoneal mesothelioma, fluid may collect inside your abdomen. If too much fluid collects, it makes your abdomen swell. This can be uncomfortable and heavy.

You can have the fluid drained off. This is called abdominal paracentesis or an ascitic tap.

Your care will be managed by a palliative care team. This is a team of doctors and nurses who are expert in controlling the symptoms of advanced cancer. The team may also include a physiotherapist and a dietician.