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Chemotherapy for pleural mesothelioma

Find out when, where and how you have chemotherapy for pleural mesothelioma and about the possible side effects.

What it is

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in the bloodstream.

When you have it

You may have chemotherapy for early stage pleural mesothelioma, alongside surgery and radiotherapy. This can be: 

  • chemotherapy before surgery (neoadjuvant chemotherapy) to shrink the tumour and make it easier to remove
  • chemotherapy after surgery (adjuvant chemotherapy) to stop the cancer coming back for as long as possible

Chemotherapy can also help to shrink or control advanced pleural mesothelioma for some time. This helps some people to live longer. 

You will have to be fit enough to cope with the side effects to have this treatment. You should talk this over with your cancer specialist.

Types of chemotherapy

You have chemotherapy weekly, or every 2 to 3 weeks. This depends on the type of chemotherapy drugs used. 

The drugs most often used to treat pleural mesothelioma are:

  • pemetrexed and cisplatin or sometimes carboplatin
  • raltitrexed usually in combination with cisplatin
  • vinorelbine
  • gemcitabine

How you have chemotherapy

You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You’ll sit in a chair for a few hours so it’s a good idea to take newspapers, books or electronic devices to help to pass the time.

You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump you take home.

For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.

Before you start chemotherapy

You need to have blood tests to make sure it’s safe to start treatment. You have these either a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

Side effects

Common chemotherapy side effects include:

  • feeling sick
  • loss of appetite
  • losing weight
  • feeling very tired
  • a lower resistance to infections
  • bleeding and bruising easily
Contact your doctor or nurse immediately if you have any signs of infection such as a temperature higher than 38C or generally feeling unwell. Infections can make you very unwell very quickly.

Side effects depend on:

  • which drugs you have
  • how much of each drug you have
  • how you react

Tell your treatment team about any side effects that you have.

Most side effects only last for the few days that you’re having the chemotherapy drugs. Your treatment team can help to reduce your side effects.

When you go home

Chemotherapy for mesothelioma can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. The nurse will give you telephone numbers to call if you have any problems at home.

If you have any questions about chemotherapy, you can talk to Cancer Research UK's information nurses on freephone 0808 800 4040, 9am to 5pm, Monday to Friday.
Last reviewed: 
24 Nov 2014
  • Malignant pleural mesothelioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

    P Baas and others on behalf of the ESMO Guidelines Committee

    Annals of Oncology 26 (Supplement 5): v31–v39, 2015

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