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Treatment decisions for peritoneal mesothelioma

Find out about how your doctor decides which treatment you need, the types of treatment you might have and treatment by stage.

Deciding which treatment you need

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT).

The treatment you have depends on:

  • where your cancer is
  • how far it has grown or spread (the stage)
  • the type of cancer
  • your general health and level of fitness

Your doctor will discuss your treatment, its benefits and the possible side effects with you.

The main treatments

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.

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 part or all of the lining of the abdomen (peritoneum). The aim is to reduce symptoms.

Chemotherapy

You might have chemotherapy into a vein to shrink the tumour and control your peritoneal mesothelioma for a time. But chemotherapy given like this does not work very well for many people with mesothelioma

If you have early stage peritoneal mesothelioma, you might have chemotherapy directly into the tummy (abdomen). You might have it alongside surgery or soon after if you are fit enough.

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.

This is called palliative care. It’s managed by a team of doctors and nurses who are experts in controlling symptoms of advanced cancer. The team may also include a physiotherapist and dietician.

Draining fluid from the abdomen (abdominal paracentesis)

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

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

Diagram showing fluid (ascites) being drained from the abdomen.jpg

Clinical trials to improve treatment

Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to improve treatment by:

  • making existing treatments better
  • developing new treatments
Last reviewed: 
17 Dec 2015
  • Surgical biology for the clinician: peritoneal mesothelioma: current understanding and management

    T Chua and others

    Canadian Journal of Surgery. 2009 February;52(1):59-64.

  • Role of explorative laparoscopy to evaluate optimal candidates for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with peritoneal mesothelioma

    B Laterza and others

    In Vivo. 2009 January-February;23(1):187-90.

  • Combined laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in a patient with peritoneal mesothelioma

    J Esquivel and others

    Journal of Laparoendoscopic & Advanced Surgical Techniques and Videoscopy. 2009 August;19(4):505-7

  • Cyto-reductive Surgery combined with Hyperthermic Intra-peritoneal Chemotherapy for Peritoneal Surface Malignancies: current treatment and results

    A Sommariva and others

    Cancer Treatment Reviews. 2012 June;38(4):258-68. 

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