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Chemotherapy for peritoneal mesothelioma

Find out about having chemotherapy for peritoneal mesothelioma and 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

Chemotherapy is often given into a vein for peritoneal mesothelioma. This is to shrink the tumour and control your peritoneal mesothelioma for a time. Usually you have this treatment as an outpatient.

Unfortunately, chemotherapy given like this does not work very well for many people with mesothelioma. Researchers are looking for better ways of using chemotherapy.

Sometimes people who are fit and have early stage peritoneal mesothelioma may have chemotherapy directly into the tummy (abdomen). This is given at the same time as debulking (cytoreductive) surgery, or soon afterwards. It aims to get rid of the mesothelioma completely.

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 peritoneal mesothelioma are:

  • pemetrexed and cisplatin
  • gemcitabine
  • irinotecan
  • cyclophosphamide
  • doxorubicin

Drugs used in trials for peritoneal mesothelioma include:

  • cisplatin and doxorubicin
  • heated cisplatin and mitomycin
  • mitomycin on its own
  • fluorouracil and paclitaxel

How you have chemotherapy

Drugs into your bloodstream

You have the treatment through a drip into your arm or hand. 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.

Drugs into your abdomen

For peritoneal mesothelioma, you might have chemotherapy directly into your abdomen alongside surgery.

The doctor makes a small cut in the wall of your tummy (abdomen). Then they put a tube called a catheter through the opening and into your abdomen. 

The chemotherapy is given into your abdominal cavity through the catheter. The drugs are usually heated to a few degrees above body temperature first, because this might make the treatment more effective. This is called hyperthermic intraoperative intraperitoneal chemotherapy (HIIC).

Diagram showing chemotherapy into the abdomen for peritoneal mesothelioma

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You might 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 can usually bring a friend or family member with you.

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

COVID swab test

Due to coronavirus, you need to have a test to check for coronavirus before you have treatment. The test is called a COVID swab test.

To have the test your nurse takes a sample from the inside of your nose and the back of your throat. They use a long cotton bud to take the sample. Or the sample might be saliva or other fluid. Depending on which test your hospital uses, it can take from 90 minutes to a few days to get a result.

At most hospitals, you have a COVID swab test 48 to 72 hours (up to 3 days) before going for your treatment in the chemotherapy unit.

This means you might have the swab test on the same day that you visit the hospital for blood tests and your doctor’s clinic appointment. If you have treatment weekly or more often, some hospitals will ask you to have the swab test on the day of treatment.

Check with your team about when you’ll have the test as there are some differences between hospitals.

Blood tests

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
  • diarrhoea or constipation
  • hair loss
Contact your doctor or nurse immediately if you have signs of infection, including a temperature above 37.5C or below 36C, 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 a few days or so. Your treatment team can help to manage any side effects that you have.

The side effects of chemotherapy into the abdomen tend to be less than with chemotherapy into a vein. But some people have changes in blood pressure and heart rate during the chemotherapy procedure.

Some people also have a high temperature. The changes normally go back to normal a few hours after the treatment.

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.

Last reviewed: 
24 Nov 2015
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    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

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

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

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

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