Chemotherapy for peritoneal mesothelioma

About chemotherapy and mesothelioma

Mesothelioma usually starts in the tissue covering the lung (the pleura). Less often, it can start in tissue in your tummy (peritoneum).

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. You might have chemotherapy:

• into your vein to help control the symptoms of peritoneal mesothelioma - the drugs circulate throughout your body in the bloodstream

• directly into your tummy (abdomen) if you are having surgery - this is called hyperthermic intraperitoneal chemotherapy (HIPEC)

When you have it

You might have chemotherapy into a vein for peritoneal mesothelioma (intravenous chemotherapy). This is to shrink the tumour and control your peritoneal mesothelioma for a time. 

Unfortunately, for many people, the chemotherapy doesn't work very well. Researchers are looking for better ways of using chemotherapy.

If you are fit and have early stage peritoneal mesothelioma, you might have chemotherapy directly into your tummy (abdomen). You have this at the same time as debulking (cytoreductive) surgery, or soon afterwards. 

Read more about surgery for peritoneal mesothelioma

Types of chemotherapy

The most common drugs for treating peritoneal mesothelioma are:

• cisplatin

• pemetrexed

• gemcitabine

• vinorelbine

• carboplatin

Read more about these chemotherapy drugs

How you have chemotherapy

Drugs into your bloodstream

You have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.

Or you might have treatment through a long line: a central line, a PICC line or a portacath. These are long plastic tubes that give the drug into a large vein in your chest. The tube stays in place throughout the course of treatment. This means your doctor or nurse won't have to put in a cannula every time you have treatment.

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. 

They give you the chemotherapy drugs into your abdominal cavity through the catheter. They usually heat the drugs to a few degrees above body temperature. This can help it work better. This is called hyperthermic intraperitoneal chemotherapy (HIPEC).

Treatment cycles for chemotherapy into a vein

You take some cancer medicines in treatment cycles. This means you take the drug for a set period, followed by a break. For example, you might take a drug every day for a week and then not take it for 2 weeks. This 3 week period in total is one cycle of treatment.

Take your cancer drugs exactly as your doctor, specialist nurse or pharmacist has told you to. The break from treatment is important too. For many cancer drugs, it allows your body to recover.

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 things in to do. For example, newspapers, books or electronic devices can all 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.

Some hospitals may give certain chemotherapy treatments to you at home. Your doctor or nurse can tell you more about this.

Watch the video below about what happens when you have chemotherapy. It is almost 3 minutes long.

Before you start chemotherapy

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

Your blood cells need to recover from your last treatment before you have more chemotherapy. Sometimes your blood counts are not high enough to have chemotherapy. If this happens, your doctor usually delays your next treatment. They will tell you when to repeat the blood test.

Side effects of chemotherapy into your vein

Common chemotherapy side effects include:

• feeling sick

• loss of appetite

• losing weight

• feeling very tired

• increased risk of getting an infection

• bleeding and bruising easily

• diarrhoea or constipation

• hair loss

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.

Side effects of chemotherapy into your abdomen

The side effects of chemotherapy into the abdomen are different to chemotherapy into a vein. You have the chemotherapy at the same time as surgery. Your doctor will tell you more about the side effects.

Dietary or herbal supplements and chemotherapy

Let your doctors know if you:

• take any supplements

• have been prescribed anything by alternative or complementary therapy practitioners

It’s unclear how some nutritional or herbal supplements might interact with chemotherapy. Some could be harmful.

Read about the safety of complementary and alternative therapies

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.