Chemotherapy for pleural mesothelioma

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

You might have chemotherapy before or after surgery for pleural mesothelioma. Or to control symptoms of advanced mesothelioma. Common chemotherapy drugs for mesothelioma are pemetrexed and cisplatin.

This page is about chemotherapy for pleural mesothelioma. Pleural mesothelioma starts in the tissue (pleura) that cover your lungs.

When you have it

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

  • chemotherapy before surgery (neoadjuvant chemotherapy) 
  • chemotherapy after surgery (adjuvant chemotherapy) 

Chemotherapy can also help to shrink or control advanced pleural mesothelioma. This can help with symptoms, and help some people to live longer. 

You 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 might have a combination of drugs to treat mesothelioma. The most common chemotherapy drugs for treating pleural mesothelioma are:

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

Check the name of the chemotherapy treatment with your doctor or nurse. You can then find out about it on our A to Z list of cancer drugs.

How you have chemotherapy

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.

Treatment cycles

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.

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.

Side effects

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
Contact your doctor or nurse immediately if you have signs of infection. These include 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.

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.

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.

  • ERS/ESTS/EACTS/ESTRO guidelines for the management of malignant pleural mesothelioma
    I Opitz and others
    European Journal of Cardiothoracic Surgery, 2020.  Volume 58, Issue 1, Pages 1-24

  • Malignant pleural mesothelioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
    S Popat and others
    Annals of Oncology, 2022. Volume 33, Issue 2, Pages 129–142

  • Initial management of malignant pleural mesothelioma
    I Harvey and others
    UpToDate, accessed June 2023

  • Pemetrexed for the treatment of malignant pleural mesothelioma [TA135]
    National Institute for Health and Care Excellence, 2008

Last reviewed: 
23 Jun 2023
Next review due: 
23 Jun 2026

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