Treatment options for peritoneal mesothelioma

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 can have surgery to try to remove the peritoneal mesothelioma. Unfortunately, it can't usually get rid of the mesothelioma for good.

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 peritoneal mesothelioma. Or you may have it before or after surgery.

Cancer treatments 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 is not often possible for peritoneal mesothelioma. 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.


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.

For early stage peritoneal mesothelioma, you might have chemotherapy. This goes 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

Clinical trials

Your doctor might ask if you’d like to take part in a clinical trial. Trials make existing treatments better and develop new treatments.

Your choices

Your doctor might offer you a choice of treatments. Discuss each treatment with them and ask how they can control any side effects. This helps you make the right decision for you. You also need to think about the other factors involved in each treatment, such as:

  • whether you need extra appointments
  • if you need more tests
  • the distance you need to travel to and from hospital

You might have to make further choices as your situation changes. It helps to find out as much as possible each time. You can stop a treatment whenever you want to if you find it too much to cope with.

Last reviewed: 
23 Jun 2021
Next review due: 
23 Jun 2024
  • Surgical biology for the clinician: peritoneal mesothelioma: current understanding and management

    T Chua and others

    Canadian Journal of Surgery, 2009. Vol 52, Issue 1. Pages 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. Vol 23, Issue 1. Pages 187-190

  • 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. Vol 19, Issue 4. Page 505-507

  • 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. Vol 38, Issue 4. Pages 258-268. 

  • Malignant peritoneal mesothelioma: Treatment
    RH Alexander and others
    UpToDate, 2021

  • Peritoneal mesothelioma: PSOGI/EURACAN clinical practice guidelines for diagnosis, treatment and follow-up 
    S. Kusamura and others 
    European Journal of Surgical Oncology, 2020. Vol 47. Pages 36-59 

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