This section tells you about the treatment for pleural (lining of the lungs) and peritoneal (lining of the abdomen) mesothelioma. It includes information about the factors which affect which treatment you have as well as information about the main treatments.
Pleural mesothelioma treatment
Unfortunately mesothelioma can be very difficult to treat as it is often found when it is advanced. Nearly all treatment is aimed at controlling the mesothelioma for as long as possible and keeping symptoms under control.
Your treatment options will depend on
- Your general fitness
- The stage of your cancer
- Any other medical conditions you may have
If you have more advanced mesothelioma, you may have chemotherapy to shrink it and reduce symptoms. We know from research that chemotherapy can help some people to live some weeks or months longer. Radiotherapy may also shrink the cancer and control symptoms.
Chemotherapy
Chemotherapy uses anti cancer drugs, which for mesothelioma are usually injected into a vein. Depending on the type of chemotherapy drugs used, you may have treatment weekly, or every 2 to 3 weeks.
Chemotherapy may be used to control symptoms in more advanced mesothelioma which cannot be removed surgically. The treatment may also help to slow down the growth of the cancer.
If you have surgery for early stage mesothelioma, you may have chemotherapy before or afterwards. Chemotherapy before surgery is called neoadjuvant chemotherapy and aims to shrink the tumour and make it easier to remove. Chemotherapy after surgery is called adjuvant chemotherapy and aims to delay the cancer coming back for as long as possible.
Radiotherapy is usually given to reduce the symptoms of stage 2, 3, or 4 mesothelioma. It may also slow down the growth of the tumour.
If you have surgery for stage 1 mesothelioma you may have radiotherapy afterwards to try to stop the cancer coming back or to delay it coming back for as long as possible. Radiotherapy given after surgery is called adjuvant radiotherapy.
The length of your radiotherapy treatment will depend on the type and size of your mesothelioma and on why you are being treated.
Chemotherapy may be used to control symptoms in more advanced mesothelioma which cannot be removed surgically. The treatment may also help to slow down the growth of the cancer.
If you have surgery for early stage mesothelioma, you may have chemotherapy before or afterwards. Chemotherapy before surgery is called neoadjuvant chemotherapy and aims to shrink the tumour and make it easier to remove. Chemotherapy after surgery is called adjuvant chemotherapy and aims to delay the cancer coming back for as long as possible.
Radiotherapy
If you have surgery for stage 1 mesothelioma you may have radiotherapy afterwards to try to stop the cancer coming back or to delay it coming back for as long as possible. Radiotherapy given after surgery is called adjuvant radiotherapy.
The length of your radiotherapy treatment will depend on the type and size of your mesothelioma and on why you are being treated.
Surgery
Surgery can be used to try to completely remove the
mesothelioma. There are 2 main types of operation for this. These are
removing the pleura (pleurectomy) or removing the pleura together with
the lung, pericardium and diaphragm (extrapleural pneumonectomy).
For people with advanced mesothelioma, the surgery aims to remove as much tumour as possible to relieve symptoms - this is called palliative surgery or debulking.
For people with advanced mesothelioma, the surgery aims to remove as much tumour as possible to relieve symptoms - this is called palliative surgery or debulking.
Supportive care (palliative care)
Mesothelioma is often diagnosed when it is quite advanced.
Some people with very advanced disease may be too ill to cope with
treatments such as chemotherapy, radiotherapy or surgery. But they can
still have treatment to try to relieve symptoms such as pain, breathing
problems and weight loss. Your care will be managed by a palliative care
team. This is a team of doctors and nurses who are expert in
controlling symptoms of advanced cancer. The team may also include a
physiotherapist and dietician.
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. The results of the trials will be used to improve treatment in the future.
Some people with peritoneal mesothelioma may have chemotherapy
(anti cancer drugs) injected into a vein. Depending on the type of
chemotherapy drugs used, this treatment can be given weekly or every two
to three weeks. Usually the treatment is given as an outpatient. It
aims to shrink the mesothelioma and keep it under control for as long as
possible. But chemotherapy given like this does not work very well for
many people with mesothelioma. Research is continuing to try to find
better ways of using chemotherapy.
For people who are fit and have early stage peritoneal mesothelioma, chemotherapy may be given directly into the abdomen at the same time as cytoreductive surgery, or soon afterwards. The doctor makes a small cut in the wall of your abdomen. Then they put a tube called a catheter through the opening and into your tummy (abdomen). The chemotherapy is given into your abdominal cavity through the catheter. It is usually heated to a few degrees above body temperature first.
This is called hyperthermic intraoperative intraperitoneal chemotherapy (HIIC). A study looking at how well this treatment works found that about half of people who had this treatment were alive at 5 years.
Your care will be managed by a palliative care team. This is a team of doctors and nurses who are expert in controlling the symptoms of advanced cancer. The team may also include a physiotherapist and a dietician.
Peritoneal mesothelioma treatment
The choice of treatment for peritoneal mesothelioma depends on a number of factors. These include
- The stage of your cancer
- Any other medical conditions you may have
- Your general fitness
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. The results of the trials will be used to improve treatment in the future.
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
the part of the peritoneum (the lining of the abdomen) in which the
mesothelioma is growing. This aims to reduce symptoms.
You may have a technique known as cytoreductive surgery. This involves the surgeon carrying out a total peritonectomy procedures, to remove as much of the cancer as possible. At the same time as the surgery, and afterwards, heated chemotherapy is given straight into the peritoneal cavity. Doctors have achieved some promising results using these techniques.
You may have a technique known as cytoreductive surgery. This involves the surgeon carrying out a total peritonectomy procedures, to remove as much of the cancer as possible. At the same time as the surgery, and afterwards, heated chemotherapy is given straight into the peritoneal cavity. Doctors have achieved some promising results using these techniques.
Chemotherapy
For people who are fit and have early stage peritoneal mesothelioma, chemotherapy may be given directly into the abdomen at the same time as cytoreductive surgery, or soon afterwards. The doctor makes a small cut in the wall of your abdomen. Then they put a tube called a catheter through the opening and into your tummy (abdomen). The chemotherapy is given into your abdominal cavity through the catheter. It is usually heated to a few degrees above body temperature first.
This is called hyperthermic intraoperative intraperitoneal chemotherapy (HIIC). A study looking at how well this treatment works found that about half of people who had this treatment were alive at 5 years.
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.
With peritoneal mesothelioma, fluid may collect inside your abdomen. If too much fluid collects, it makes your abdomen swell. This can be uncomfortable and heavy.
You can have the fluid drained off. This is called abdominal paracentesis or an ascitic tap.With peritoneal mesothelioma, fluid may collect inside your abdomen. If too much fluid collects, it makes your abdomen swell. This can be uncomfortable and heavy.
Your care will be managed by a palliative care team. This is a team of doctors and nurses who are expert in controlling the symptoms of advanced cancer. The team may also include a physiotherapist and a dietician.