For most people treatment for peritoneal mesothelioma is given to control symptoms and to slow its growth. Occasionally, more aggressive treatment is offered if a better outcome is considered possible. Your doctor will recommend the best treatment for you, depending on:
• whether the mesothelioma has spread
• your age, fitness and general health
• your preferences.
Paracentesis
As well as being used to diagnose mesothelioma, paracentesis can also provide pain relief in patients with ascites. A small tube is inserted to allow fluid to flow out of the abdomen into a bottle.
Surgery
For many people peritoneal mesothelioma is diagnosed at an advanced stage, when it is aggressive or has spread through the body. This means surgery is not suitable for most people. If you have advanced mesothelioma, you may be offered debulking surgery.
During this procedure, as much of the cancer is removed as possible in the hope of stopping the spread of disease and relieving pressure on vital organs. Debulking surgery is generally regarded as palliative treatment, which means it helps to reduce symptoms and improve quality of life, but does not aim to cure the cancer.
If the cancer is not widespread, it is possible for some people to have an operation called a peritonectomy (or cytoreductive surgery). During this procedure, a surgeon removes the parts of the peritoneum where the mesothelioma is growing.
The aim is to achieve the complete removal of the cancer to reduce symptoms, improve quality of life and increase life expectancy. For a small number of carefully selected people, peritonectomy may be combined with heated intraoperative intraperitoneal chemotherapy (HIPEC).
This is when chemotherapy drugs are heated to 42°C and inserted into the abdomen for 60-90 minutes during the operation.
After surgery, a course of chemotherapy may be delivered directly into the abdomen through a thin tube, called early postoperative intraperitoneal chemotherapy (EPIC).
Peritonectomy surgery is complex and has an extended recovery time. It is performed by a limited number of surgeons in Australia. It is recommended you seek an opinion from one of these surgeons if considering this surgery.
Chemotherapy
Chemotherapy may be offered as part of a treatment plan. This is a way to treat cancer using anti-cancer (cytotoxic) drugs. It aims to kill off or shrink the mesothelioma and keep it under control for as long as possible.
Chemotherapy can be delivered through a vein (intravenously). In this case, it is given on a regular basis (weekly or every 2-3 weeks) over a period of time. Chemotherapy can also be injected directly into the abdomen, through a thin tube called a catheter.
This is called intraperitoneal chemotherapy. Chemotherapy may be given on its own or before, during or after surgery.
