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Treatment for peritoneal mesothelioma

It is possible for some people with peritoneal mesothelioma that has not spread to have an operation called a peritonectomy. The surgeon removes the parts of the peritoneum where the mesothelioma is growing. The amount of surgery needed will vary between people. Surgery is usually followed by chemotherapy.

Removing as much of the cancer as possible will help reduce symptoms such as abdominal pain and poor appetite. It will also improve quality of life and increase life expectancy.

Peritonectomy surgery is complex and recovery can take a long time. Whether this surgery is an option for you will depend on several factors, including your overall health and fitness, and whether the small bowel is cancer-free.

Only a small number of surgeons in Australia perform this surgery. It is recommended you seek an opinion from one of these surgeons if considering a peritonectomy. To find contact details, talk to your treatment team or contact a mesothelioma support organisation.

Chemotherapy is sometimes used to treat peritoneal mesothelioma. It may be given as a systemic treatment (into the bloodstream) on its own, or before or after surgery. Systemic chemotherapy for peritoneal mesothelioma is similar to that given for pleural mesothelioma.

Having chemotherapy

If you have a peritonectomy, you will have chemotherapy directly into the abdomen. This is known as intraperitoneal chemotherapy and may be given in several ways:

HIPEC – Heated intraoperative intraperitoneal chemotherapy (HIPEC) is known as “heated chemotherapy”. It involves heating the drugs to 42.5°C and inserting the solution into the abdomen for 60–90 minutes during the operation.

EPIC – After surgery, chemotherapy may be delivered into the abdomen through a thin tube. When given soon after surgery as a single course, it is called early postoperative intraperitoneal chemotherapy (EPIC).

NIPEC – There is evidence that receiving a long-term course of normothermic (normal temperature) intraperitoneal chemotherapy (NIPEC) may offer some benefit.