Peritoneal Mesothelioma Treatment

Your choice of treatment for peritoneal mesothelioma will depend on a number of factors. These include:

• The stage of your cancer
• Any other medical conditions you may have
• Your general fitness

Treatment of Peritoneal Cancer:

1. Surgery. Surgery is not possible for everyone with peritoneal mesothelioma. If surgery is possible, the operation is called a peritonectomy. This means removing the peritoneum (the lining of the abdomen) where the mesothelioma has started growing. In recent years some doctors have been developing a technique known as cytoreductive surgery for peritoneal mesothelioma. Cytoreductive surgery involves the surgeon carrying out up to 6 different peritonectomy procedures, to remove as much of the cancer as possible. At the same time, or shortly after, chemotherapy may be given straight into the peritoneal cavity.
2. Medical Management. In addition to the symptoms of abdominal pain, distension and ascites peritoneal mesothelioma can be associated with hypoalbuminemia, night sweats, inguinal and umbilical hernia, and hypercoagulability. A new drug combination such as cisplatin plus pemetrexed that have shown promise in pleural mesothelioma may also be effective in peritoneal mesothelioma. Immunotherapeutic agents such as interferon and various cytokines may have a role in treating this disease especially when the amount of disease is minimal.
   
3. Chemotherapy. Chemotherapy uses anti-cancer drugs, which are usually injected into a vein. For mesothelioma, chemotherapy may be given directly into the abdomen. Depending on the type of chemotherapy drugs used, this treatment can be given weekly or every two to three weeks. It can be given at the same time as cytoreductive surgery, or soon after. The doctor has to make a small cut in the wall of your abdomen. Then the doctor puts a tube called a catheter through the opening and into your tummy (abdomen). The chemotherapy is given into your abdominal cavity through the catheter. Some studies have suggested that this can work better if it is heated to a few degrees above body temperature first. This is called hyperthermic intraoperative intraperitoneal chemotherapy (HIIC).
4. Radiation Therapy. Radiation may be targeted directly at cancer cells or can be used for palliative reasons such as to reduce pain or shortness of breath or to control the spread of the tumor. This internal radiation therapy has a number of advantages, including the ability for doctors to treat a small area with a higher dose of radiation in a shorter amount of time. Brachytherapy may be either temporary or permanent.
5. 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 other symptoms such as fluid in the abdomen.
   With more advanced 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. It is sometimes called an ascitic tap.
   
   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. By: Cancer Help
6. Clinical Trial.

• Promoting new drug.
• Perfused Heated Cisplatin. This study will test the effectiveness of an experimental treatment for peritoneal cancer involving surgical removal of the tumor, perfusion of the abdomen during surgery with a heated solution of the drug cisplatin, and post-surgery combination chemotherapy in the abdomen with fluorouracil (5-FU) and paclitaxel.