On this page: Staging | Making decisions about treatment | Treatment
Staging is a way to describe how far the disease has
spread in the body. Using the results from the tests
taken to diagnose mesothelioma, your medical team
will discuss with you how far it has spread.
Making decisions about treatment
Understanding the available treatment and possible
side effects can help you weigh up the pros and cons of different options. You may want to get a second
opinion from another specialist to confirm or clarify
your doctor’s recommendations.
More on making treatment decisions
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.
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.
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
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
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. For more information call
Cancer Council 13 11 20.
More on surgery
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
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.
More on chemotherapy
Taking part in a clinical trial
Doctors and researchers are working to improve the
diagnosis and treatment of mesothelioma. You may
be offered treatment as part of a clinical trial.
Over the years, trials have improved treatments and led
to better outcomes for people diagnosed with cancer.
It may be helpful to talk to your specialist or clinical
trials nurse, or to get a second opinion. If you decide to
take part in a trial, you can withdraw at any time.
For more information see Understanding Clinical Trials and Research or search for a trial through the Victorian Cancer Trials Link.
Palliative treatment helps to improve a person’s
quality of life by reducing pain and managing
other physical and emotional symptoms. Treatment
may include paracentesis, debulking surgery,
chemotherapy or other medicines.
Because palliative treatment is not intended to cure
the cancer, it is often assumed that it is only for
people at the end of life. However, it is beneficial for
people at any stage of a mesothelioma diagnosis.
Contacting the palliative care team soon after
diagnosis gives them the opportunity to get to
know you, your family and your circumstances.
Although other professionals will be responsible for
your treatment in the earlier part of your diagnosis,
the palliative care team can become involved when
needed and manage your care when active medical
management becomes less effective.
More on palliative care
Reviewed: Prof Paul
Moroz, Professor of Surgery, University of Western Australia and Director of the
Western Australian Peritonectomy Service, Joondalup Health Campus, WA;
Carole Arbuckle, 13 11 20 nurse, Cancer Council Victoria, VIC; Sharyn Fenech,
consumer; Dr Vinod Ganju, Head of Translational Research, Monash Cancer
Centre, VIC; Vicki Hamilton, CEO, Asbestos Council of Victoria-GARDS, VIC;
Dr Tom John, Medical Oncologist, Austin Hospital, VIC; Victoria Keena,
Executive Officer, Asbestos Diseases Research Institute, NSW; Prof David
Morris, University of New South Wales, Department of Surgery, St George
Hospital, NSW; Evelyn Ramirez, consumer; Rod Smith, Bernie Banton
Foundation; Elaine Spellman, Peritonectomy, Clinical Nurse Specialist,
Joondalup Health Campus, WA; Prof Nico van Zandwijk, Director of the
Asbestos Diseases Research Institute and Professor of Medicine, University
of Sydney, NSW and A/Prof Winston Liauw, Cancer Services Stream Director,
South Eastern Sydney Local Health District, NSW.
Note to reader
Always consult your doctor about matters that affect your