Chemotherapy for peritoneal mesothelioma

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells.

You might have chemotherapy:

into your vein to help control the symptoms of peritoneal mesothelioma - the drugs circulate throughout your body in the bloodstream
directly into your tummy (abdomen) if you are having surgery - this is called hyperthermic intraperitoneal chemotherapy (HIPEC)

This page is about chemotherapy for peritoneal mesothelioma. Peritoneal mesothelioma starts in the tissue covering your abdomen.

When you have it

You might have chemotherapy into a vein for peritoneal mesothelioma (intravenous chemotherapy). This is to shrink the tumour and control your peritoneal mesothelioma for a time.

Unfortunately, for many people, the chemotherapy doesn't work very well. Researchers are looking for better ways of using chemotherapy.

If you are fit and have early stage peritoneal mesothelioma, you might have chemotherapy directly into your tummy (abdomen). You have this at the same time as debulking (cytoreductive) surgery, or soon afterwards.

Types of chemotherapy

The most common drugs for treating peritoneal mesothelioma are:

cisplatin
pemetrexed
gemcitabine
vinorelbine
carboplatin

How you have chemotherapy

Drugs into your bloodstream

You have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.

Or you might have treatment through a long line: a central line, a PICC line or a portacath. These are long plastic tubes that give the drug into a large vein in your chest. The tube stays in place throughout the course of treatment. This means your doctor or nurse won't have to put in a cannula every time you have treatment.

Drugs into your abdomen

For peritoneal mesothelioma, you might have chemotherapy directly into your abdomen, alongside surgery.

The doctor makes a small cut in the wall of your tummy (abdomen). Then they put a tube called a catheter through the opening and into your abdomen.

They give you the chemotherapy drugs into your abdominal cavity through the catheter. They usually heat the drugs to a few degrees above body temperature. This can help it work better. This is called hyperthermic intraperitoneal chemotherapy (HIPEC).

Diagram showing chemotherapy into the abdomen for peritoneal mesothelioma

Treatment cycles for chemotherapy into a vein

You take some cancer medicines in treatment cycles. This means you take the drug for a set period, followed by a break. For example, you might take a drug every day for a week and then not take it for 2 weeks. This 3 week period in total is one cycle of treatment.

Take your cancer drugs exactly as your doctor, specialist nurse or pharmacist has told you to. The break from treatment is important too. For many cancer drugs, it allows your body to recover.

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so it’s a good idea to take things in to do. For example, newspapers, books or electronic devices can all help to pass the time. You can usually bring a friend or family member with you.

You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump that you take home.

For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.

Some hospitals may give certain chemotherapy treatments to you at home. Your doctor or nurse can tell you more about this.

Watch the video below about what happens when you have chemotherapy. It is almost 3 minutes long.

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Transcript

Download transcript [pdf]

Clare Disney (nurse): Hello, my name is Clare and this is a cancer day unit.

So when you arrive and you’ve reported into with the receptionist, one of the nurses will call you through when your treatment is ready, sit you down and go through all the treatment with you.

Morning, Iris. My name is Clare. I am the nurse who is going to be looking after you today. We’re going to start by putting a cannula in the back of your hand and giving you some anti sickness medication. And then I am going to come back to you and talk through the chemotherapy with you and the possible side effects you may experience throughout your treatment. Is that okay?

Before you have each treatment you’ll need to have a blood test to check your bloods are okay. And you’ll also be reviewed by one of the doctors to make sure you’re fit and well for your treatment. Sometimes you’ll have the blood test taken on the day of your treatment; other times you’ll have it the day before your treatment when you see the doctor.

Each chemotherapy is made up for each individual patient, depending on the type of cancer they have and where it is and depending their height, weight and blood results.

So, depending on where your cancer is some people have their chemotherapy drug, their cancer drug by drip, some will have an injection and other people will have tablets.

So, Iris, your chemotherapy is going to be given to you in what we call cycles and the cycles are given every three weeks for a period of six cycles. So, you will be coming in for approximately five months for your chemotherapy.

Depending on where your cancer is and what type of cancer you have will be dependent on how often you come in for treatment. An example of a treatment cycle would be for you to come in on Day 1, Day 8 and Day 15 then to have a week’s break before you come back again for Day 1 treatment.

Depending on the type of treatment that you are having we will also give you some anti sickness tablets to take alongside your chemotherapy and also some drugs to prevent any reactions if that’s appropriate.

All chemotherapy is given over different time periods so it’s best to check with your nurse about how long you are likely to be in the unit for. This can range from anything up to an hour to an all day treatment slot so please be prepared to bring along some bits to keep you occupied, such as books and music.

So, before you go home it’s important to make sure you have got the tablets you need to go home with your anti sickness medications and any other symptom control tablets that you may require. Also, to make sure that you’ve got the telephone numbers for the oncology unit to phone if you have a temperature or you are experiencing any other symptoms at home that you need to ask advice about.

So, please make sure when you leave the unit that you’ve got all the information you require and if you’ve got any questions at all don’t hesitate to ask the nurse who will be able to answer them for you.

Before your next cycle of treatment you will come in and see the doctor in the clinic room, you’ll have a blood test and an examination to make sure you are fit and well for treatment you will then come back the following day or later on that week for treatment.

Before you start chemotherapy

You need to have blood tests to make sure it’s safe to start treatment. You usually have these a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

Your blood cells need to recover from your last treatment before you have more chemotherapy. Sometimes your blood counts are not high enough to have chemotherapy. If this happens, your doctor usually delays your next treatment. They will tell you when to repeat the blood test.

Side effects of chemotherapy into your vein

Common chemotherapy side effects include:

feeling sick
loss of appetite
losing weight
feeling very tired
increased risk of getting an infection
bleeding and bruising easily
diarrhoea or constipation
hair loss

Contact your hospital advice line immediately if you have signs of infection. These include a temperature above 37.5C or below 36C, or generally feeling unwell. Infections can make you very unwell very quickly.

Side effects depend on:

which drugs you have
how much of each drug you have
how you react

Tell your treatment team about any side effects that you have.

Most side effects only last for a few days or so. Your treatment team can help to manage any side effects that you have.

Side effects of chemotherapy into your abdomen

The side effects of chemotherapy into the abdomen are different to chemotherapy into a vein. You have the chemotherapy at the same time as surgery. Your doctor will tell you more about the side effects.

Dietary or herbal supplements and chemotherapy

Let your doctors know if you:

take any supplements
have been prescribed anything by alternative or complementary therapy practitioners

It’s unclear how some nutritional or herbal supplements might interact with chemotherapy. Some could be harmful.

When you go home

Chemotherapy for mesothelioma can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. The nurse will give you telephone numbers to call if you have any problems at home.