Treatment of Peritoneal Mesothelioma

How Doctors Manage This Rare Abdominal Cancer with Surgery, HIPEC, and More

Peritoneal mesothelioma is rare but treatable—especially when diagnosed early. Thanks to major advances in surgical techniques and targeted chemotherapy, some patients now live 5 years or more after diagnosis.

This page breaks down the most common and effective treatment options for peritoneal mesothelioma, including surgery, HIPEC, and newer therapies like immunotherapy and clinical trials.

Goals of Treatment

Treatment for peritoneal mesothelioma focuses on:

  • Removing or shrinking tumors

  • Killing cancer cells left behind

  • Managing symptoms like fluid buildup or pain

  • Improving quality of life and survival

Primary Treatment Options

🩺 1. Cytoreductive Surgery (CRS)

Also called "debulking surgery," this procedure removes as much visible tumor as possible from the abdominal cavity.

  • May involve removing portions of affected organs (e.g., intestine, spleen)

  • Often followed by HIPEC (see below)

  • Best outcomes are in patients with epithelioid subtype and low tumor burden

This surgery is complex and should only be performed by a specialist experienced in peritoneal mesothelioma.

🔥 2. HIPEC (Heated Intraperitoneal Chemotherapy)

This is the most effective treatment available for peritoneal mesothelioma. It is typically performed immediately after cytoreductive surgery.

How it works:

  • A heated chemotherapy solution (around 107°F) is circulated throughout the abdominal cavity for 60–90 minutes

  • Heat improves drug absorption and helps destroy residual cancer cells

  • Chemotherapy is confined to the abdomen, minimizing whole-body side effects

HIPEC has significantly improved survival outcomes, especially when paired with surgery.

💉 3. Systemic Chemotherapy

For patients who aren’t candidates for surgery or HIPEC, standard chemotherapy drugs can still help slow disease progression and relieve symptoms.

  • Most common combination: Pemetrexed (Alimta) + Cisplatin

  • Alternative regimens: Carboplatin + Gemcitabine for those who can’t tolerate first-line options

Systemic chemo may also be used before surgery (neoadjuvant) or after surgery (adjuvant) to shrink tumors or reduce recurrence risk.

Other Important Treatment Options

🧪 4. Clinical Trials and Emerging Therapies

Researchers are actively exploring new approaches to treat peritoneal mesothelioma, including:

  • Immunotherapy: Checkpoint inhibitors like pembrolizumab (Keytruda) show promise

  • Targeted therapies: Drugs designed to disrupt specific cancer mutations

  • CAR-T cell therapy and gene therapy: Still in early trials, but may offer long-term breakthroughs

Participation in a clinical trial may give access to therapies not yet available to the public.

❤️ 5. Palliative Care

Palliative treatment is not the same as end-of-life care—it’s about improving comfort and functionality.

Includes:

  • Fluid drainage (paracentesis) to reduce abdominal pressure

  • Pain relief using medication or nerve blocks

  • Nutritional support and digestive symptom management

  • Counseling and emotional support

Palliative care is a key part of treating peritoneal mesothelioma—whether it’s early-stage or advanced.

Treatment Plan = Team Effort

Most patients benefit from a personalized, multidisciplinary approach involving:

  • Surgical oncologists

  • Medical oncologists

  • Radiologists

  • Palliative care specialists

  • Nutritionists and counselors

Your care plan may change depending on how your body responds to treatment, but having a dedicated care team is essential.

Financial Support for Treatment

Advanced treatments like HIPEC can be expensive. Many patients use legal compensation from asbestos trust claims, lawsuits, or veterans' benefits to help pay for care.

Learn more about Legal Help for Peritoneal Mesothelioma →

Get Help Starting Your Treatment Journey

We help patients:

  • Connect with top HIPEC and mesothelioma treatment centers

  • Understand which therapies may be right for them

  • Explore options for financial support and legal compensation

📞 Call 833-4-ASBESTOS
Or request a free consultation today.

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