Standard Treatment Therapy for peritoneal mesothelioma is difficult, especially as it is usually widespread by the time it is diagnosed. Removal of the tumors for cure is rarely possible and the role of surgery is generally confined to relief of bowel obstruction, relief of ascites by placing shunts for drainage or the palliative removal of large tumors.
Radiation therapy has often been used, but its role has not yet been defined. Since the entire abdomen is at risk, all of the abdominal organs will also be affected by radiation. To protect the liver, kidney, bowel and spinal cord, the dose has to be lower than would be desirable for tumor control.
Although radiation may not be effective in most patients with large, bulky tumors because of the problems posed by an adequate dose, there may be some benefit from lower doses—in the range of 3,000 cGy—if most of the tumor has been successfully removed and only small amounts remain.
The use of chemotherapy for peritoneal mesothelioma has lately focused on the use of chemotherapy given via a catheter directly into the abdominal cavity (intraperitoneal). This permits a much higher concentration of drug to be delivered to the area of the tumor. Intraperitoneal cisplatin , with special measures to neutralize the drug's toxic effects in the body, resulted in a significant complete response rate in one study, but unfortunately many of these patients relapsed after treatment.
