Chemotherapy for mesothelioma

Your doctor may offer you chemotherapy to help slow the growth of mesothelioma and control symptoms.

About chemotherapy for mesothelioma

Your doctor may offer you chemotherapy to help slow the growth of pleural and peritoneal mesothelioma and control symptoms. Your doctor will tell you if chemotherapy is suitable for you.

How chemotherapy is given

Chemotherapy drugs for mesothelioma are usually given by injection into a vein (intravenously), or by a drip (infusion).

Chemotherapy is usually given as a session of treatment. Each session of treatment may last between one and a few days. This is followed by a rest period of a few weeks. The treatment and the rest period make up a cycle of treatment. The number of cycles you have will depend on the stage of the cancer and how well it is responding to treatment.

The most commonly used drugs to treat mesothelioma are pemetrexed (Alimta®) together with cisplatin (or sometimes carboplatin).

You usually have these drugs as an outpatient on the same day. You will then have a rest period with no chemotherapy for 20 days, before starting your next cycle of treatment. If you have pemetrexed, you will be given vitamin B12, folic acid and steroids. These help to reduce the side effects of treatment.

Other chemotherapy drugs are sometimes used. These may be given as part of a clinical trial.

Chemotherapy into the abdomen

If you are having surgery for peritoneal mesothelioma, your doctor may suggest having chemotherapy into the tummy (abdomen) during the surgery. This is called HIPEC (hyperthermic intraperitoneal chemotherapy).

Side effects of chemotherapy

Chemotherapy can cause side effects. These can often be managed with drugs and usually improve after treatment has finished. Different drugs cause different side effects. Your cancer doctor or nurse will explain what to expect based on the treatment you will have.

Common side effects of pemetrexed, cisplatin and carboplatin include:

  • Risk of infection
  • Bruising and bleeding
  • Anaemia (low red cells)
  • Feeling sick
  • Feeling tired.

Always tell your cancer doctor or nurse about any side effects you have.

About our information

  • References

    Below is a sample of the sources used in our mesothelioma information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

    Woolhouse I et al. British Thoracic Society Guideline for the investigation and management of malignant pleural mesothelioma. Thorax. 2018.

    Thomas A et al. Mesothelioma. BMJ Best Practice. 2019.

    Baas P et al. Malignant pleural mesothelioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.  Annals of Oncology. 26 (Supplement 5): v31–v39. 2015. Available from: www.pubmed.ncbi.nlm.nih.gov/26223247

    Kusamara S et al. Peritoneal mesothelioma: PSOGI/EURACAN clinical practice guidelines for diagnosis, treatment and follow-up. European Journal of Surgical Oncology. March 2020.


  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr David Gilligan, Consultant Clinical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.