Surgery is a patient’s best hope to live long past the usual life expectancy for mesothelioma.

Not many people can get surgery, though, and doctors are again and again trying to shrink tumors and cause remission any way possible.

For peritoneal mesothelioma, a chemotherapy spray is an outside-the-box option. A study in France looked into pressurized intraperitoneal aerosol chemotherapy (PIPAC). Chemotherapy spray for peritoneal mesothelioma is not a common type of treatment, but it could be used more often.

This type of chemotherapy is sent directly into the peritoneal cavity. Doctors create a small incision for direct access to the peritoneum and abdominal cavity. A pump converts liquid chemotherapy into a spray.


Chemotherapy Spray for Peritoneal Mesothelioma: Study Results

The aforementioned study, published in the Annals of Surgical Oncology, had 26 people with malignant peritoneal mesothelioma. Six of the 26 patients had cytoreductive/HIPEC surgery already but were experiencing a recurrence.

Most importantly, none of them were resectable at the time of the study’s start. Surgery wasn’t an option, and these cases are usually limited to systemic chemotherapy. The goal of the study was to see if PIPAC could turn these unresectable cases to resectable cases.

Half of the 26 patients received three PIPAC procedures. Similarly, 14 patients had cytoreductive surgery and heated intraperitoneal chemotherapy (HIPEC) after completing chemotherapy spray. All but one had a complete resection, meaning doctors removed all visible tumors.

Traditional chemotherapy (through an IV) is sometimes not effective due to a low number of blood vessels in the peritoneal cavity. Without enough blood vessels to transfer the chemotherapy toxins, chemotherapy cannot reach the area to injure cancer cells.

Chemotherapy spray for peritoneal mesothelioma reaches this cavity and other hard-to-see areas of the abdominal cavity. Where traditional chemotherapy falls short, chemotherapy spray fills the void.

The median survival was 12 months for the study, with surgical patients doing much better. The progression-free survival for the two groups were:

  • 33.7 months after PIPAC and cytoreduction/HIPEC
  • 7.4 months with PIPAC and no surgery

The results are a proof-of-concept to using chemotherapy spray for peritoneal mesothelioma before surgery/HIPEC. It’s important to do whatever possible to shrink tumors and bring surgery into the discussion.

If you’d like to look into new and novel treatments to shrink your mesothelioma tumors, reach out to our patient advocate team. Email lead advocate Karen Ritter, a registered nurse, at

    Sources & Author

    • Treated with Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) Plus Systemic Chemotherapy Could Lead to Secondary Complete Cytoreductive Surgery: A Cohort Study. Annals of Surgical Oncology. Retrieved from: Accessed: 11/02/2021.
Devin Goldan image

About the Writer, Devin Golden

Devin Golden is the content writer for Mesothelioma Guide. He produces mesothelioma-related content on various mediums, including the Mesothelioma Guide website and social media channels. Devin's objective is to translate complex information regarding mesothelioma into informative, easily absorbable content to help patients and their loved ones.

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