Peritoneal Mesothelioma - Causes, Symptoms and Care

Peritoneal mesothelioma is an extremely rare type of cancer that targets lining of the abdominal cavity. Approximately 100-500 cases are reported in the United States each year, i.e. they comprise less than 30% of all mesothelioma cases. Since peritoneal mesothelioma affects the abdominal lining i.e. peritoneum, it is often called abdominal mesothelioma.

Peritoneal mesothelioma is less common than pleural mesothelioma and constitutes approximately one-fifth to one-third of the total of mesothelioma cases diagnosed. According to the SEER (Surveillance, Epidemiology, and End Results) database, approximately 54.7% males and 45.3% females are diagnosed with peritoneal mesothelioma with the median age being 65-69. Asbestos exposure related symptoms in peritoneal mesothelioma usually appear within 20 to 30 years. The good news is that the prognosis and treatment options for peritoneal mesothelioma are more encouraging than for other forms of mesothelioma cancer.

Causes of Peritoneal Mesothelioma

It is widely believed that peritoneal mesothelioma is caused by asbestos exposure. Asbestos is a lightweight natural fiber that was used heavily in industries in the past before being banned. Once asbestos fibers are ingested, they reach the abdominal wall and become lodged in the peritoneum. If asbestos fibers are inhaled they may be transported through the lungs and lymph nodes to the peritoneal cavity. This will ultimately lead to the development of abnormal cell growth, causing peritoneal mesothelioma.

Symptoms of Peritoneal Mesothelioma

Doctors report that clinical symptoms of peritoneal mesothelioma are usually experienced 6 months to 2 years before diagnosis. Misdiagnosis is also common because peritoneal mesothelioma symptoms are closely associated with minor stomach or abdominal discomfort and hernia. Diagnosis happens when a tumor mass is discovered during a medical examination.

Symptoms of peritoneal mesothelioma may include, but are not limited to:

  • Ascites (abnormal collection of fluid in the abdomen)
  • Pain or swelling in the abdomen
  • Weight loss
  • Bowel obstruction
  • Anemia
  • Fever
  • Abdominal mass
  • Increased abdominal girth
  • Distention of the abdomen
  • Fatigue
  • Digestive disturbances

Diagnosis

Diagnosis of peritoneal mesothelioma is extremely difficult because most symptoms associated with abdominal mesothelioma accompany other less serious medical conditions. Patients with a history of asbestos exposure are recommended to get themselves regularly checked by physicians. Peritoneal mesothelioma can be diagnosed with the help of physical examination, X-ray, CT (or CAT) scan, or MRI and collection of a biopsy.

Diagnosis of peritoneal mesothelioma helps determine the type and location of the tumor. The two clinical types of peritoneal mesothelioma are "dry" or "wet". Dry-painful is the most common type of peritoneal mesothelioma in which multiple small masses or a single dominant localized mass are seen. There is normally little or no ascites (accumulation of fluid in the abdominal cavity).While in the wet type, widespread small nodules but no dominant mass are seen. Ascites is usually present in this case.

Treatment Methods

Prognosis of peritoneal mesothelioma is poor. Some palliative treatment options such as mesothelioma chemotherapy, radiation therapy and surgery are considered as preferred treatment options for tackling peritoneal mesothelioma.

Chemotherapy

Chemotherapy is the most common treatment for peritoneal mesothelioma. Alimta (pemetrexed) is a chemotherapy regimen that is prescribed therapy for the treatment of malignant pleural mesothelioma. Chemotherapy drugs such as Gemcitabine, Navelbine, Onconase, are also used for the treatment of malignant peritoneal mesothelioma.

Radiation Therapy

Radiation therapy is also used as a treatment for peritoneal mesothelioma in which radiations are used for directly attacking the cancerous cells and help in relieving the patient of physical pain and abdominal swelling.

Surgery

Surgery is suggested to peritoneal mesothelioma patients diagnosed in the early stages to remove the tumor mass. Surgical options include peritonectomy and palliative procedures. In cytoreductive (debulking) surgery, the entire tumor mass is removed; this may be combined with Intra-Peritoneal Hyperthermic Chemotherapy (IPHC), intraperitoneal chemotherapy and radiation.

These treatment options are most effective for peritoneal mesothelioma patients diagnosed in the early stages. As there is no complete cure for this type of cancer, these treatment methods are aimed to manage the discomfort of the patients. Early detection is extremely important, so if you notice any of these symptoms and have a history of asbestos exposure, seek help immediately in order to slow down the progression of the disease.