Peritoneal mesothelioma is a malignant tumor developing in the lining of the abdominal cavity. Mesothelioma can manifest itself in a number of ways. While the pleural cancer of the lining of the lungs - is the most prevalent form of the disease, peritoneal mesothelioma accounts for about 15% to 20% of all mesothelioma cases diagnosed throughout the world, making it the second most common form.
What Causes Peritoneal Mesothelioma?
As with any form of mesothelioma, the only known cause at this time is exposure to hazardous asbestos. While most asbestos fibers tend to lodge in the lining of the lungs, doctors have a few theories as to why some individuals develop peritoneal rather than pleural mesothelioma.
Some experts believe the fibers may be inhaled and transported through the lymphatic system to the peritoneal cavity. Others maintain that after the fibers are ingested and make their way to the intestinal tract, they may work themselves into the peritoneal cavity and peritoneum. Still, some researchers believe that that the fibers are captured and then held by the mucus in the trachea or bronchi and are eventually swallowed.
Regardless of how the fibers reach the peritoneum, their presence in the abdominal area causes inflammation, and eventually, tumors form. The malignancy will grow and ultimately cover the abdominal cavity, spreading aggressively to other areas of the body.
Symptoms of Peritoneal Mesothelioma
Like all forms of asbestos-caused cancer, peritoneal mesothelioma can mysteriously lay dormant in the system for up to five decades. Victims of this cancer are usually difficult to diagnose because when the symptoms finally surface, it's often difficult to make the connection with asbestos, especially when the individual hasn't been exposed to the substance for many, many years. This means, of course, that by the time diagnosis is confirmed, the disease has reached its advanced stages and treatment is difficult.
Furthermore, the symptoms of peritoneal mesotheliomacan be easily confused with those of other more common diseases. Therefore, many victims go undiagnosed or are improperly diagnosed for months before the proper conclusion is determined. Symptoms of peritoneal mesothelioma can include:
- Abdominal pain, acute to severe
- Swelling of the abdominal region due to fluid accumulation
- Breathing difficulties
- Loss of appetite resulting in weight loss
- Bowel obstruction
Symptoms may vary with each patient and can be affected by the location of the tumors, the size of the tumors, and the age and general health of the individual in question. When presenting symptoms for diagnosis, it's important for patients to tell the doctor about their exposure to asbestos, even if the exposure occurred many years ago. This knowledge will aid in diagnosis and possibly spare the patient a number of unnecessary tests.
Diagnosis and treatment
Diagnosis of this rarer form of mesothelioma is much the same as with pleural mesothelioma. Your doctor may order such tests as a traditional x-ray or perhaps a more sophisticated test, such as an MRI or CT scan. While the x-rays can provide some answers the doctor may be seeking, he or she will usually order a tissue biopsy in order to make a conclusive diagnosis. These biopsies take a sample of the tissue around the abdominal cavity, which is then analyzed to determine whether tumors are present. The biopsy can be uncomfortable but is quick and over in just a few minutes.
Once a diagnosis is determined, an oncologist will help decide which treatment is best for the patient. Because peritoneal mesothelioma is often diagnosed in its very late stages, tumor removal by surgery is usually not an option. If, however, surgery is in order, it may involve removing a portion of the lining and tissue from the abdominal area in order to remove the tumor. If the tumor is unusually large, a lung or a section of the diaphragm may need to be removed as well.
More often, radiation and are recommended in the treatment of peritoneal mesothelioma. Radiation may be aimed directly at the tumors or used as a palliative measure to relieve pain or lessen symptoms. Common chemotherapy techniques for this kind of mesothelioma include intra-peritoneal chemo, which involves injecting chemotherapy drugs directly into the abdomen. Different chemo drugs in various combinations are recommended, depending on each individual case. Like radiation, chemotherapy can be a palliative measure, relieving uncomfortable symptoms and improving the quality of life for mesothelioma patients.
Clinical trials are offered through many clinics and health centers for those diagnosed with mesothelioma. These trials usually offer the opportunity to try experimental medications or treatments that have not yet been approved by the government organization that oversees the sale of drugs.
Prognosis and Outlook
Because it takes so long to diagnose peritoneal mesothelioma, the outcome is not positive. As with other types of the disease, many victims live for less than a year after diagnosis. Doctors and research scientists continue to make strides towards finding a way to cure mesothelioma and/or prolong the life of the patient.
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- Asensio JA: Primary malignant peritoneal mesothelioma: a report of seven cases and a review of the literature. Arch Surg 1990, 125:477-481.
Last modified: April 19, 2011.