Peritoneal Mesothelioma

Peritoneal Mesothelioma

Peritoneal mesothelioma is a cancer that develops in the lining of the abdomen, which is known as the peritoneum. It is caused by ingesting asbestos fibers. Over time, irritation from the fibers can cause scarring and inflammation. This leads to mesothelioma tumor growth on the affected site. Peritoneal mesothelioma patients face an average prognosis of six to twelve months. Treatments like heated chemotherapy (HIPEC) can improve life expectancy.

What Is Peritoneal Mesothelioma?

Peritoneal mesothelioma is a form of cancer caused by asbestos. When asbestos fibers are ingested or inhaled, they can become embedded in the lining of the abdomen. Research suggests the fibers reach the abdominal lining through the digestive or lymphatic systems.

  • Peritoneal mesothelioma is the second-most common form of mesothelioma cancer, accounting for about 15 – 20% of all diagnoses.
  • Each year, about 500 people are diagnosed with the disease.
  • Common symptoms include abdominal pain and swelling, weight loss and fluid buildup in the abdominal cavity.
  • Diagnosis consists of a series of tests, including imaging tests, blood tests and biopsies.
  • Peritoneal mesothelioma is treated with surgery, heated chemotherapy and immunotherapy.
  • Peritoneal mesothelioma prognosis may vary depending on an individual’s case, with an average life expectancy of six to twelve months.

What Is the Prognosis for Peritoneal Mesothelioma?

The life expectancy for peritoneal malignant mesothelioma cancer is more favorable than other types of malignant mesothelioma.

With treatment, abdominal mesothelioma patients survive one year on average. However, more patients are surviving five years or longer with advancements in treatment.

What Are the Symptoms of Peritoneal Mesothelioma?

Peritoneal mesothelioma symptoms can take 10 – 50 years to appear after an individual inhales or ingests asbestos fibers. The fibers become lodged in the peritoneum, the lining of the abdomen, which leads to irritation and scar-tissue buildup. These damaged cells can develop into tumors and cause symptoms.

For most patients, early peritoneal mesothelioma symptoms will typically present in the abdomen or gastrointestinal system. Patients may also experience systemic symptoms, such as weight loss, which can further complicate diagnosis.

How Is Peritoneal Mesothelioma Diagnosed?

A peritoneal mesothelioma diagnosis consists of a series of tests. Diagnosis often starts with imaging tests, like CT scans and X-rays. These tests can rule out more common diseases and other forms of cancer, like adenocarcinoma and ovarian cancer.

If a tumor is detected through imaging tests, a doctor will order blood tests to identify biomarkers that can further differentiate mesothelioma from other cancers.

Biopsies are the only way to confirm a peritoneal mesothelioma diagnosis. A doctor will take a fluid or tissue sample to confirm the cancer. The biopsy can also identify cell type and mesothelioma progression.

Peritoneal Mesothelioma Stages

When diagnosing peritoneal mesothelioma, a doctor will also determine the stage of the cancer. Although there is no well-defined staging system for peritoneal malignant mesothelioma, doctors may identify the advancement of the disease with relevant criteria. For example, doctors may identify if the cancer has metastasized to other organs or lymph nodes.

In some cases, doctors may also rely on a tool called the Peritoneal Cancer Index (PCI), developed for abdominal cancers. With this method, the abdominal region is split into 13 distinct sections and scored on a scale of 0 – 3 based on the presence and size of tumors.

The 13 sections are then totaled for an overall PCI score, with 39 being the highest. Doctors suggest peritoneal mesothelioma stages equivalent to the scores. A higher PCI score indicates a more advanced stage of abdominal mesothelioma.

Peritoneal Mesothelioma Treatment

Peritoneal mesothelioma is often treated with a multimodal approach, which combines conventional treatments like surgery, chemotherapy and radiation therapy.

Traditional chemotherapy and radiation therapy have shown limited success in peritoneal mesothelioma patients, with many clinical trials showing a median survival time of one year. However, some studies indicate success when using chemotherapy during surgery to treat peritoneal mesothelioma.

For patients with advanced stage peritoneal malignant mesothelioma, standard treatments may be used as palliative care. Palliative treatments are used to improve quality of life and extend life expectancy.

Minimally invasive procedures, like paracentesis, are often used palliatively. This procedure removes buildup of fluid and relieves symptoms associated with peritoneal malignant mesothelioma.

Clinical trials are continually testing new treatments for peritoneal mesothelioma. Emerging treatment options include pressurized intraperitoneal aerosol chemotherapy (PIPAC), a chemotherapy applied in a pressurized form. Treating mesothelioma with PIPAC is in early phases and requires further testing. However, the treatment has shown a median life expectancy of approximately 27 months.