Peritoneal mesothelioma is a type of cancer that will account for nearly 20% of all the cases. Despite being the second-most common form of mesothelioma, peritoneal mesothelioma is rare — approximately 500 patients are diagnosed annually. As with other forms of mesothelioma, almost all cases can be traced back to asbestos exposure. Patients with this cancer actually have higher life expectancies than other forms. Some patients may even live up to five years after having cytoreductive surgery.
Causes and Risk Factors
This form of Mesothelioma is often found in males that range between 50-69 years of age. The highest numbers are seen in those men that are military veterans (especially from the Navy) or that were exposed to asbestos during their work. However, second-hand asbestos exposure can also lead to the development of mesothelioma.
You will find that this does not often make its way into the lymph nodes. It will usually form a large tumor and remain in the same location where it originated.
- The asbestos is taken in through inhalation.
- The fibers are sharp, and they are not easily removed once they become lodged. They become stuck in the peritoneum and they irritate the lining causing cell damage.
- Your cells are not going to receive the signals that they need to stop duplicating themselves and a tumor will develop.
Symptoms of Peritoneal Mesothelioma
There are many patients that are not going to have symptoms when this cancer is just forming. However, there are times when there will be pockets of fluid on the abdomen and the stomach may bulge. Some of the other symptoms that may be experienced include:
- Pain in the abdomen
- Lack of appetite or Anorexia
- Blood Clots
- Being tired
- Fluid building up
- Swelling in the abdomen
- Fevering or suffering from sweating, including night sweats
- Lumps in the abdomen
- Trouble with bowels
- Intestinal obstructions or lesions
You will find that in most cases this is not going to spread to the lungs. But, it can make its way to the ovaries, your liver or even into your intestines. It can be misdiagnosed as a hernia or even a simple upset stomach.
Diagnosis of Peritoneal Mesothelioma
You should know that a CT scan and even MRI tests will not show this type of cancer because it is often thought to be gas. The most effective way to find this type of cancer is to use X-rays. Your doctor may also order a series of blood tests to help diagnose through a process of elimination.
In many cases, the doctor could also use the procedure called peritoneoscopy. This is when the doctor will make a small cut in the abdomen and then use a camera to explore the area. Tissue can also be removed at this time so that it can be tested.
Biopsies on the removed tissue are the only way to confirm peritoneal mesothelioma; this test will also allow doctors to identify which type of cells make up the mesothelioma. The results may also tell your doctor how the cancer will progress over time.
Occasionally, biopsy results will reveal the presence of more rare forms of mesothelioma, such as the rare benign papillary mesothelioma that can be surgically removed or the rarer Omental mesothelioma, which forms in the layer of the abdominal membrane covering our intestines and stomach.
The doctor will determine what stage the cancer is in. If it is in stage 1, you will see that it is going to be found in the abdomen only. In stage 2, it may have spread, but it will still be in the peritoneum. If it reaches stage 4, it will have spread to the colon or even into the liver.
Surgical and Non-surgical Treatment Options
Surgical Treatment Options
This is used to help remove as much of the cancerous tumor as possible. Many times the entire tumor may not be able to be removed. In many cases, the lining of the abdomen and even other organs may need to be removed during this surgery. It can be used when someone is in stage 1 or stage 2 of this cancer.
You will need to go through a recovery process that could take up to 13 days once the surgery has been completed. Some individuals will even feel nauseated for up to 13 days. Patients may be able to begin their normal activities approximately 11 days after they have had the surgery.
Heated Intraperitoneal Chemotherapy
This is used to kill the cancer cells that may be left after the surgery. This type of treatment will use heated and sterilized chemotherapy.
Our doctors have been effective when it comes to cytoreduction and heated intraperitoneal chemotherapy. What is really nice to know is that this type of chemotherapy has less side effects than other types of chemotherapy. After 60-90 minutes of the treatment, the chemotherapy will be washed from the body.
- This may also be called ‘hot chemo”.
- It is usually completed after the surgery.
- Can be used during surgery, or after it is complete, with a catheter.
Non-Surgical Treatment Options
Alimta and cisplatin are generally used at the same time. These are the medications that are used together in most cases.
One study showed that when this type of cancer was found with patients, and they were given this combination of chemotherapy in six different cycles, they were found to be cancer free after six months. The same positive results were found four years later. Drugs such as vinorelbine and gemcitabine are also being studied with cisplatin.
This type of treatment is not usually effective when it comes to this type of cancer. It can help shrink a tumor when combined with surgery but it has not been found to be effective on its own. A specialist will be able to take each case individually and determine if radiation may be effective.