Peritoneal Mesothelioma

Peritoneal mesothelioma is a cancer found in the peritoneum, a thin membrane surrounding the abdomen. Caused by exposure to asbestos, peritoneal mesothelioma is extremely rare, and the prognosis is generally poor.

What You Need to Know About Peritoneal Mesothelioma

• Peritoneal mesothelioma is the second most common form of asbestos-related cancer.
• Fewer than 500 people are diagnosed with peritoneal mesothelioma each year.
• Standard treatments include debulking surgery, chemotherapy, and radiation
• Cytoreductive surgery with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) has shown promise as an effective therapy for significantly improving survival.

Cause

• Asbestos inhalation or ingestion

Location

• Abdominal lining (peritoneum)

Common Symptoms

• Abdominal/stomach pain
• Ascites/swelling
• Anorexia/weight loss

Treatment 

• Surgery
• Chemotherapy
• HIPEC
• Radiation

Prognosis

• 6 – 12 months

Peritoneal Mesothelioma Overview

Peritoneal mesothelioma (formally known as diffuse malignant peritoneal mesothelioma) is the second-most common type of mesothelioma, accounting for approximately 15 – 20 percent of all new mesothelioma diagnoses each year. There are four key differences between peritoneal mesothelioma and other types of the disease:

Location: Peritoneal mesothelioma occurs in the abdominal lining (peritoneum), a dual-layer membrane that surrounds the stomach and other abdominal organs. The visceral layer protects organs like the liver and gall bladder within the abdomen, while the parietal layer covers the outside of the abdomen.

Organs Affected by Peritoneal Mesothelioma

Symptoms: Due to the location of the disease, peritoneal mesothelioma symptoms most often develop in the abdomen and/or gastrointestinal system, rather than the chest and lungs.

Treatment: The most effective treatment for peritoneal mesothelioma is cytoreductive surgery followed by Hyperthermic Intraperitoneal Chemotherapy (HIPEC) – a heated chemotherapy “wash” that kills cancer cells within the abdomen.

What is the Prognosis for Peritoneal Mesothelioma?

While the prognosis for all forms of mesothelioma is generally poor, the prognosis for peritoneal mesothelioma is somewhat better than for other types of the disease. The median survival period for peritoneal mesothelioma is 1 year, and the longest known survival was 19 years

Survival: Peritoneal mesothelioma patients generally have a better prognosis and survival rate than those with other forms of the disease.

Prognosis Factors for Peritoneal Mesothelioma Patients

• Cell type
• Tumor size and staging
• Gender of the patient
• Whether the cancer has spread (metastasis)

Patients who undergo cytoreductive surgery with HIPEC have significantly better survival rates. According to one study, approximately half of peritoneal mesothelioma patients who undergo this form of treatment lived more than five years.

Two subtypes of peritoneal mesothelioma — multicystic mesothelioma and well-differentiated peritoneal (or papillary) mesothelioma — usually occur in women and are generally considered benign. Survival rates for these uncommon forms of the disease are much higher.

Common Symptoms

• Abdominal pain
• Abdominal swelling
• Anorexia / weight loss
• Ascites (fluid in the peritoneal cavity)

Less Common Symptoms

• Night sweats
• Hypercoagulability (blood clotting)
• Fever with no known origin
• Intestinal obstruction
• Inflammatory lesions

Peritoneal mesothelioma can cause certain other conditions, known as paraneoplastic syndromes, that may exhibit additional symptoms. These include:

• Thrombocytosis – high platelet numbers in the body’s blood supply
• Hypoglycemia – low blood sugar
• Venous thrombosis – blood clots that form in a vein

How is Peritoneal Mesothelioma Diagnosed?

Because the symptoms of peritoneal mesothelioma are often similar to those of other diseases, diagnosis can be difficult. Usually, diagnostic tests focus on first ruling out more common diseases, including other forms of cancer.

• Imaging Scans — Used to look for tumor masses
• Blood Tests — Used to look for biomarkers and abnormal substances in the bloodstream
• Abdominal Biopsy — Used to obtain a tissue sample to confirm a peritoneal mesothelioma diagnosis

The most common misdiagnoses for peritoneal mesothelioma include irritable bowel syndrome (IBS), hernia, and other abdominal cancers, especially ovarian cancer.

As part of the mesothelioma diagnosis, the doctor will determine the stage of the cancer. Although there is no staging system for peritoneal mesothelioma, doctors may try to identify how advanced the disease is using relevant criteria.

What Treatments are Available for Peritoneal Mesothelioma?

All types of mesothelioma are treated using a combination of three types of therapy:

• Surgery – Known as debulking or cytoreduction, the primary goal is to remove as much of the tumor(s) as possible.
• Chemotherapy – A systemic drug treatment (usually administered intravenously) that kills fast-growing cells, including mesothelioma cancer cells.
• Radiation – A blast of targeted radiation to reduce the size of cancer tumors.