Peritoneal Mesothelioma
Malignant Peritoneal Mesothelioma
Peritoneal mesothelioma is a cancer affecting the abdominal lining, or peritoneum, which is why is is sometimes referred to as abdominal mesothelioma. This membrane supports and covers the organs of the abdomen.
The peritoneum is made of two parts, the visceral and parietal peritoneum. The visceral peritoneum covers the internal organs and makes up most of the outer layer of the intestinal tract. Covering the abdominal cavity is the parietal peritoneum.
Peritoneal mesothelioma, like all types of mesothelioma, is caused by asbestos exposure. Though it can take many years for a patient to demonstrate symptoms of the mesothelioma peritoneal, the cancer develops when the asbestos fibers become lodged in the spaces between the mesothelial cells.
Peritoneal mesothelioma is unusual in that it demonstrates a wide spectrum of biological aggressiveness. The cystic variant of mesothelioma may cause recurrent episodes of severe lower abdominal pain but may not result in the death of the patient for many years. In contrast, the most aggressive mesothelioma variants may show metastases from the peritoneal surface to mesenteric lymph nodes at the time of initial surgery.
Symptoms
Clinical symptoms at the time of presentation may include abdominal pain, abdominal mass, increased abdominal girth, distention of the abdomen, fever, weight loss, fatigue, anemia and digestive disturbances. Some patients complain of more non-specific symptoms for a number of months prior to a confirmed diagnosis. In a percentage of cases, peritoneal mesothelioma is found incidentally when the patient has sought help for another health problem such as gallbladder, hernia or pelvic mass.
Once the cancerous tumors start to grow in the peritoneum, fluid begins to rapidly accumulate in the abdominal area. This fluid causes swelling and discomfort and leads to the first common symptoms of peritoneal mesothelioma, upper abdominal pain. Less common symptoms include cough and shortness of breath. Many patients have symptoms four to six months before diagnosis.
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 the mesothelioma peritoneal disease and/or prolong the life of the patient.
Diagnosis
Diagnosis of peritoneal mesothelioma is based on these and other symptoms, as well as the results of diagnostic procedures such as x-rays, CT scans and MRI scans. These are used not only to diagnose the disease itself, but also to discover how far it has advanced. This information will help to determine the best course of mesothelioma treatment. Often a biopsy is also required to confirm a diagnosis of peritoneal mesothelioma. This may take the form of a needle biopsy or tissue biopsy, although in some cases both may be required.
For patients with confirmed peritoneal mesothelioma, radical resection is associated with better prognoses and should be pursued when possible. Other treatments for the mesothelioma peritoneal disease include intensive loco-regional therapeutic strategies: cytoreductive surgery, hyperthermic intraoperative or early postoperative intraperitoneal chemotherapy, and immunotherapy.
Mesothelioma treatment is designed to treat the immediate area of the primary mesothelioma growth or the whole body. Whole body treatments are called systemic treatments. Localised treatments include surgery and radiotherapy. Systemic treatments act on cancer cells no matter where they may be in the body and include chemotherapy.
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