Peritoneal Mesothelioma

Peritoneal mesothelioma is a relatively rare form of malignant mesothelioma, making up slightly less than 30% of diagnosed mesothelioma cases. This type of mesothelioma affects the cells of the abdominal lining, also known as the peritoneum, which supports and protects organs in the abdomen.
The peritoneum is made up of two layers, called the visceral and parietal layers. The parietal layer is an outer layer that covers the abdominal cavity, while the visceral layer covers internal organs and the intestinal tract.
Asbestos and Peritoneal Mesothelioma
Exposure to asbestos may cause peritoneal mesothelioma in one of two ways. One theory suggests that asbestos fibers are ingested and eventually work their way into the peritoneum, while another suggests that asbestos fibers that are inhaled are transported to the peritoneum via the lymphatic system.
Once in the peritoneum, asbestos fibers cause changes in peritoneal cells that cause them to divide without restraint, causing the peritoneal layers to thicken. The growth of cancer cells puts pressure on internal organs, and this pressure is increased by fluid that builds up in the area as a result of cancer growth.
Symptoms of Peritoneal Mesothelioma
Mesothelioma is a very late onset form of cancer. After initial asbestos exposure has occurred, it is common for two or three decades to elapse before symptoms begin to appear. Symptoms of peritoneal mesothelioma may include the following:
Weight loss
Fever or night sweats
Pain or swelling in the abdominal area
Obstruction of the small or large intestine
Anemia
Peritoneal Mesothelioma 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 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. A needle biopsy involves using a long needle to remove fluid from the abdominal cavity, while a tissue biopsy requires minor surgery to remove tissue from the area. The fluid or tissue is then tested to determine whether malignant mesothelial cells are present.
Treatment for Peritoneal Mesothelioma
Symptoms of peritoneal mesothelioma are non-specific in that they are often associated with other less serious conditions. Diagnosis is therefore often made too late for curative treatment to be an effective option.
For most patients with peritoneal mesothelioma, treatment is palliative, and is designed reduce the rate at which the cancer spreads, and to provide relief from the symptoms of the disease. Treatment typically involves a combination of surgery and chemotherapy, as either treatment alone is much less effective as when they are used in conjunction with each other.
Surgery is not always a practical option for individuals with peritoneal mesothelioma. Surgical procedures involve the removal of diseased sections of the peritoneum, and are often followed up with intravenous or intraperitoneal chemotherapy (where drugs delivered through a vein or directly to the peritoneal cavity) to remove residual cancer cells that were not able to be removed during surgery.
In cases where surgery and chemotherapy are not suitable treatment options, palliative treatment is used to provide symptomatic relief; however, such treatments cannot slow the progression of the cancer. These types of treatments are used simply to manage pain and provide relief from symptoms such as the build up of fluid in the peritoneal cavity.