Peritoneal Mesothelioma

Peritoneal, or abdominal, mesothelioma is the second most common type of this cancer. According to figures compiled by the World Health Organization, there were 92,253 mesothelioma deaths reported by 83 countries between 1994 and 2008, and 4.5% of these were peritoneal (41.3% was pleural and 43.1% was unspecified)1. Although that is a relatively small percentage of the overall number of cases, the US reported the most peritoneal mesothelioma deaths. As a result, it is more commonly diagnosed in industrialized countries, with hundreds of cases diagnosed and documented annually.

Peritoneal mesothelioma affects the abdomen, specifically the peritoneum. The peritoneum is protective tissue that lines the walls of the abdominal cavity (parietal) and the abdominal organs (visceral). It is made up of two layers and is formed by mesolethial cells. Uncontrolled division of mesolethial cells in the peritoneum is how it develops, and worsens to become multicystic peritoneal mesothelioma.

How is peritoneal mesothelioma caused?

Asbestos: Asbestos is considered a primary cause however evidence suggests that the association is not as strong as in the case of pleural mesothelioma. It also depends on the type of asbestos—more deaths are related to exposure to amphibole asbestos fibers. Asbestos fibers reach the peritoneum in one of two ways:

  • They may be ingested, reaching the peritoneum via the digestive system.
  • They may be inhaled then travel to the peritoneum via the lymphatic system.

Chronic pancreatitis: Formal research has not been conducted to prove this.

Simian virus 40 infection: Limited research has been conducted. This may be more of a factor related to epithelial mesothelioma.

How do you diagnose peritoneal mesothelioma?

Like other forms of mesothelioma, symptoms tend to appear later on which is why diagnosis is often delayed. It can take 20-30 years before you seek medical attention for your condition and are finally diagnosed.

Diagnosing peritoneal mesothelioma tends to be a bit more difficult than the pleural type. A tumor biopsy or examination of abdominal fluid tends to be the most reliable. This involves analyzing cells to see if any look abnormal.

CT imaging may help in detecting existing tumors and staging the disease. Tumors that are localized may be multicystic peritoneal mesothelioma.

Symptoms

If you have peritoneal mesothelioma, you may experience any of these symptoms:

  • abdominal pain (often related to a tumor)
  • abdominal swelling (caused by excess fluid)
  • anorexia
  • weight loss
  • nausea and vomiting
  • fever
  • fatigue
  • bowel obstructions
  • night sweats

Treatments

Surgical removal of cancerous tumors is the most common form of treatment. Cytoreductive surgery, chemotherapy (applied directly to the affected area) and immunotherapy may also be considered. Research has found that there is an average survival rate of 50 to 60 months following treatment with cytoreductive surgery and chemotherapy2.

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