Peritoneal Mesothelioma | Causes, Diagnosis and Available Treatment Options

The malignant peritoneal mesothelioma is a deadly cancer found in the tissue lining of the abdomen. It is often also referred to as abdominal mesothelioma which surrounds the abdominal cavity.

Peritoneal Mesothelioma | Causes, Diagnosis and Available Treatment Options
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According to published research in the Medscape General Medicine journal, this form of the mesothelioma cancer accounts for 20 – 33% of all recorded mesothelioma cases. Now this makes the peritoneal mesothelioma the second most common type just behind the pleural mesothelioma. The other forms are the pericardial and the tunica vaginalis mesothelioma.

Although this critical health condition has no cure, there are treatment options available to help ease the pain and effects of the symptoms that a patient experiences, and possibly prolong life expectancy.

Factors that cause the Development and Spread of Peritoneal Mesothelioma

The only known major cause of this cancerous disease is an asbestos exposure to a person. Reports by the Occupational Safety and Health Administration say that industrial building and common household products mostly contains the asbestos, these include:

  • Insulation
  • Gaskets and Packing
  • Lab Equipment
  • Floor tiles
  • Plaster, caulk, cement and putty
  • Ceiling tiles spray-on coatings
  • Boilers, Turbines, Valves and Pumps
  • Roofing and siding

The people at most risk of developing the peritoneal mesothelioma are those whose work or service exposed to the asbestos. Construction workers, mechanics, veterans, shipbuilders, and industrial workers in the city of New York and throughout the whole of the United States usually make up the majority of these health cases.

Spread of the Disease

It is also very important to note that in the families of these listed work groups, the asbestos disease has also been seen to cause an outbreak of the mesothelioma disease in family members and also among close friends. This is because the asbestos fibers can be transferred from clothing, uniforms or any order materials used by the worker.

You may also like to see ways to prevent further spread of the asbestos fibers in your home

The asbestos is still not completely banned from use in the United States, even though it has been definitively identified as the cause of the peritoneal mesothelioma and other types as well.

In fact, Asbestos exposure is still a real life threat in the whole of New York City, New York State and the Tri-state area.

Development of the Peritoneal Mesothelioma

People can easily get exposed to the microscopic asbestos fibers when they work in environments where materials that contain the asbestos are being worked with, or they directly handle materials that contain the asbestos.

These fibers are usually inhaled in most cases, and can result Pleural mesothelioma (which is the most common form of this cancerous asbestos disease). However, they can also be ingested by swallowing and accumulate in the peritoneal tissue lining of the abdominal cavity, the lymph nodes and the organs in it.

When these cancerous fibers are ingested, they can get stuck in the abdominal region and stay in the body for years before they begin to show any signs of irritation and peritoneal mesothelioma eventually.

Scientists and experts have warned that it can take up to 15 – 60 years for the symptoms to develop, which means that most victims of this disease are people who got exposed to the asbestos fibers decades ago.

Basic Symptoms of the Peritoneal Mesothelioma

The symptoms of this disease often get confused with other illnesses or diseases of the abdomen. Most of these patients initially experience:

  • Lumps in the abdomens
  • A fluid buildup in the abdominal area
  • Loss of weight
  • Fever
  • Pain or swelling in the abdomen

For a patient to get a proper diagnosis, it may take up to some months because these symptoms are similar to that of some other unrelated health conditions. And in that time, the cancerous disease may spread aggressively, leaving the affected victim with just a few options for treatment.

So then, if a person gets to experience any one of these symptoms and also have been exposed to asbestos in the past, it is advised that such a person discusses this with a healthcare specialist as soon as possible.

Diagnosis of the Peritoneal Mesothelioma

For a proper diagnosis of the form of cancer, the physician starts by running some physical examination and asks about the history of the patient. It is always very important for patients to open up to their physicians, letting them know if they have experienced any form of asbestos exposure in the past. The sooner diagnosis can be made on a patient with this health condition the better.

To make the peritoneal diagnosis, the physician will typically order these tests to be conducted on the patient. They are:

Fine needle aspiration: Fluid and tissue are collected from the abdominal cavity with a very small needle, and tested for any abnormalities or signs of cancer.

MRI, X-ray or CT scan: Tumors and cancer locations can be identified through the help of these imagining tests. They are not detailed enough however, to diagnose the cancer as a peritoneal mesothelioma.

Biopsy: to make diagnosis, doctors will need to take tissue sample from their patients through a biopsy. This can be achieved by running a peritoneoscopy, whereby the abdominal wall gets cut and a thin tube-like instrument with a camera and light is inserted into the abdomen. The biopsy can also be done through a laparotomy, whereby an incision is made in the abdominal wall to look for any signs of the cancer.

Peritoneal Mesothelioma Cell Type Diagnosis

The pathology result for any patient contains information about what cellular subtype of the peritoneal mesothelioma the patient has.

Common cell types are:

  • Epithelioid cells: This makes up about 75% of all cases.
  • Biphasic cells: This makes up about 25% of all cases.

The epithelioid cells can grow in four different patterns: deciduous, tubular, papillary and diffuse. The most common is the papillary and t often appears alongside with the others.

The pure sarcomatoid tumors are not common at all in peritoneal mesothelioma. In fact studies show that since 2006, only 30 patients have been diagnosed with the variant tumors. The sarcomatoid cells usually generates alongside the epithelioid cells to for the biphasic cell type.

Stages of the Peritoneal Mesothelioma

For this type of the mesothelioma cancer disease, there is no official staging system. Experts in the area of peritoneal mesothelioma spent decades adapting other staging systems for their use instead.

Based on history, the TNM system of staging used for other cancers has not been a good fit for the peritoneal mesothelioma as a result of its diffuse growth pattern. However, based on a research report in 2020, oncologists have adapted the TNM staging system into three stages for the peritoneal mesothelioma. They are:

  • Stage 1: When the lymph nodes are free of cancer tumors, cancerous tissue is minimal, and tumors only appear within the lining of the abdomen.
  • Stage 2: The tumors have not spread outside of the abdominal lining or into lymph nodes, and the cancerous tissue is still moderate.
  • Stage 3: In this stage, tumors may have spread outside of the abdominal lining or into the lymph nodes and the cancerous tissue have become more extensive.

Although many doctors consider the stage 4 to involve more extensive tumors that have spread across to distant organs all over the body, in the adapted TNM staging system for the peritoneal mesothelioma, there is no precise fourth stage.

Available Treatment Options for the Peritoneal Mesothelioma

Most of the treatment options for this type of the cancerous disease are usually palliative (aimed at creating relieve to the pain and making the patient more comfortable), instead of curative (killing the cells of the cancer and preventing further spread or growth). This is mainly because many of these patients do not get diagnosed on time, until the cancer has reached an advanced stage.

The peritoneal mesothelioma treatment may involve cytoreduction surgery combined with heated chemotherapy, for patients that are strong enough for surgery.

Cytoreduction Surgery for Peritoneal Mesothelioma

This surgical process is also known as debulking. It aims at removing all visible cancer tumors from the peritoneal cavity.

This process can get quite complicated because the cancer may have spread to the omentum (a sheet of fat in the abdomen) and some other organs like the pancreas, intestines, colon, liver, spleen, uterus, gallbladder, stomach, ovaries, and bladder.

Heated Intraoperative Chemotherapy (HIPEC) for Peritoneal Mesothelioma

A doctor can administer a heated chemotherapy directly to the abdominal area while the patient is in surgery. This form of treatment can be more effective than the traditional chemotherapy. Additionally, the patient may opt for medication, radiation, or clinical trials as treatment for the peritoneal mesothelioma.

Life Expectancy and Prognosis for Patients living with the Peritoneal Mesothelioma

According to a report in the Medscape General Medicine journal, approximately 200 – 400 people are diagnosed with the peritoneal mesothelioma every year in New York and all over the United States.

Studies by the American Cancer Society estimates the median survival time range to be around 12 – 21 months, and it depends on how early the cancer was diagnosed. A prognosis on the peritoneal mesothelioma will also depend on the gender, age, health, and type of cancer cells detected in the patient.

Generally, if you are being diagnosed with the peritoneal mesothelioma, be rest assured that there is a support community of specialists on mesothelioma, nurses, caregivers and advocates that are here to help you and your loved ones through this unpleasant journey.

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