A dangerous cancer called peritoneal mesothelioma is brought on by consuming asbestos fibers. As a result of its development in the peritoneum, the tissue lining the belly, it is often referred to as abdominal mesothelioma. Stomach discomfort, motion sickness, and abdominal swelling are all signs of peritoneal mesothelioma.
What Is Peritoneal Mesothelioma?
Asbestos is the cause of the malignancy peritoneal mesothelioma. When asbestos fibers are consumed or breathed, they can anchor themselves in the abdominal lining. Fibers may go to the belly lining via the lymphatic or digestive systems. There isn’t a single process that explains how asbestos enters the abdomen lining that has been accepted by specialists, though.
- Peritoneal mesothelioma is the second-most common form of mesothelioma cancer, accounting for about 15 – 20% of all diagnoses.
- Each year, less than 1,000 people are diagnosed with the disease in the United States.
- Common symptoms include abdominal pain and swelling, weight loss, and fluid buildup in the abdominal cavity.
- Diagnosis consists of a series of tests, including imaging tests, blood tests, and biopsies.
- Peritoneal mesothelioma is treated with surgery, heated chemotherapy, and immunotherapy.
- Peritoneal mesothelioma prognosis may vary depending on an individual’s case, with life expectancy ranging from two to six years.
What Is the Prognosis & Life Expectancy for Peritoneal Mesothelioma?
The life expectancy for peritoneal malignant mesothelioma cancer is more favorable than other types of malignant mesothelioma.
Peritoneal mesothelioma prognosis may vary depending on an individual’s case, with life expectancy ranging from two to six years. More patients are surviving five years or longer with advancements in treatment.
| CRS stands for cytoreductive surgery, which is a surgical method of removing tumor tissue. HIPEC stands for hyperthermic intraperitoneal chemotherapy. It is a form of heated chemotherapy administered within the abdomen. |
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| Survival of Peritoneal Mesothelioma Patients Treated With CRS + HIPEC | |
|---|---|
| 1-year survival | 86% |
| 2-year survival | 77% |
| 3-year survival | 59% |
| 5-year survival | 59% |
Several factors can influence an individual patient’s prognosis, including:
- Cell type (histopathology)
- Tumor size and mesothelioma stage
- Gender and age of the patient
Epithelioid cell type is most common in peritoneal mesothelioma. It responds more favorably to treatment, with a median life expectancy of 79 months with treatment.
A small percentage of peritoneal malignant mesothelioma patients are diagnosed with sarcomatoid cell type. Peritoneal mesothelioma patients diagnosed with this cell type have an average survival of 10 months with treatment.
How Does Asbestos Cause Peritoneal Mesothelioma?
Malignant peritoneal mesothelioma is brought on by ingesting asbestos fibers. The method through which the mineral enters the abdomen is yet unknown to experts. However, examinations revealed asbestos fibers in certain regions of the digestive system and abdomen.
Asbestos may induce mesothelioma after entering the abdomen in a number of ways, including:
- Causing irritation and inflammation
- Destabilizing chromosomes
- Disrupting normal cellular processes
Research has also tied certain genetic factors to mesothelioma, such as BAP1 mutations. Still, asbestos exposure is the only known cause of mesothelioma. The best way to minimize mesothelioma risk is to avoid asbestos exposure.
Peritoneal mesothelioma symptoms can take 10 – 50 years to appear after an individual inhales or ingests asbestos fibers. The fibers become lodged in the peritoneum, the lining of the abdomen, which leads to irritation and scar-tissue buildup. These damaged cells can develop into tumors and cause symptoms.
For most patients, early peritoneal mesothelioma symptoms will typically present in the abdomen or gastrointestinal system. Patients may also experience systemic symptoms, such as weight loss, which can further complicate diagnosis.
How Is Peritoneal Mesothelioma Diagnosed?
A number of tests are used to determine the diagnosis of peritoneal mesothelioma. Imaging studies, such as CT scans and X-rays, are frequently used to establish the diagnosis. These examinations can rule out less serious conditions and other types of cancer, such as ovarian and adenocarcinoma.
A doctor may request blood tests to find biomarkers that can further distinguish mesothelioma from other malignancies if an imaging test reveals a tumor.
Only biopsies can definitively diagnose peritoneal mesothelioma. To confirm the malignancy, a doctor will collect a sample of fluid or tissue. The biopsy can also be used to determine the cell type and stage of mesothelioma.
Peritoneal Mesothelioma Stages
When diagnosing peritoneal mesothelioma, a doctor will also determine the stage of the cancer. Although there is no well-defined staging system for peritoneal malignant mesothelioma, doctors may identify the advancement of the disease with relevant criteria. For example, doctors may identify if the cancer has metastasized to other organs or lymph nodes.
The Peritoneal Cancer Index for Staging Peritoneal Mesothelioma
The Peritoneal Cancer Index (PCI), a measure designed for abdominal malignancies, may be used by clinicians in certain circumstances. The abdomen region is divided into 13 different sections using this procedure, and each sector is given a score between 0 and 3 depending on the number and size of tumors present.
The 13 elements are then added together to get a PCI score, with a maximum of 39. The phases of peritoneal mesothelioma recommended by doctors correspond to the scores. Abdominal mesothelioma at a more advanced stage is indicated by a higher PCI score.
The Tumor Node Metastasis (TNM) System for Staging Peritoneal Mesothelioma
The TNM cancer staging system is commonly used for pleural mesothelioma but has been adapted for peritoneal mesothelioma. The adapted TNM system for peritoneal mesothelioma incorporates three components:
- T factor: This factor is meant to account for the location and size of the primary tumor. Because peritoneal mesothelioma often has many tumors, doctors use the PCI score for this factor.
- N factor: This factor accounts for the extent of tumor spread to lymph nodes. Because lymph node involvement is rare, doctors simply give patients a score of N0 or N1 for this factor. N0 means tumors have not spread to any lymph nodes, and N1 means they have.
- M factor: This factor accounts for distant spread of mesothelioma. Patients receive a score of M0 or M1. M0 means the cancer has not spread to distant areas. M1 means the tumors have spread to distant areas.
Based on these factors, patients may fall into one of three stages. In this system, stage 3 indicates the most advanced stage.
No matter which staging system doctors use, many factors affect prognosis. Patients can consult a mesothelioma doctor to determine the best treatment for their stage of peritoneal mesothelioma.
Treatment of Peritoneal Mesothelioma
A multimodal strategy, which includes traditional therapies including surgery, chemotherapy, and radiation therapy, is frequently used to treat peritoneal mesothelioma.
Patients with peritoneal mesothelioma have had very modest success with conventional chemotherapy and radiation treatment, with some clinical trials reporting a median survival period of one year. However, recent research suggests that peritoneal mesothelioma can be successfully treated with chemotherapy when combined with surgery.
Standard therapies may be utilized as palliative care for individuals with peritoneal malignant mesothelioma that has progressed to an advanced stage. Palliative care is used to lengthen life expectancy and enhance the quality of life.
Palliative care frequently involves the use of minimally invasive techniques like paracentesis. This technique eliminates fluid accumulation and alleviates peritoneal malignant mesothelioma symptoms.
Clinical trials are continually testing new treatments for peritoneal mesothelioma. Emerging treatment options include pressurized intraperitoneal aerosol chemotherapy (PIPAC), chemotherapy applied in a pressurized form. Treating mesothelioma with PIPAC is in early phases and requires further testing. However, the treatment has shown a median life expectancy of approximately 27 months.
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