Mesothelioma of the peritoneal lining is very rare and poses a challenge to diagnose as well as treat. Unfortunately, it often becomes fatal.
Peritoneal mesothelioma is a cancer that occurs in the abdominal lining, which serves to protect the abdominal organs and secretes fluids allowing for the organs to move smoothly. The cancer of the peritoneum leads to swelling of the abdomen and kills the healthy cells of the cavity while allowing for the growth of cancer cells.
Causes of Peritoneal Mesothelioma
The most common cause of peritoneal mesothelioma is exposure to asbestos. Lodged asbestos in the lining of the abdomen has been proven to be the cause of the cancer, although it is not understood how the lining becomes infested. The most accepted theory is that dust of the asbestos is ingested which allows the fibers to easily enter the abdomen. This leads to inflammation and, eventually, cancer. Another theory as to how asbestos reaches the peritoneal membrane is that fibers of asbestos are inhaled and travel to the membrane by way of the limphatic system.
Regardless of how these toxic fibers enter the peritoneal membrane, the fact of the matter is, once they are there the body has a very difficult time getting rid of the fibers. Due to the nature of the fibers, they get lodged in the membrane and over 20 to 50 years begin to change the dynamics of the healthy mesothelial cells, causing them to grow rapidly and uncontrollably.
This rapid growth of cells causes a thickening of the peritoneum and a consequent build-up of fluid in the peritoneal layers resulting in discomfort for patients. Eventually this cell growth begins to form tumors.
Latency Period
After the initial asbestos exposure, the cancer often does not manifest itself for up to 50 years. Despite the long latency period, this form of cancer is the most rapidly fatal. At the start of the disease, there are rarely any symptoms of the cancer. The first symptom is typically pain in the abdomen, which can often be mistaken for other conditions therefore delaying correct diagnosis. Later symptoms include swelling of the abdomen, loss of weight, nausea and vomiting, difficulty breathing, as well as obstruction of the bowels, fever, and hernias.
Symptoms of Peritoneal Mesothelioma
This, second most common form of mesothelioma, develops in the tissue surrounding the abdominal cavity known as the peritoneum. Symptoms of this disease include:
- Nausea or vomiting
- Inexplicable weight loss
- Sweating or fever
- Swelling or pain in the abdomen
- Ascites (fluid buildup between the peritoneum and the abdominal organs)
- Anemia
- Fatigue
- Diarrhea, constipation or any other inexplicable changes in the bowels
- Development of lumps under the skin on the abdomen
These symptoms usually arise as a result of the thickening of the membrane surrounding the abdomen. This thickening is brought on by rapidly growing cancerous cells. Generally, this rapid growth leads to an accumulation of fluid between the membranes in this area putting pressure on the abdomen which brings on symptoms of this cancer.
Diagnosing Peritoneal Mesothelioma
In order to obtain a diagnosis, the physician will conduct physical examinations, review medical histories, as well as conduct imaging scans such as CT and MRI scans. After the location of the tumor is found, a biopsy will be performed in order to determine whether or not the tumor is cancerous. Unlike pleural mesothelioma, there is no current system for determining the stage of this cancer. Instead, most physicians go straight to the treatment options. Unfortunately, radiation, chemotherapy, and surgical removal have not been shown to be useful when used separately.
Treating the Disease
The most useful treatment options found are a combination of traditional therapies. Radiation can be used to directly target the cancer cells in order to relieve pain and decrease swelling in the abdomen. After the radiation is complete, chemotherapy drugs are then inserted into the abdomen to shrink the tumor. Third, surgery can be used to remove the remaining tumor. Chemotherapy may then again be used. If the diagnosis is made early, these treatments may be effective although a cure is rarely possible. Instead, the goal is often the management of pain and relief of the symptoms.
Ongoing Research
Research studies as well as clinical trials are currently in process in order to determine a way to increase the likelihood of developing a cure for peritoneal mesothelioma. Currently, the only chance of cure is to find the cancer very early in its stages. Persons who have undergone exposure to asbestos should receive frequent checkups in order to decrease the patient’s risk of developing mesothelioma or other asbestos-related conditions and diseases.
