Peritoneal mesothelioma is a cancer found in the peritoneum, a thin membrane surrounding the abdomen.
The Peritoneal Mesothelioma is known to influence personnel falling in the 20 to 40 age bracket. This is one of the regular forms of cancer found to be affecting a small share of the worker population. Swelling of the abdomen is the common symptom, because the lining covers the entire abdominal cavity. Along with the swelling, the patient may experience suffering in the region. Normally these are discarded as work related abnormalities. If you know persons who work with asbestos and who is suffering from the above-mentioned symptoms, then they have to be subjected to medical tests to diagnose the condition.
Peritoneal Mesothelioma is basically classified into two types. They are the dry Peritoneal Mesothelioma and the wet Peritoneal Mesothelioma. It is tough for the physicians to diagnose this condition, and it might require the assistance of trained physicians to study the scan report and resolve their theory. Visible indications will be present and this is how doctors are known to diagnose the condition. The swelling might be caused by the accumulation of fluids in the innings. The initial phase of the treatment includes eliminating these accumulated fluids from the region, with the help of suitable surgical measures.
Peritoneal Mesothelioma Symptoms
At the time of presentation, symptoms of peritoneal mesothelioma includes abdominal mass, abdominal pain, enlarged abdominal girth, fluid in the abdomen (ascites), distention of the abdomen, weight loss, fever, anemia, fatigue and digestive disturbances. For a few months before a confirmed diagnosis, some patients even complain of symptoms that are non-specific. Incidentally, peritoneal mesothelioma is found in a percentage of cases once the patient has other health complaints such as hernia, gallbladder or pelvic mass.
Doctors who have experiences in this field have noted that typically, patients have these symptoms six months to two years prior to the diagnosis. Men often come to the doctor complaining of a bulge in the groin (hernia) or around the belly button (umbilical hernia). For women, the first sign of a problem often occurs after a pelvic test when a tumor mass have been discovered.
A lining can be found in the abdominal cavity. This lining is known as mesothelium. When the cells of this lining start multiplying at an irregular rate, then the condition is termed as Peritoneal Mesothelioma. The Peritoneal Mesothelioma is also known as the cancer of the peritoneal region. The exact cause of cancer in the region is still undecided, but researchers and doctors hold the opinion that the condition is the result of constant exposure to asbestos. This condition can be considered as a subdivision of asbestos cancer Mesothelioma. This opinion was formulated when studies conducted throughout the world found a high convergence of the cancer on people who are constantly subjected to asbestos.
Even if an expert in the niche diagnoses the condition, the treatment options are known to be futile in most of the cases. The stages of infection of the cancerous cells are classified into three stages. In the first stage, it is possible to extract the cancerous cells from the infected region using surgical measures. In the second stage, the major part of the abdominal cavity might be already infected and treatment options report futile from this stage. With the help of appropriate medications, the growth of cancer cells can be inhibited to a great extent.
In the third and the final stage, the cancer cells might have grown apart from the abdominal cavity. It might have started infecting the nearby organs. The patient will stop responding to the treatment at this stage and doctors are known to prescribe painkillers to eliminate the pains in the region. Chemotherapy is known to work in the case of some patients. It entirely depends on how the body is responding to the treatment. Doctors have recorded instances where a patient undergoing stage three could recover, because his body responded to the chemotherapy sessions. When dealing with asbestos, necessary protection must be endowed to the employee in order to avoid Peritoneal Mesothelioma.
Malignant peritoneal mesothelioma is a rare type of mesothelioma which attacks the lining of abdomen also known as peritoneum. Malignant peritoneal mesothelioma (MPM) is a universally fatal disease affecting 20% to 30% of the mesothelioma cases. It’s was first described by Miller and Wynn in the year 1908. According to the statistics, in the past two decades, the incidence of malignant peritoneal mesothelioma cancer has increased.
Peritoneal mesothelioma affects the lining of the abdomen also known as peritoneum. The location of malignant cell is human’s abdominal lining and because of that, MPM can sometimes known as abdominal mesothelioma. However, most common term used to describe this type of cancer is peritoneal mesothelioma.
The main cause of MPM in humans is asbestos. Asbestos typically is the one of most commonly roofing materials since it is not only cheaper but is easy to fix on a roof. Asbestos exposure contributed to almost 70 to 80 percent of mesothelioma lung cancer. Humans come into contact with asbestos when they swallow or inhale the fibers. Asbestos inhalation may increase risk to develop asbestos related diseases, most importantly mesothelioma.
Asbestos was completely banned in UK since it was recognized to be a serious health hazard, and it is now responsible for about 4000 deaths each year and many cases of serious disease. The people at increase risk of developing health asbestos related disease are those whose work brings them into direct contact with asbestos such as builders, heating engineers, roofers and demolition workers. In addition to mesothelioma, asbestos exposure will increase the risk of other health problems such as lung cancer, asbestosis (chronic lung ailment) and other type of cancer such as larynx and kidney cancer.
Symptoms of Malignant Peritoneal Mesothelioma
It can takes such a long time for cancer to develop the symptoms and sometimes may take up to 30 years, between exposure to asbestos and the start of the disease. Most common symptoms of the disease are abdominal pain, abdominal swelling, abnormal weight loss, anemia, easy fatigue, nausea and vomiting. Abdominal pain and swelling result from fluid accumulation in the abdominal cavity. Other than that, people can easily get fever when the disease starts to shows its symptoms. Among the symptoms stated above, abdominal pain is the most common reported initial symptoms of MPM.
Unexplained night sweats and blood coagulation problems are less frequent symptoms occurring when the cancer develops. If the cancer cells spread to the other part of the body, the symptoms may lead to trouble swallowing or swelling of the neck and face.
Diagnosis of Abdominal Mesothelioma
It is very difficult to diagnose peritoneal mesothelioma since there is no defined system so far that can differentiate the stages of the development of cancerous tumor cells. If required, TNM staging system normally used to detect the cancer in stages. Other than that, Serum mesothelin-related protein (SMRP) may be a potentially useful serum marker used to diagnose and to follow-up the cancer progression. Computer tomography (CT) findings may be a useful tool in detection and characterization of peritoneal mass.
Malignant Peritoneal Mesothelioma is a deadly neoplasm. MPM’s diagnosis is difficult to perform since the symptoms will take a long time to show up. Early detection is the key in peritoneal mesothelioma treatment since the cancer cell normally spread very fast.
The cancer of the lining of the abdominal cavity is called peritoneal mesothelioma. It is not as common as pleural form; it comprises an estimated one fifth to one third of all diagnosed mesothelioma cases. This report of the Surveillance, Epidemiology and End Results (SEER) approximates the number as 54.7% male and 45.3% female, with the age ranging from 65 to 69. The period of latency is shorter for patients exposed in asbestos, the symptoms appearing after 20 to 30 years from exposure; the usual latency period for pleural mesothelioma is 30 to 40 years.
In later stages of peritoneal mesothelioma, among the symptoms are increased occurrences of blood clots and obstruction of the bowel. There is a noticeable increase on the platelet count for 50% of peritoneal patients but this may be caused by various disorders, so this is actually of little help in the diagnosis. Low albumin level and anemia can also be among the symptoms.
Peritoneal Mesothelioma Diagnosis
Peritoneal mesothelioma has two clinical types which can be differentiated with the help of CT findings, the “dry” type and the “wet”. It is classified as “dry” when there are multiple tiny masses or one dominant localized mass and generally little or no ascites. The “wet” type has widespread small nodules, no dominant mass and a presence of ascites.
If fluid is found, the process of eliminating it is through paracentesis; however the analysis of this fluid has limited diagnostic significance. Normally, a definitive diagnosis may be obtained through tissue biopsy.
As there is currently no staging system for peritoneal mesothelioma, the most popular system for general cancer staging (TNM system) is used. TNM system has the following criteria: (T) status of the tumor, (N) lymph nodes and (M) metastases. Other general categories may also be helpful in order to determine the stage.
Category 1 – with a localized lesion that can entirely be removed (resected)
Category 2 – the disease is located inside the abdominal cavity on peritoneal or organ surfaces where there is a probability of removing as much tumor as possible (debulking)
Category 3 – the disease is located inside the abdominal cavity and invades organs such as liver or colon.
Category 4 – the disease extends outside of the abdominal cavity
Peritoneal Mesothelioma Treatment
In the past years, the effectiveness of surgery alone or intraperitoneal chemotherapy in the treatment of peritoneal mesothelioma were not proven, that is why multimodality treatment is becoming more popular. Debulking (cytoreductive) surgery is removing all or nearly all visible tumors and may be combined with IPHC (Intra-Peritoneal Hyperthermic Chemotherapy), intraperitoneal chemotherapy and radiation.
Removing all tumors is not always probable; the prognosis for survival can then be in accordance with the completeness of cytoreduction which is established by these criteria:
(CC-0): No peritoneal seeding is found within the operative areas
(CC-1): Nodules less than 2.5 cm carries on after cytoreduction which can be penetrated by intra-cavity chemotherapy; thus the process is termed complete.
(CC-2) Nodules with sizes of 2.5 to 5 cm carry on after cytoreduction
(CC-3) Nodules that are larger than 5 cm are found; or there is a merging of tumor nodules that are unresectable at any area within the pelvis or abdomen.
Some patients might have widespread disease where surgery is not considered as “potentially curative”, palliative madication may be done by debulking. Take note that specialized medications must only be administered by seasoned doctors as peritoneal mesothelioma is a rare malignant disease. Latterly, a clinical trial discovered Alimta (pemetrexed) to be powerful as chemotherapy agent on treating peritoneal mesothelioma, either on its own or combined with cisplatin or any platinum-based drug. This describes the previous findings regarding pemetrexed medication of pleural mesothelioma.
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