As the name suggests, peritoneal mesothelioma is a type of mesothelioma cancer. However, unlike other mesotheliomas, peritoneal mesothelioma cancer developed on the tissue lining of the abdomen. Several extensive research has concluded that this type of cancer is caused by prolonged asbestos exposure. So, here’s all you need to know about this asbestos cancer.
What is peritoneal mesothelioma?
There are four types of mesothelioma cancer: pleural mesothelioma, pericardial mesothelioma, testicular mesothelioma, and peritoneal mesothelioma cancer. Peritoneal mesothelioma occurs on the thin membrane that encases your abdomen and pelvis. This thin membrane is commonly known as the peritoneum. Therefore, cancer that occurs on the peritoneum is called malignant peritoneal mesothelioma cancer.
The peritoneum itself is divided into two layers, the inner layer, and the outer layer. The inner layer, also known as the visceral peritoneum, lines the surface of organs in your abdomen, such as the ovaries, liver, and bowel. Meanwhile, the outer parietal peritoneum lines the walls of your abdomen and pelvis.
Normally, a thin film of liquid is contained between the two layers. This liquid allows the two-layer to slide around as you move. However, people with peritoneal mesothelioma cancer often have an excessive amount of fluid that accumulates between the peritoneum layers.
Causes of peritoneal mesothelioma cancer
As previously mentioned, most cases of malignant peritoneal mesothelioma cancer are caused by prolonged exposure to asbestos. However, several cases indicated that this type of cancer is not related to asbestos. Such an example can be found in a 1975 study on a village in central Cappadocia, Turkey. The research shows that the primary cause of peritoneal mesothelioma in the village was a genetic predisposition to mineral fiber carcinogenesis.
However, those findings only represent cases in a specific area. In other countries like Australia, mesothelioma rates are the highest in the world. In the US, most peritoneal mesothelioma cancers are caused by asbestos exposure. Each year, around 1000 cases are discovered in the US. Most of the patients used to work in asbestos-related industries, such as builders, asbestos miners, and asbestos cement manufacturing workers.
Peritoneal mesothelioma symptoms
Malignant peritoneal mesothelioma cancer could take decades to develop. Due to this long latency period, most asbestos patients are around the age of 60 to 70. However, this type of cancer can also be diagnosed in younger people. Ingested asbestos fibers could cause irritation and inflammation in the abdomen.
The fibers could also destabilize chromosomes which will lead to normal cellular process disruption. These damages can further develop into tumors. The most common symptoms of peritoneal mesothelioma cancer are:
- Pain in the abdominal area
- Abdominal swelling
- Extreme weight loss
- Fluid buildup in the peritoneal cavity
- Blood clotting
- Inflammatory lesions
- Intestinal obstruction
- Night sweats
While common symptoms of peritoneal mesothelioma can be felt by the patient, proper diagnosis still needs to be performed by a medical professional. Other than that, it is also recommended to get the diagnosis from a peritoneal mesothelioma cancer specialist. This is due to the common cases of misdiagnosis. Due to the rarity of this cancer, doctors often misdiagnosed the cancer with other common types of cancer with similar symptoms.
Peritoneal mesothelioma cancer diagnosis
Like other types of cancer, peritoneal mesothelioma is diagnosed through several stages. Commonly, the first stage of diagnosis involves imaging tests, such as CT scans and X-rays. In the next stage, the doctor will request a blood test. A blood test is necessary to reveal specific biomarkers associated with the cancer. At a later stage, a doctor will need to confirm the cancer through biopsies.
Biopsies are performed by collecting the buildup fluid on the patient’s peritoneal membrane. Other than that, this method is performed to collect the tissue sample. This process is necessary to identify the cell type and the progression of the cancer.
Peritoneal mesothelioma staging
During the diagnosis, the doctor will also determine the stage of cancer. However, unlike pleural mesothelioma, there is no definite staging system for peritoneal mesothelioma. Despite that, doctors can still classify cancer based on certain criteria through the PCI system. PCI (Peritoneal Cancer Index) is the most commonly used tool for peritoneal mesothelioma staging.
Through this method, the patient’s abdominal region is divided into 13 sections. Each section is scored on a scale of 0-3 based on the presence of tumors. The higher the score, the wider the tumor has spread. After the end of the test, the total score is accumulated. The highest possible score from this method is 39. If the score is high, it is indicated that the patient has reached the advanced stage of peritoneal mesothelioma cancer.
Other than the PCI, there is another method that is also suitable for peritoneal mesothelioma staging. The Tumor Node Metastasis (the TNM system) is also widely used to determine the stage of peritoneal mesothelioma. According to a research report in 2020, the TNM system has been adapted by several oncologists to classify peritoneal mesothelioma into three stages.
- Stage 1: There is minimal cancerous tissue in the abdomen. The tumors can only be found on the abdominal lining.
- Stage 2: Cancerous tissue begins to develop further. However, the tumors have not spread outside the abdominal lining.
- Stage 3: Cancer has spread to various nearby organs, including several lymph nodes.
Peritoneal mesothelioma treatments
Due to its rarity, there are no established treatments for peritoneal mesothelioma cancer. In most cases, this cancer is often treated with a multimodal approach, combining treatments such as chemotherapy, surgery, and radiation therapy. Each of those methods has a different success rate.
Please be aware that these treatments cannot completely cure the cancer, especially for advanced-stage patients. Instead, these treatments might be used as palliative treatment to improve patient’s life quality and extend their life expectancy. Some of the most common treatments for peritoneal mesothelioma are:
Surgery is one of the most common methods to treat malignant peritoneal mesothelioma cancer. The goal of the surgical procedure is to reduce the PCI number to zero. Surgery is also one of the most common treatments in terms of patients’ eligibility. According to data retrieved from Surgical Oncology, even the patients with the highest PCI score can be reduced to PCI zero.
Chemotherapy is one of the most common methods to treat peritoneal mesothelioma cancer. It involves injecting various drugs into a patient’s body to kill cancer cells. Despite being the most common, the overall success rate of this method is relatively low. For this reason, new and improved methods are developed. Hyperthermic intraperitoneal chemotherapy (HIPEC) is one of those methods.
HIPEC procedure is initiated by injecting various heated drugs into the patient’s body before the surgery is finished. However, due to the intensity of this procedure, more than 60% of patients are ineligible for this treatment.
3. Radiation therapy
The aim of radiation therapy is to eliminate and reduce the size of malignant peritoneal mesothelioma cancer tumors. Compared to other methods, radiation is one of the safest treatments for this type of cancer. It is also the most time-efficient. Despite all that, radiation cannot completely cure cancer. Instead, it is only used to prolong a patient’s life expectancy.
So, that’s all you need to know about one of the rarest asbestos cancers. To sum up, this type of cancer has a long latency period. Therefore, it is mostly diagnosed in 60 and up patients. Several treatments for the cancer are available. However, due to its rarity, there has not been a treatment that is effective enough to completely cure mesothelioma cancer.
Lastly, If your or your loved ones felt the symptoms as above, immediately seek a medical professional. Do not attempt to perform a self-diagnosis due to the symptoms’ similarity with other types of cancer. When seeking treatment, make sure that you have researched all of the available options to determine the best treatment for peritoneal mesothelioma cancer.