Peritoneal mesothelioma is a rare form of cancer that develops in the lining of the abdomen, known as the peritoneum. It is one of several types of cancer linked to asbestos exposure, representing approximately 20% to 25% of the 3,000 cases of mesothelioma cancer diagnosed each year in the United States.
The following information is provided to help you learn more about peritoneal mesothelioma. If you are concerned about mesothelioma, your doctor can evaluate any symptoms you may be experiencing and determine a course of action, if necessary.
Peritoneal Mesothelioma Symptoms
The peritoneum is a thin serous membrane that protects and supports the organs in the abdomen. It is made up of an outer layer (parietal peritoneum), which is attached to the abdominal wall, and an inner layer (visceral peritoneum), which covers the internal organs. A small space between the two layers contains fluid that allows for movement of organs within the abdomen as they function normally.
Peritoneal mesothelioma can take 10 to 60 years after asbestos exposure to exhibit symptoms. Once these symptoms develop, they are often similar to those of common abdominal ailments or discomfort, which makes this cancer difficult to detect. In addition, symptoms typically don't appear until the cancer has progressed to a more advanced stage.
A common symptom of peritoneal mesothelioma is a condition called ascites, in which the body accumulates excess fluid in the abdominal cavity. Individuals with peritoneal mesothelioma may also experience:
- Pain or swelling in the abdomen
- Unexplained weight loss
- Obstruction of the small or large intestine
- Fever
- Anemia
- Swelling or thrombosis in the legs
These symptoms could be related to other conditions besides mesothelioma. If you have symptoms that are troublesome or persistent, speak with your doctor.
What Causes This Cancer?
The only known cause of peritoneal mesothelioma is exposure to asbestos, a naturally occurring mineral that has been used for decades in a variety of different industries. Many people have been exposed to asbestos in their workplace, home or school; however, individuals working in certain environments have experienced a much higher level of exposure. For example, asbestos has been widely used in manufacturing, construction, shipyards and the military. Because it is heat resistant and particularly strong, asbestos can be found in many construction materials, such as roofing shingles, insulation, cement and flooring products. Heat-resistant fabrics, brake and clutch linings, gaskets and coatings may also contain asbestos.
While it is known that asbestos causes peritoneal mesothelioma, it is unclear how the asbestos fibers reach the peritoneum. This may occur when asbestos fibers are ingested and travel through the intestinal system to the peritoneum. It is also possible that the fibers are inhaled and carried through the lymphatic system. In some cases, mesothelioma found in the peritoneum originated as pleural mesothelioma and spread to the peritoneum. Because the abdominal lining extends into the area of the scrotum in men, there are very rare instances in which the cancer starts there. When it does, it is sometimes referred to as "testicular mesothelioma."
As these fibers reside in the peritoneum, they can cause irritation that may eventually lead to inflammation and a buildup in the membrane's fluid. Cells in the peritoneum then may also become abnormal and divide out of control. Tumors growing in the peritoneum, as well as the fluid buildup, then put pressure on the organs in the abdominal cavity.
Diagnosing Peritoneal Mesothelioma
Because symptoms of peritoneal mesothelioma are often similar to those of more common conditions, it can take several tests for doctors to reach a diagnosis of this cancer. Doctors may start with a review of the patient's medical history, consider his or her general health, and complete a physical exam to determine if further tests are necessary. If you visit your doctor with concerns about symptoms you are experiencing, be sure to mention if you have been exposed to asbestos.
When further tests are warranted, the next step is likely to take an image of the abdomen, which might include x-rays, a CT scan or a PET scan. These images are helpful in detecting tumors or fluid build-up; however, a fluid or tissue sample is usually necessary to make a definitive diagnosis of mesothelioma.
These images can also help identify which type of peritoneal mesothelioma a patient has developed. The "dry" form is characterized by multiple small masses or one large localized mass, and typically does not cause ascites. The "wet" form typically exhibits small widespread nodules and ascites, with no solid mass.
Peritoneal Mesothelioma Treatment Options
A treatment plan for peritoneal mesothelioma may include surgery, chemotherapy and/or radiation, depending on the stage at which the cancer is found and other health factors of the patient. With surgery, doctors try to remove all or as much of the tumor(s) as possible. Because peritoneal mesothelioma may be spread throughout the peritoneum, this can often be difficult to achieve. While there is no cure for peritoneal mesothelioma, a combination of these treatment tools may help prolong the lives of patients and provide relief from the disease's symptoms. In addition, researchers continue to search for more successful treatments of mesothelioma, and clinical trials are ongoing for additional medications to fight this cancer.
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