	What is Peritoneal Mesothelioma and its Symptoms and Causes?

Peritoneal Mesothelioma - Median Survival Rate

Peritoneal mesothelioma is rarer than pleural mesothelioma, and often more aggressive; it lines itself within the abdominal cavity, and may invade the liver, spleen, bowel or other organs. It is often an extension of pleural mesothelioma, but it can also be the primary site of the cancer. Life expectancy is lower than it is for the pleural form – the median survival rate for untreated cases is 5 to 13 months – but a contributing factor may be that it often takes longer to detect than other forms. If wasting, or weight loss, is more advanced when peritoneal mesothelioma is diagnosed, for example, the chances of longer-term survival, even with recently-developed treatment methods, will be lessened.

Peritoneal Mesothelioma Symptoms

The initial symptoms of peritoneal mesothelioma can be much like the flu – abdominal pain, nausea, vomiting, and fever, for example. Other symptoms include swelling of the feet and the abdomen, and weight loss. As the tumor gets bigger, it can cause bowel obstruction, or impair breathing capacity if it presses upward. If the pressure is in an area with more nerve fibers, or if the bowel gets distended, the pain can increase substantially.

Abdominal swelling is caused by ascites, the accumulation of fluid in the peritoneal area. Frequently, this is the first symptom that will bring a patient to the doctor for diagnosis and treatment.

Peritoneal Mesothelioma Causes

Like other forms of the disease, peritoneal it is associated with exposure to asbestos fibers, particularly the chrysotile variety. In cases where peritoneal mesothelioma is the primary location of disease (in other words, it started in the peritoneum rather than in the pleura), it might be hard to understand how asbestos fibers came to be in the peritoneum, since most asbestos fibers appear to enter the body by being breathed in with the air they are floating in. One conjecture is that they may have been swallowed, then worked their way into the peritoneum through the intestinal wall. Another possibility is that they work their way from the lungs into the lymph system, then into the peritoneum.

It is also not known exactly what causes the cancerous reaction to the fibers, or how much exposure is necessary to cause the reaction.

Treatment

Options for treatment are similar to those for treating the pleural variety. If the disease is still in Stage 1, the membrane can be removed surgically along with the tumors, augmented with chemotherapy or another therapy to assure that all microscopic malignant cells have also been killed.

Intravenous chemotherapy does not provide very effective treatment for PM, much like the pleural variety, but because the disease stays in the peritoneal cavity for most of the course of the illness, localized chemotherapy can be a good alternative.

With surgery to reduce the size of the tumor, followed by chemotherapy and other adjuvant treatments, it is possible to greatly extend the median time of survival as well as the quality of life for patients.

"Asbestos-Induced Peritoneal Mesothelioma in a Construction Worker" Environmental Health Perspectives (EHP)
http://www.ehponline.org/members/2003/6542/6542.html

"Specialty Section for the Treatment of Peritoneal Mesothelioma" Sugarbaker Oncology Associates
http://www.surgicaloncology.com/meso.htm