Peritoneal Mesothelioma: Causes, Treatment & Survival Rates

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What Is Peritoneal Mesothelioma?

Peritoneal mesothelioma is a rare asbestos-related cancer that forms on the abdominal lining, known as the peritoneum. An evening rarer form of this cancer develops in a layer of the abdominal membrane, the omentum, that covers the abdomen and early organs .
Peritoneal mesothelioma is besides known as abdominal mesothelioma or mesothelioma of the stomach .

Quick Facts:

  • Early symptoms include abdominal swelling and fluid buildup (known as ascites).
  • Peritoneal mesothelioma accounts for less than 20% of all mesothelioma cases.
  • Surgery with heated chemotherapy is the most effective treatment, helping some patients survive for more than five years.

The primary campaign of peritoneal mesothelioma is swallowing airborne asbestos fibers or drink contaminated water. The digest fibers become trapped in the peritoneum .

W. Charles Conway
“ The first thing I like to tell [ peritoneal mesothelioma patients ] is that they surely do have options. With good treatment that we use nowadays, that median survival could actually be several years. ” Dr. W. Charles Conway
Peritoneal mesothelioma specialist

What Are the Symptoms of Peritoneal Mesothelioma Cancer?

early symptoms of peritoneal mesothelioma include bloat, pain or affection around the abdomen, and digestion issues such as stultification or diarrhea .
Peritoneal mesothelioma symptoms include :

  • Abdominal pain
  • Abdominal swelling (ascites)
  • Night sweats
  • Nausea
  • Fever
  • Unexplained weight loss
  • Fatigue
  • Diarrhea
  • Constipation
  • Loss of appetite

These symptoms tend to mimic many other abdominal disorders. An accurate diagnosis frequently requires a mesothelioma specialist and a biopsy sample .
Anyone with a history of asbestos photograph should monitor their health and see their doctor for new or worsening symptoms .
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What Causes Peritoneal Mesothelioma?

The main causal agent of malignant peritoneal mesothelioma is ingesting asbestos fibers. Current research suggests that asbestos fibers travel from the digestive nerve pathway and persist trapped in the abdomen, causing cancer after years of inflammation .

Process of Peritoneal Mesothelioma Development

Like other asbestos-related diseases, peritoneal mesothelioma develops over a long period of time. The trap asbestos fibers cause inflammation and aggravation, damage and degrading DNA .
Damaged deoxyribonucleic acid can lead to abnormal and unregulated cell growth. These errors cause tumors to form, and the tumors can grow uncontrollably and spread to other areas of the soundbox .

How Peritoneal Mesothelioma Develops

  • Swallowed asbestos fibers pass through the stomach and digestive system.
  • Ingested asbestos fibers reach the lymphatic system and travel to the peritoneum.
  • Fibers become stuck in the peritoneum, irritating cells and damaging DNA for years.
  • The irritated cells become inflamed, form scar tissue and thicken the peritoneal lining.
  • Years of inflammation and scar tissue formation cause excess abdominal fluid buildup.
  • After prolonged damage, malignant tumors begin to form on the diseased peritoneum.
  • As tumors grow, they put pressure on vital organs and can spread to form new tumors.

inquiry on peritoneal mesothelioma is even ongoing. other sources of this disease may include abdominal radiation sickness and fibrous minerals besides asbestos, such as erionite .

How Is Peritoneal Mesothelioma Diagnosed?

Imaging scans, blood tests and biopsies are used to make an abdominal mesothelioma diagnosis .

  • Imaging scans show the size and location of tumors.
  • Blood tests reveal certain biomarkers associated with cancer.
  • Biopsies show what kind of cancerous cells are present.

Patients will besides receive a exhaustive examination of their medical history, occupational history and overall physical condition .
While every test serves a contributing function to the diagnostic process, the alone way to confirm a peritoneal mesothelioma diagnosis is with a biopsy .
Biopsies are samples of tumor tissue that doctors examine under a microscope in a lab. medical professionals, called pathologists, perform tests on the biopsy sample to reveal the kinds of cancerous cells within the tumors. They then summarize the results in a pathology report .

Diagnosing Cell Types of Peritoneal Mesothelioma

The pathology report contains information about which cellular subtype of peritoneal mesothelioma you have .

Common Cell Types

  • Epithelioid cells: are the most common, making up 75% of cases.
  • Biphasic Cells: Second-most common type, making up 25% of cases. A mix of epithelioid and sarcomatoid cells.

Epithelioid peritoneal mesothelioma can grow in four different patterns : Papillary, tubular, diffuse and deciduous. Papillary is the most coarse and often appears alongside the others .
Pure sarcomatoid tumors are uncommon in peritoneal mesothelioma. Specialists have entirely diagnosed about 30 cases of this variant since 2006. Sarcomatoid cells normally occur aboard epithelioid cells to form the biphasic subtype .

Rare Cell Types

  • Well-Differentiated Papillary Mesothelioma: This variant is uncommon with less potential for malignancy and typically presents in younger women.
  • Multicystic Mesothelioma: This subtype often recurs after surgery and does not have a definitive link with asbestos exposure.
  • Desmoplastic Mesothelioma: This tumor type can present as nodules or a mass-like peritoneal thickening, ascites or lymph node disease.
  • Lymphohistiocytoid Mesothelioma: A dense lymphatic infiltrate characterizes this variant.
  • Pure Sarcomatoid Mesothelioma: The rarest and most lethal form of peritoneal mesothelioma, this subtype is associated with aggressive metastasis.

additionally, omental mesothelioma is a rare discrepancy in the omentum, a part of the peritoneum surrounding the digest and early abdominal organs. The omentum is a level of fatso tissue that plays a function in immune function and metabolism .
Did you know ?
The Mesothelioma Center at has helped more than 1,000 patients diagnosed with peritoneal mesothelioma since 2017 .


Because this cancer is rare, doctors lacking experience with the disease frequently misdiagnose abdominal mesothelioma patients with more common illnesses that share similar symptoms. Peritoneal mesothelioma misdiagnosis can delay proper treatment .
If you have a history of asbestos exposure, the best way to ensure an accurate diagnosis is to schedule an date with a mesothelioma specialist. Doctors who specialize in peritoneal mesothelioma have the cognition and tools needed to make a accurate diagnosis .

Tamron Little, mesothelioma survivor and an expert contributor
“ Getting an accurate diagnosis was not slowly. A fibroid tumor tumor was what they said I had and that it would go away on its own. I asked the doctors, and they all told me, ‘ You will be fine. ’ It took a specialist to get the breakthrough I needed. ” Tamron Little
Peritoneal mesothelioma survivor

Cancer Misdiagnosis Experience

Watch: Peritoneal mesothelioma survivor Tamron Little talks to The Mesothelioma Center about her initial misdiagnosis and the importance of finding a specialist .

Stages of Peritoneal Mesothelioma

There is no official stage system for peritoneal mesothelioma. alternatively, peritoneal mesothelioma experts spent decades adapting other staging systems for their manipulation .
historically, the TNM spy system used in other cancers has not been a estimable fit for peritoneal mesothelioma due to its diffuse growth traffic pattern. however, a research report in 2020 suggested that oncologists adapt the TNM organization for peritoneal mesothelioma into three stages .

3 Stages of Peritoneal Mesothelioma

  • Stage 1: Cancerous tissue is minimal, tumors are only within the abdominal lining and lymph nodes are free of cancer.
  • Stage 2: Cancerous tissue is moderate and tumors have not spread outside the lining or into lymph nodes.
  • Stage 3: Cancerous tissue is more extensive and tumors may have spread outside the peritoneal lining or into lymph nodes.

There is no accurate one-fourth stage in the adapted TNM organization for peritoneal mesothelioma. many doctors consider degree 4 to involve extensive tumors that have spread to distant sites throughout the consistency .

Peritoneal Cancer Index

The Peritoneal Cancer Index is a diagnostic tool that doctors use to assess tumor location and spread in the abdomen. It helps them determine the approximate mesothelioma stage and appropriate treatments .
This index divides the abdomen into 13 parts. Doctors assign a phone number ( one to three ) to each area based upon the most goodly tumor in that area. The Peritoneal Cancer Index seduce is the sum of the individual scores from the 13 regions. A patient ’ s maximum grudge is 39 ( 13 times three ) .
Lower index scores mean the patient may qualify for operation. Index scores above 20 argue cancer has spread besides army for the liberation of rwanda and the affected role probably won ’ thymine react well to operation .

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Peritoneal Mesothelioma Treatment Options

The most effective peritoneal mesothelioma treatment option is operating room with heated chemotherapy, known as hyperthermic intraperitoneal chemotherapy, or HIPEC. however, chemotherapy alone is the treatment most used for peritoneal mesothelioma.

More than 60 % of patients are ineligible for operating room with heated chemotherapy because of the operation ’ south intensity. Cytoreductive operating room can take several hours and may involve removing big portions of the intestines or hale organs .

Heated Intraperitoneal chemotherapy (HIPEC) treatment for peritoneal mesothelioma

HIPEC treatment process


Patients who don ’ deoxythymidine monophosphate qualify for operation with heat chemotherapy can receive systemic chemotherapy alone. Chemotherapy drugs can shrink peritoneal mesothelioma tumors and slow the emergence and diffuse of cancer. Chemotherapy drugs that are effective against peritoneal mesothelioma include pemetrexed, cisplatin, carboplatin and gemcitabine .
U.S. Navy pilot program and peritoneal mesothelioma survivor Jim Madaris decided to seek out the HIPEC operation after his diagnosis in 2013. The operation took 14 hours and removed his gallbladder, spleen and parts of his intestine. Madaris extended his life by four years, allowing him to find joy in the little things and see his youngest child graduate high school .

Mesothelioma survivor Jim Madaris
“ I ’ megabyte fortunate. I ’ ve lasted four times longer than my first doctor expected. tied if something happens tomorrow, we ’ re inactive calling it a victory. ” Jim Madaris
Diagnosed with peritoneal mesothelioma in 2013

Cytoreductive surgery for peritoneal mesothelioma

Cytoreductive operation targets multiple sites in the abdomen .

Cytoreductive Surgery with Heated Chemotherapy

Cytoreductive operating room, besides known as a peritonectomy, attempts to remove equally much cancer as possible. then, heated chemotherapy is applied locally to the abdomen before the operation ends. Doctors only perform this procedure on a individual basis. A 2019 analyze reported that more than 65 % of the patients who underwent this procedure lived five years or longer .

Palliative Treatment Options

In accession to anti-cancer treatments, many peritoneal patients receive alleviative care to control symptoms and improve timbre of life. For exemplar, a abdominocentesis procedure may be recommended to certain peritoneal patients to drain overindulgence fluid from the abdomen .
A palliative manage specialist order medications to control pain and side effects. They may refer patients to physical or occupational therapy or recommend complemental therapies .

Top Peritoneal Doctors

Dr. Paul H. Sugarbaker, peritoneal mesothelioma doctor
Paul H. Sugarbaker
surgical oncologist
Dr. Paul Sugarbaker is the area ’ s leading technical on peritoneal mesothelioma. He developed the widely renowned cytoreductive surgery and heated chemotherapy technique that changed the landscape of peritoneal cancer treatment. many people with peritoneal mesothelioma are alert nowadays because of Sugarbaker ’ south innovations .
Dr. W. Charles Conway
W. Charles Conway
surgical oncologist
Dr. W. Charles Conway is an expert in peritoneal mesothelioma and the Director of Surgical Oncology at Ridley-Tree Cancer Center in Santa Barbara, California. He specializes in minimally invasive robotic surgery and heated chemotherapy for peritoneal mesothelioma .
Dr. J.F. Pingpank Jr., peritoneal mesothelioma doctor
J.F. Pingpank Jr.
surgical oncologist
Dr. J.F. Pingpank Jr. is a peritoneal mesothelioma expert who advocates for regional therapy. The approach applies treatment locally around the cancer to limit damage to the lie of the soundbox. Pingpank specializes in cytoreductive surgery and heated chemotherapy .

Peritoneal Mesothelioma Life Expectancy and Prognosis

The prognosis for peritoneal mesothelioma is by and large poor people for patients who don ’ thymine modify for operation. Peritoneal mesothelioma life anticipation is approximately 12 months for patients who receive chemotherapy alone. The median survival of untreated peritoneal mesothelioma patients is six months .
Diagram showing average peritoneal mesothelioma life expectancy
25 % of peritoneal mesothelioma patients survive three years after diagnosis .
however, the prognosis for surgical candidates is significantly better. Surgery and heated chemotherapy can improve peritoneal survival by respective years .
About half of peritoneal patients who undergo a combination of cytoreductive surgery with heated chemotherapy have a life anticipation of more than five years .
According to a 2020 sketch published in the american Journal of Surgical Pathology, women with peritoneal mesothelioma tend to live longer than men. In the discipline, 77.8 % of women treated with cytoreductive operating room and heated chemotherapy at MD Anderson Cancer Center in Houston survived longer than five years .

Alexis was diagnosed with peritoneal mesothelioma in 2007, had major surgery that removed partially of her diaphragm, yet kept her wedding plans in place. She hush rides to work on her motor scooter and refuses to let mesothelioma get in the means of the life she and her husband built. They don ’ thymine know how many wedding anniversaries they will have, but they celebrate their meter together. “ It ’ s kind of aplomb nowadays to hear people say, ‘ You don ’ metric ton look or dissemble disgusted, ’ ” Alexis said .
Mesothelioma survivor Alexis Kidd
Alexis K .
Peritoneal mesothelioma survivor, 2007
When averaging short- and long-run survival, women live approximately 13 months on average, and men live approximately six months .

Prognostic Factors

Patients with tumors containing epithelial cells have a longer life anticipation than patients with sarcomatoid or biphasic cells. epithelial cells tend to respond better to treatments such as chemotherapy .

  • Stage at diagnosis
  • Cell type
  • Tumor grade (how fast it grows)
  • Gender
  • Genetic mutations
  • Treatments selected

The tumor ’ sulfur grade besides impacts prognosis. Tumor grade indicates how cursorily tumors are likely to grow and spread, based upon how abnormal the cells appear .

Chemotherapy Survival Rates

Systemic ( whole-body ) chemotherapy combined with cisplatin and pemetrexed has the following benefits :

  • A response rate of about 30%
  • Average progression-free survival around 11.5 months
  • Median survival around 13 months

chemotherapy delivered directly to the peritoneum without surgery has a higher reception rate of 47 %. When combined with heat chemotherapy given during operating room, the response pace is 84.6 % .
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Is There a Cure for Peritoneal Mesothelioma?

There is no remedy for peritoneal mesothelioma or any early type of mesothelioma. however, peritoneal patients eligible for operation and HIPEC typically hot longer than five years .
Some patients may be eligible for a repeat surgery with heated chemotherapy if a cancerous mesothelioma recurrence happens .
In 2017, Dr. Paul Sugarbaker reported better survival among patients who received early post-operative chemotherapy and long-run chemotherapy after cytoreductive surgery with heated chemotherapy .
Of the 29 patients who had surgery with HIPEC, post-operative chemotherapy and long-run chemotherapy, 75 % lived longer than five years. No patients in the report received intravenous or systemic chemotherapy .
Insight from a Peritoneal Mesothelioma Survivor
They tell you how HIPEC affects you physically, but no one tells you how it affects you mentally. To be honest, it was a morsel uncut, but I ’ megabyte gladiolus I got through it .
Tamron Little, mesothelioma survivor and expert contributor
Tamron Little
Peritoneal Mesothelioma Survivor
Feelings of depression or aloneness are common among peritoneal mesothelioma patients. Support services such as counselors and patronize groups are available. Talking to a counselor or joining a digest group can help improve quality of life .
The Mesothelioma Center, for model, hosts an on-line patronize group that connects mesothelioma patients and families with one another and offers professional guidance from facilitators. Dana Nolan, MS, LMHC, is a accredited counselor and serves as our moderator. patient advocate and registered nurse Karen Selby is besides available to answer medical questions .

Concept of a Mesothelioma Cure

Watch: Registered Nurse Karen Selby, a patient Advocate at The Mesothelioma Center, discusses the possibility of absolution for mesothelioma patients .

Common Questions About Peritoneal Mesothelioma

What are the symptoms of peritoneal mesothelioma ?
The symptoms of peritoneal mesothelioma include abdominal trouble, abdominal swell or dilatation, diarrhea or constipation, weight personnel casualty and fatigue. other symptoms may develop as the disease progresses such as fever and night sweats .
Is peritoneal mesothelioma curable ?

Peritoneal mesothelioma is incurable at all four stages. clinical trials are searching for a cure by testing modern treatments including immunotherapy and multimodal therapy .
How hanker do peritoneal mesothelioma patients live ?
Peritoneal mesothelioma patients have a life sentence anticipation of about one year. however, survival is importantly better for patients who qualify for surgery with heat chemotherapy. half of the patients who qualify for this procedure live at least five years .
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