Peritoneal Mesothelioma

Cancer of the Peritoneum

The peritoneum is the part of the mesothelium that surrounds and protects organs in the abdominal cavity. It consists two layers called the visceral peritoneum and the parietal peritoneum.

Mesothelioma spreads easily and quickly compared to many other cancers. It typically spreads first from one layer of the peritoneum to the other. It may then grow into organs within the abdominal cavity, like the liver, stomach and intestines.

The cancer also may spread to the omentum, a layer of fatty tissue covering the abdominal organs. In extremely rare cases—only about five have ever been reported—the cancer may begin in the omentum and then spread to the peritoneum. This is still considered to be peritoneal mesothelioma.

Causes and Risk Factors

The main cause for any type of mesothelioma is asbestos exposure. Experts believe other risk factors, like genetics and family history, also play a role because not everyone exposed to asbestos develop cancer.

Even with genetics the strongest risk factor remains exposure to asbestos. The more prolonged the exposure, the greater the risk. People who worked with or around asbestos for years are at the highest risk of all.

Prolonged asbestos exposure is most often associated with pleural mesothelioma, but asbestos also causes the peritoneal type. Pleural mesothelioma, which affects lung tissue, is more common because asbestos exposure usually occurs when someone inhales the fibers.

Loose asbestos fibers can also be ingested, though. This can trigger cancer that begins in abdominal tissues. Another way asbestos may cause cancer in the abdomen is through migration of inhaled fibers. The lymphatic system may carry the fibers to the abdomen.

The Development of Peritoneal Mesothelioma

Peritoneal mesothelioma has a long latency period. Several decades long, this is the time between exposure to asbestos and diagnosis of cancer. Though the asbestos fibers begin to do damage as soon as they enter the body, it takes many years for their impact to be felt and noticed.

Asbestos fibers embed in the cells of the body and trigger inflammation and damage. This damage can cause cells to become cancerous, growing and dividing out of control. They then develop into tumors.

Diagnosing Peritoneal Mesothelioma

The early symptoms of peritoneal mesothelioma make it challenging to diagnose. They are similar to symptoms of irritable bowel syndrome, Crohn’s disease, colitis, and other gastrointestinal disorders. All of these are much more common than peritoneal mesothelioma. Doctors are more likely to diagnose these first, especially if they are unaware of any asbestos exposure.

For this reason it is crucial that patients tell their doctors about any asbestos exposure they know or suspect they  experienced. This gives doctors an important clue to look for any signs of cancer, and especially for signs of mesothelioma.

After a physical exam, the next step in making a diagnosis is to take images of the abdomen with X-rays, a CT scan, an MRI, a PET scan, or some combination of these. These scans provide a picture of any abnormal tissue in the abdomen that might be cancerous.

If there tissue abnormalities are visible in a scan, doctors will then perform a biopsy. A biopsy is a procedure that removes a small amount of tissue or fluid for testing. If it is easy to access, a tumor may be biopsied with a needle in an easy outpatient procedure.

In some cases, a more invasive surgical biopsy may be necessary. This happens when the tissue in question is difficult to reach.

Prognosis for Peritoneal Mesothelioma

The prognosis for peritoneal mesothelioma is unfortunately not very good, although it is usually better than the outlook for pleural mesothelioma.

Factors such as extent and duration of the asbestos exposure, age and health, and staging of the disease all contribute to an individualized prognosis. Only about one quarter of people with a diagnosis of peritoneal mesothelioma will live for three years or longer.

An early diagnosis is crucial for the best prognosis and any chance of remission. Aggressive treatments can also help improve the prognosis for a patient. Not everyone can withstand the side effects of these treatments, but those who can tolerate them will likely live longer.

Getting a diagnosis for peritoneal mesothelioma may be devastating, but you always have options. You may get a second opinion and then seek treatment at a specialty center. You can choose from among treatments that are aggressive and those that will make you feel more comfortable in the time you have left. You may also be able to file a lawsuit to seek compensation if you were exposed to asbestos in the workplace.