The cancer of the lining in the abdominal cavity is known as peritoneal mesothelioma cancer. It is not as common as pleural type, it comprises an estimated one fifth to one third of all identified mesothelioma cases. This report of the Surveillance, Epidemiology and End Results (SEER) approximates the number as 54. 7% male and 45. 3% female, with the age starting from 65 to 69. The period of latency is actually shorter for patients exposed in asbestos, the symptoms appearing after 20 to 30 years from exposure, the usual latency interval for pleural mesothelioma is 30 to 40 years.
# Peritoneal Mesothelioma Symptoms
At the time of presentation, symptoms of peritoneal mesothelioma contains abdominal mass, abdominal pain, enlarged abdominal girth, fluid in the abdomen (ascites), distention of the abdomen, weight loss, fever, anemia, fatigue and digestive disturbances. For a few months before a confirmed diagnosis, some patients even complain of symptoms which are non-specific. Incidentally, peritoneal mesothelioma is obtained in a percentage of cases once the patient has other health complaints for example hernia, gallbladder or pelvic mass. Doctors who have experiences with this field have noted which typically, patients have these symptoms 6 months to 2 years before the diagnosis. Men often come to the doctor complaining of a bulge in the groin (hernia) or around the belly button (umbilical hernia). For women, the first sign of any problem often occurs after a pelvic test every time a tumor mass have been discovered.
In later stages of peritoneal mesothelioma, among the symptoms are generally increased occurrences of blood clots and obstruction in the bowel. There is a noticeable increase to the platelet count for 50% of peritoneal patients but this might be caused by a variety of disorders, so this is actually of little help in the diagnosis. Low albumin level and anemia can be among the symptoms.
# Peritoneal Mesothelioma Diagnosis
Peritoneal mesothelioma cancer has two clinical types which are often differentiated by using CT findings, the "dry" type and the "wet". It is classified as "dry" when there are multiple tiny masses or one dominant localized mass and generally minimum ascites. The "wet" type offers widespread small nodules, no dominant mass including a presence of ascites. If fluid is found, the process of eliminating its through paracentesis, however the analysis of the fluid has limited diagnostic significance. Normally, a definitive diagnosis could be obtained through tissue biopsy.
# Peritoneal Mesothelioma Staging
As there is currently no staging system for peritoneal mesothelioma, the most popular procedure for general cancer staging (TNM system) is used. TNM system has the following criteria: (T) status of the tumor, (N) lymph nodes and (M) metastases. Other general categories will also work helpful in order to determine the stage.
Category I = with a localized lesion that can entirely be removed (resected)
Category II = the disease is located inside the abdominal cavity on peritoneal or organ surfaces where there is a probability of removing all the tumor as possible (debulking)
Category III = the disease is located inside the abdominal cavity and invades organs like liver or colon.
Category IV = the disease extends outside of the abdominal cavity
# Peritoneal Mesothelioma Treatment
In the past years, the effectiveness of surgery treatment alone or intraperitoneal chemotherapy in the treating peritoneal mesothelioma were not proven, that is why multimodality treatment has become more popular. Debulking (cytoreductive) surgery treatment is removing all or the majority of visible tumors and might be combined with IPHC (Intra-Peritoneal Hyperthermic Chemotherapy), intraperitoneal chemotherapy and radiation.
Removing all tumors seriously isn't always probable, the prognosis for survival can then be prior to the completeness of cytoreduction that is established by these criteria :
I. Complete cytoreduction
(CC-0): No peritoneal seeding is found within the operative areas
(CC-1): Nodules less than 2. 5 cm carries on after cytoreduction which can be penetrated by intra-cavity chemotherapy; thus the process will be termed complete.
II. Incomplete cytoreduction
(CC-2) Nodules with sizes of 2. 5 to 5 cm carry on after cytoreduction
(CC-3) Nodules that are larger than 5 cm are found, or there is the merging of tumor nodules that are unresectable at any area in the pelvis or abdomen.
Some patients may have widespread disease where surgery is not considered as "potentially curative", palliative treatment may become done by debulking. Take note that specific treatments should only be administered by seasoned medical doctors because peritoneal mesothelioma is a rare malignant disease. Recently, a clinical trial found Alimta (pemetrexed) to be effective as chemotherapy agent about treating peritoneal mesothelioma, either on its own or combined with cisplatin or any platinum-based drug. This reflects the previous findings regarding pemetrexed treatment of pleural mesothelioma.
# Peritoneal Mesothelioma Symptoms
At the time of presentation, symptoms of peritoneal mesothelioma contains abdominal mass, abdominal pain, enlarged abdominal girth, fluid in the abdomen (ascites), distention of the abdomen, weight loss, fever, anemia, fatigue and digestive disturbances. For a few months before a confirmed diagnosis, some patients even complain of symptoms which are non-specific. Incidentally, peritoneal mesothelioma is obtained in a percentage of cases once the patient has other health complaints for example hernia, gallbladder or pelvic mass. Doctors who have experiences with this field have noted which typically, patients have these symptoms 6 months to 2 years before the diagnosis. Men often come to the doctor complaining of a bulge in the groin (hernia) or around the belly button (umbilical hernia). For women, the first sign of any problem often occurs after a pelvic test every time a tumor mass have been discovered.
In later stages of peritoneal mesothelioma, among the symptoms are generally increased occurrences of blood clots and obstruction in the bowel. There is a noticeable increase to the platelet count for 50% of peritoneal patients but this might be caused by a variety of disorders, so this is actually of little help in the diagnosis. Low albumin level and anemia can be among the symptoms.
# Peritoneal Mesothelioma Diagnosis
Peritoneal mesothelioma cancer has two clinical types which are often differentiated by using CT findings, the "dry" type and the "wet". It is classified as "dry" when there are multiple tiny masses or one dominant localized mass and generally minimum ascites. The "wet" type offers widespread small nodules, no dominant mass including a presence of ascites. If fluid is found, the process of eliminating its through paracentesis, however the analysis of the fluid has limited diagnostic significance. Normally, a definitive diagnosis could be obtained through tissue biopsy.
# Peritoneal Mesothelioma Staging
As there is currently no staging system for peritoneal mesothelioma, the most popular procedure for general cancer staging (TNM system) is used. TNM system has the following criteria: (T) status of the tumor, (N) lymph nodes and (M) metastases. Other general categories will also work helpful in order to determine the stage.
Category I = with a localized lesion that can entirely be removed (resected)
Category II = the disease is located inside the abdominal cavity on peritoneal or organ surfaces where there is a probability of removing all the tumor as possible (debulking)
Category III = the disease is located inside the abdominal cavity and invades organs like liver or colon.
Category IV = the disease extends outside of the abdominal cavity
# Peritoneal Mesothelioma Treatment
In the past years, the effectiveness of surgery treatment alone or intraperitoneal chemotherapy in the treating peritoneal mesothelioma were not proven, that is why multimodality treatment has become more popular. Debulking (cytoreductive) surgery treatment is removing all or the majority of visible tumors and might be combined with IPHC (Intra-Peritoneal Hyperthermic Chemotherapy), intraperitoneal chemotherapy and radiation.
Removing all tumors seriously isn't always probable, the prognosis for survival can then be prior to the completeness of cytoreduction that is established by these criteria :
I. Complete cytoreduction
(CC-0): No peritoneal seeding is found within the operative areas
(CC-1): Nodules less than 2. 5 cm carries on after cytoreduction which can be penetrated by intra-cavity chemotherapy; thus the process will be termed complete.
II. Incomplete cytoreduction
(CC-2) Nodules with sizes of 2. 5 to 5 cm carry on after cytoreduction
(CC-3) Nodules that are larger than 5 cm are found, or there is the merging of tumor nodules that are unresectable at any area in the pelvis or abdomen.
Some patients may have widespread disease where surgery is not considered as "potentially curative", palliative treatment may become done by debulking. Take note that specific treatments should only be administered by seasoned medical doctors because peritoneal mesothelioma is a rare malignant disease. Recently, a clinical trial found Alimta (pemetrexed) to be effective as chemotherapy agent about treating peritoneal mesothelioma, either on its own or combined with cisplatin or any platinum-based drug. This reflects the previous findings regarding pemetrexed treatment of pleural mesothelioma.
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