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Monday 19 December 2011

Peritoneal Mesothelioma

Peritoneal Mesothelioma

Asbestos exposure can lead to a type of cancer called mesothelioma. Peritoneal mesothelioma is a cancer of the mesothelial lining (also called mesothelium) of organs in the chest and/or abdomen. The mesothelium is a thin layer of cells that produce fluid that lubricates and protects organs such as the heart, lungs, stomach and testicles.
Peritoneum is the medical word for the wall that lines the abdomen and pelvis. Along the peritoneal wall is a mesothelium. When cancer attacks the mesothelial lining of the peritoneum, that cancer is called peritoneal mesothelioma.

How does Peritoneal Mesothelioma Form?

When asbestos fibers are breathed or swallowed into the body, they can migrate to the mesothelium of the peritoneum and lodge there. Over time, the fibers cause irregularities in the cells there that develop into cancer - peritoneal mesothelioma.
Like other types of mesothelioma, peritoneal mesothelioma typically has a long latency period. It usually takes years or even decades after asbestos exposure for the cancer to be diagnosed, but not always. Mesothelioma is rare. Thankfully, only 2000 – 3000 cases a year are diagnosed in the United States. Of these, only 15% - 20% begin in the peritoneum.

Diagnosis and Treatment

As is true for other types of mesothelioma, peritoneal mesothelioma is rarely diagnosed in an early stage, when more treatment options may be available. There are several reasons the disease is typically not caught early:
  • Many victims may not be aware they are at risk.
  • The symptoms of peritoneal mesothelioma may be confused with other less serious conditions.
  • The disease is very rare, and most primary care physicians have no experience with it.

Symptoms

Symptoms of peritoneal mesothelioma may include:
  • Abdominal pain, swelling and/or weakness
  • Loss of appetite, nausea or unexplained weight loss
  • Fever or night sweats
  • Bowel obstruction
  • Fatigue or a general feeling of being unwell

Diagnosis

Peritoneal mesothelioma is so rare and the disease has such a long latency period (time between asbestos exposure and diagnosis) that it usually is diagnosed when it is in the latter stages.
Typically, a patient will visit their family doctor complaining of symptoms that are mistaken for a less serious condition. After several visits and no improvement from the prescribed treatments, diagnostic tests will be run such as x-rays, MRI or other procedures. Those procedures may show fluid or a mass in or near the peritoneum. During a surgical procedure, a specialist will remove some of the fluid or tissue from the mass (this procedure is called a biopsy) and it will be examined by a laboratory.
If the biopsy shows the presence of cancer cells in the mesothelium of the peritoneum, a peritoneal mesothelioma diagnosis is made.

Treatment

The right treatment for you depends on several factors, such as the stage of the disease, your overall health, the recommendations of your physicians, and the choice of you and your family.
Peritoneal mesothelioma treatments fall into three categories:
Palliative therapies - these treatments typically include pain medication and surgeries to remove fluid or bulky tumors. Peritoneal mesothelioma is always fatal. Palliative treatments are meant to ease the patient’s pain and discomfort but do nothing to cure or slow the disease.
Some people may also find prayer, meditation, yoga, herbal and nutritional supplements, a strict diet, or oxygen therapies comforting or helpful in some manner, but no scientific evidence indicates these alternative palliative treatments do anything to slow or cure the disease.
Curative therapies - currently, there is no cure for peritoneal mesothelioma. Curative treatments aren’t meant to cure the disease. Rather, they are meant to slow the progression of the disease and help the victim have survive longer. Curative treatments for mesothelioma are the same as most other cancers and include surgery to remove tumors and cancerous tissues, chemotherapy, and/or radiation.
Experimental therapies - these are new treatments that are being researched or tested in clinical trials. Patients must meet certain requirements to participate in clinical trials.
At this point, none have been found to cure the disease, but several offer hope that a cure may not be far off. Some of the most promising clinical trials are immunotherapy, photodynamic therapy, anti-angiogenesis therapy and gene therapy.

Survival

Cases that are found early typically offer the best treatment options and longest survival rate. With peritoneal mesothelioma, nearly half of those diagnosed early live around two years. As many as 20% may live up to five years. Those diagnosed in the disease’s latter stages face the same survival rate of other types of mesothelioma—typically a year or less.

 

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