Peritoneal Mesothelioma
Peritoneal mesothelioma is a cancer that occurs in the lining of the abdominal cavity, the peritoneum. The disease is relatively rare, affecting approximately 10 to 25 percent of all diagnosed mesothelioma patients. There are two clinical types of peritoneal mesothelioma known as "dry" and "wet," reflecting their appearance in CT images. Dry peritoneal mesothelioma typically shows up as a single large mass in one location or many tiny masses. Wet peritoneal mesothelioma is never visible as a large mass; instead, it appears as pervasive smaller lumps combined with abdominal fluid called ascites. This fluid may be removed from the body for analysis during a needle or catheter withdrawal procedure called paracentesis, but a tissue biopsy is more helpful in terms of making an informed diagnosis.
Function of the Peritoneum
Comprised of two layers -- mesothelium and connective tissue -- the peritoneum supports the abdominal organs, including the small and large intestines, stomach, liver, gallbladder and pancreas. It also helps blood, nerves and lymph muscles flow.
Symptoms
Individuals with peritoneal mesothelioma may experience pain, swelling and unusual mass in the abdominal region. Women typically have tumorous lumps and men usually present with an umbilical or inguinal hernia (a mass in the groin and around the belly button, respectively). This type of cancer can cause fever and a number of digestive issues as well as anemia, weight loss, and fatigue. Symptoms usually occur anywhere from six months to two years before the cancer is diagnosed. When peritoneal mesothelioma is more advanced, patients may experience higher platelet counts, obstructed bowels and increased blood clotting.
Diagnosis
Diagnosing peritoneal mesothelioma may be a difficult process, since most symptoms resemble those of other health issues like gallstones. Despite the disease's symptomatic similarities to so many different ailments, cases thus far suggest that peritoneal mesothelioma is caused only by asbestos exposure. After confirming a history of asbestos exposure, a doctor will run a series of tests, beginning with x-rays, MRIs and CT scans.
The medical community does not have specific peritoneal mesothelioma stage criteria, instead relying on the more general Tumor, Nodes and Metastases (TNM) system. The TNM system consists of four increasingly serious categories, beginning with compact, removable lesions and ending with cancer that has metastasized to other parts of the body besides the abdomen.
Treatment
In the past, doctors treated peritoneal mesothelioma with chemotherapy or surgery, usually to little or no effect. Contemporary treatments are usually combined.
During Intra-Peritoneal Hyperthermic Chemotherapy, an electrical generator produces a high-frequency alternating current that uses heat to kill tumorous cancer cells. Usually used when surgery has failed or is not possible, Intra-Peritoneal Hyperthermic Chemotherapy can be implemented in conjunction with radiation and intra-peritoneal chemotherapy. All of these methods may be utilized along with cytoreductive surgery, during which doctors attempt to remove as much of the visible tumor as they can.
Prognosis
While combined methods of treatment have seen more success in recent years, peritoneal mesothelioma can be managed best when it is diagnosed early with less severe symptoms. Tumor cell structure and disease treatment methods may greatly affect the life expectancy of anyone diagnosed with peritoneal mesothelioma.
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