Peritoneal mesothelioma is a cancer that occurs in the lining of the stomach. It is not as common as pleural mesothelioma. If every one third case is a pleural mesothelioma concern, only one fifth of the cases are peritoneal mesothelioma concerns. According to the SEER studies, these diagnoses are 55 per cent male versus 45 per cent females with the median age group belonging to 65 to 69 years of age. The latency period is shorter for asbestos exposed patients as their symptoms appear only 20 to 25 years after their exposure rather than 30 to 35 years latency that is normally associated with pleural mesothelioma.
Symptoms at the time of diagnosis of peritoneal mesothelioma may include abdominal mass, abdominal pain, ascites or fluids in the abdomen, persistent fever and cough, excessive weight loss, fatigue and bowel disturbances. Most patients complain of more non specific problems till he is actually diagnosed with mesothelioma which is not before really long. Usually, peritoneal mesothelioma is incidentally found only when the patient is looking for help for another health problem such as hernia, gallbladder etc.
The diagnosis of all forms of mesotheliomas is very challenging. CT findings sometimes help to differentiate between two kinds of peritoneal mesothelioma which can either be dry or wet. In the dry form, there is usually no ascites to be found while in the latter ascites are detected in the CT. A method called paracentesis can be used to remove this fluid also called ascites.
There is no established staging system for peritoneal mesothelioma that has been framed yet. However when the disease is stages, it usually follows the TNM system which is the most commonly used cancer staging system – the system refers to the tumours (T), nodes (N) and metastases (M). In the first stage, the localized lesion can be completely removed from the system; in the second stage, the cancer is contained in the cavity of the stomach but on the surface of the organs. In that case debulking is required but that is a possible solution. In the third stage, where you begin to lose hope in being able to avail of any treatment, the cancer is contained in the cavity of the body with it having invaded organs like the liver or the abdomen. Stage four is the final stage and in this case the cancer is seen to be extending outside the body walls.
The latest treatment for peritoneal mesothelioma is multimodality treatment because surgery and chemotherapy have proved time and over again to be ineffective in treating mesothelioma. In this case, all visible tumours are removed and then the surrounding are is burnt with the help of intraperitoneal chemotherapy so that the living cancer cells that might still be alive are killed. This stops the cancer from growing and spreading further across different parts of the body. Of all the available treatment options, this has proved to be most effective so it is used to try and cure most cases these days but further studies are still being conducted to come up with something more concrete.
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