Peritoneal Mesothelioma

Peritoneal mesothelioma is a form of cancer that can be found when asbestos fibers have made their way into the lining of your abdomen. It is the second most common type of mesothelioma making up around 20% of known diagnoses.

Peritoneal Mesothelioma Explained

Peritoneal mesothelioma is a type of cancer that will account for nearly 20% of all the cases. Despite being the second-most common form of mesothelioma, peritoneal mesothelioma is rare— approximately 500 patients are diagnosed annually. As with other forms of mesothelioma, almost all cases can be traced back to asbestos exposure. Patients with this cancer actually have higher life expectancies than other forms. Some patients may even live up to five years after having cytoreductive surgery.

Treatment Options

Cytoreductive Surgery – This type of surgery is the only kind that’s available for peritoneal mesothelioma patients. It can be very effective if it is used with chemotherapy.

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Chemotherapy – Many patients have had success with this type of treatment and it will often be given in the abdomen while surgery is taking place.


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Radiation – This treatment option will not be very invasive and it can also be given during surgery.


Symptoms of Peritoneal Mesothelioma

There are many patients that are not going to have symptoms when this cancer is just forming. However, there are times when there will be pockets of fluid on the abdomen and the stomach may bulge. Some of the other symptoms that may be experienced include:

  • Pain in the abdomen
  • Lack of appetite or Anorexia
  • Blood Clots
  • Being tired
  • Fluid building up
  • Nausea
  • Swelling in the abdomen
  • Fevering or suffering from sweating, including night sweats
  • Lumps in the abdomen
  • Anemia
  • Seizures
  • Trouble with bowels
  • Intestinal obstructions or lesions

You will find that in most cases this is not going to spread to the lungs. But, it can make its way to the ovaries, your liver or even into your intestines. It can be misdiagnosed as a hernia or even a simple upset stomach.

Causes and Risk Factors

This form of Mesothelioma is often found in males that range between 50-69 years of age. The highest numbers are seen in those men that are military veterans (especially from the Navy) or that were exposed to asbestos during their work. However, second-hand asbestos exposure can also lead to the development of mesothelioma.

You will find that this does not often make its way into the lymph nodes. It will usually form a large tumor and remain in the same location where it originated.


  1. The asbestos is taken in through inhalation.
  1. The fibers are sharp, and they are not easily removed once they become lodged. They become stuck in the peritoneum and they irritate the lining causing cell damage.
  1. Your cells are not going to receive the signals that they need to stop duplicating themselves and a tumor will develop.

Diagnosis of Peritoneal Mesothelioma

You should know that a CT scan and even MRI tests will not show this type of cancer because it is often thought to be gas. The most effective way to find this type of cancer is to use X-rays. Your doctor may also order a series of blood tests to help diagnose through a process of elimination.

In many cases, the doctor could also use the procedure called peritoneoscopy. This is when the doctor will make a small cut in the abdomen and then use a camera to explore the area. Tissue can also be removed at this time so that it can be tested.

Biopsies on the removed tissue are the only way to confirm peritoneal mesothelioma; this test will also allow doctors to identify which type of cells make up the mesothelioma. The results may also tell your doctor how the cancer will progress over time.

Occasionally, biopsy results will reveal the presence of more rare forms of mesothelioma, such as the rare benign papillary mesothelioma that can be surgically removed or the rarer Omental mesothelioma, which forms in the layer of the abdominal membrane covering our intestines and stomach.

The doctor will determine what stage the cancer is in. If it is in stage 1, you will see that it is going to be found in the abdomen only. In stage 2, it may have spread, but it will still be in the peritoneum. If it reaches stage 4, it will have spread to the colon or even into the liver.

Treatment of Peritoneal Mesothelioma

The type of treatment that you receive will be based on the stage your cancer is in. Cytoreduction can cure the patient when they are in the early stages of this type of cancer.

Palliative treatment options, which may include chemotherapy or radiation, may be explored for those patients that are suffering from cancer in more advanced stages. They may even be able to have fluid on the abdomen drained to make them more comfortable.

A very successful treatment option for these patients has been cytoreduction surgery along with heated intraperitoneal chemotherapy. When the surgery is completed it will remove most of the cancerous cells. The chemotherapy will work to kill those that are left. This type of treatment can be used for those that have good health. It has been found to help patients live up to 7 years after the surgery.

Surgical Treatment Options


This is used to help remove as much of the cancerous tumor as possible. Many times the entire tumor may not be able to be removed. In many cases, the lining of the abdomen and even other organs may need to be removed during this surgery. It can be used when someone is in stage 1 or stage 2 of this cancer.

You will need to go through a recovery process that could take up to 13 days once the surgery has been completed. Some individuals will even feel nauseated for up to 13 days. Patients may be able to begin their normal activities approximately 11 days after they have had the surgery.

Heated Intraperitoneal Chemotherapy

This is used to kill the cancer cells that may be left after the surgery. This type of treatment will use heated and sterilized chemotherapy.

Our doctors have been effective when it comes to cytoreduction and heated intraperitoneal chemotherapy. What is really nice to know is that this type of chemotherapy has less side effects than other types of chemotherapy. After 60-90 minutes of the treatment, the chemotherapy will be washed from the body.

  • This may also be called ‘hot chemo”.
  • It is usually completed after the surgery.
  • Can be used during surgery, or after it is complete, with a catheter.

Non-Surgical Treatment Options

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Alimta and cisplatin are generally used at the same time. These are the medications that are used together in most cases.

One study showed that when this type of cancer was found with patients, and they were given this combination of chemotherapy in six different cycles, they were found to be cancer free after six months. The same positive results were found four years later. Drugs such as vinorelbine and gemcitabine are also being studied with cisplatin.

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This type of treatment is not usually effective when it comes to this type of cancer. It can help shrink a tumor when combined with surgery but it has not been found to be effective on its own. A specialist will be able to take each case individually and determine if radiation may be effective.

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There is no cure for this cancer but receiving the surgery can help to prolong your life. When you have surgery, along with other forms of treatment, you may be able to prolong your life even longer.

While the median survival rate is estimated at a year, advances in technology, understanding, and treatments are slowly extending that number. There have been some individuals that have prolonged their life up to five years. Still, there are some patients that have been in remission for more than a decade. The most success can be seen in patients where the cancer was found in the early stages.

One of the reasons the estimated life expectancy is so low is that most forms of peritoneal mesothelioma involve sarcomatoid cells, which are more aggressive and resistant to treatment than those with epithelioid cells.

No matter the type of cells forming your mesothelioma, surgery and other treatments are shown to significantly improve survival rates— recent studies have found that a minimum of 50% of malignant peritoneal mesothelioma patients extended their life expectancy to five or more years. One study found a median survival rate of 92 months.

The more we learn about mesothelioma, the better treatments we can create. New treatments, procedures, and medications are constantly in development to help patients extend and improve their lives.