Mesothelioma is a rare cancer, typically caused by previous exposure to asbestos, and diagnosed in about 2,000 people in the country each year. One type of the disease strikes the peritoneum, the thin layer of tissue that lines the abdomen and covers most of the abdominal organs.

The mesothelium is a layer of tissue that protects the internal organs and is found in three areas of the body: the chest cavity, the abdominal cavity, and the heart sac.

Mesothelioma can develop in any of the following mesothelial tissues:

  • Pleura: The tissue that lines the chest region and coats the outside of the lungs.

  • Pericardium: The tissue that surrounds and sustains the heart within the chest cavity.

  • Peritoneum: The tissue that lines the inside of the abdominal cavity and provides a protective outer layer for the internal organs.

Peritoneal mesothelioma can spread to tissues and organs in the abdominal cavity, as well as to other parts of the body. But our team has pioneered successful treatment for the disease and continues to refine its approach. Peritoneal mesothelioma experts like our Dr. Paul Sugarbaker now report five-year survival rates of 60 percent when surgery is combined with immediate chemotherapy.

Symptoms

Most individuals start to experience symptoms once the disease is more advanced. These may include:

  • Shortness of breath

  • Pain underneath the rib cage

  • Pain when coughing

  • Swelling of the abdomen

  • Unexplained weight loss

  • Lumps in the chest or abdomen

Causes

The primary risk of developing this disease is exposure to asbestos. Asbestos is a group of materials that were widely used in construction before the 1980s. Now, it is widely known for its serious risks to the health of individuals who have been exposed to it. If the fibers of asbestos have been inhaled or ingested, they can cause inflammation and lead to a number of serious health complications.

Risks factors

Several risk factors exist for developing any form of mesothelioma:

  • Asbestos: Exposure to and breathing in of asbestos, an insulation material commonly used during World War II and the following decades. Though it was banned in 1989, some buildings still contain it. The longer and more extensive your exposure, the higher your risk of developing mesothelioma
  • Smoking: While smoking alone is not a risk factor, it can combine with asbestos exposure to further increase the chances of getting the disease
  • Gender: Men are more likely than women to develop mesothelioma

What to expect at your appointment

During your appointment, your doctor will ask you to describe your symptoms and to provide your medical history. They may also want to perform a physical examination to check for signs of mesothelioma, such as lumps in the chest or abdomen.

If your doctor suspects mesothelioma, they will prescribe tests in order to make an accurate diagnosis. Some of these tests may include:

  • Imaging tests: Imaging tests, such as an MRI or a CT scan, produce detailed images of the chest and abdominal cavity. These images help physicians identify any physical abnormalities of the region of interest. Imaging tests can also help physicians understand the stage of the cancer and if it has spread to other areas of the body.

  • Biopsy: Obtaining a biopsy, a small tissue sample, is the only way to make an accurate diagnosis. The biopsy is analyzed in a laboratory for cancerous cells, which provides either a positive or negative diagnosis.

Diagnosis

Diagnosing peritoneal mesothelioma is challenging since symptoms often do not appear until 20 to 30 years after exposure to asbestos and because they are also common to other illnesses.

If you are experiencing any suspicious symptoms, your doctor should take a full medical history and ask whether you were ever exposed to asbestos. Other important tools your doctor may use to diagnose include:

  • Physical exam

  • X-ray: Pictures are taken of your abdominal area

  • Biopsy: Suspicious tissue is removed and examined under a microscope

  • Computed Tomography (CT) Scan: X-rays and computer technology create a detailed picture of the suspicious area

  • Magnetic Resonance Imaging (MRI) Scan: Magnetic fields create a detailed picture of the suspicious area

  • Peritoneoscopy: A special instrument used to remove suspicious tissue from the abdominal area

  • Surgery: Surgery can provide a better look and a more complete understanding of your condition if biopsy and/or peritoneoscopy don’t offer a definitive diagnosis

If you have peritoneal mesothelioma, your doctor will stage the cancer, which may involve further tests to determine how far the tumors have spread in the abdominal cavity.

Non-surgical treatments

Mesothelioma is an aggressive cancer. For this reason, surgical treatment of the condition is required. Treatment options will be determined based on the location of the cancer, the stage of the cancer, and the overall health of the patient. In some cases, radiation or chemotherapy may be recommended either before or after surgery.

Surgical treatment and post-treatment

Surgical treatments that can be used to treat mesothelioma include:

  • Pleurectomy: A pleurectomy procedure is performed to relieve symptoms. During this surgery, part of the pleural tissue (the tissue located in the chest that surrounds and protects the lungs) is removed
  • Extrapleural Pneumonectomy: This procedure is performed to remove the cancerous portion of the tissue in the chest region. During this surgery, the entire affected lung, a portion of the pericardium (the tissue that surrounds the heart), and a portion of the diaphragm are removed

These surgeries are considered complex surgeries and require a lengthy recovery period. Following surgery, patients will be required to stay in the hospital for monitoring for up to two weeks. This time can change depending on the extent of the surgery and the overall health of the patient.

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