Peritoneal Mesothelioma: Symptoms, Diagnosis, and Treatment Options

Writer : Dr. Cristine Naskan

Peritoneal Mesothelioma: Symptoms, Diagnosis, and Treatment Options on

Defintion: What Is Peritoneal Mesothelioma?

It is a rare asbestos-related cancer known as peritoneal mesothelioma that develops on the abdominal lining, or peritoneum. The omentum, a layer of the abdominal membrane that covers the stomach and other organs, can develop an even rarer form of this cancer.


  • Abdominal bloating and fluid accumulation are among the earliest signs (known as ascites).
  • More than one in five cases of peritoneal mesothelioma are caused by exposure to asbestos.
  • One of the most effective treatments is surgery combined with heated chemotherapy, which has allowed some patients to live for upwards of five years after surgery.

Eaten or drank contaminated water are the primary causes of peritoneal mesothelioma. Fibers that have been digested are deposited in the peritoneum, where they remain until they are expelled through the intestines.

What Are the Signs and Symptoms of Mesothelioma Cancer in the Peritoneal Peritoneum?

Pain or tenderness around the abdomen, bloating, and digestive issues such as constipation or diarrhea are all early signs of peritoneal mesothelioma.

Some of the symptoms of perineal mesothelioma include:

  • Pain in the stomach
  • Swelling in the lower abdominal area (ascites)
  • Nighttime sweats
  • Nausea\sFever
  • Loss of weight that doesn't seem to make sense
  • Fatigue
  • Diarrhea
  • Constipation
  • The inability to keep food down

It is easy to confuse these signs with those of a variety of other gastrointestinal disorders. A biopsy sample and a mesothelioma specialist are often required for an accurate diagnosis.

A person's health should be monitored and their doctor should be consulted if new or worsening symptoms arise after exposure to asbestos.

Mesothelioma of the Abdomen: What Is Its Causes?

Ingestion of asbestos fibers is the primary cause of malignant peritoneal mesothelioma. Asbestos fibers may travel from the digestive tract to the abdomen and remain there for years, causing cancer, according to current research.

The Development of Peritoneal Mesothelioma

Peritoneal mesothelioma, like other asbestos-related diseases, develops slowly over time. Asbestos fibers that become lodged in the body cause inflammation and irritation, which in turn damages and degrades DNA.

Damaged DNA can cause cells to grow abnormally and uncontrollably. Tumors can form as a result of these mistakes, and if left untreated, they can grow out of control and spread throughout the body.


  • Asbestos fibers that are ingested pass through the intestines and stomach.
  • Asbestos fibers pass through the digestive tract and enter the lymphatic system before ending up in the peritoneum.
  • Peritoneal fibers irritate and damage cells and DNA for years.
  • They become inflamed, and scar tissue is formed, which causes the lining to become thicker.
  • The accumulation of fluid in the abdomen is the result of years of inflammation and scar tissue formation.
  • A malignant tumor begins to grow on the diseased peritoneum after it has been damaged for a long time.
  • Pressure on vital organs and the spread of tumors can occur as tumors grow.

It's still possible to find out more about peritoneal mesothelioma research. Besides asbestos, abdominal radiation, and fibrous minerals like erionite may also cause this disease.

Peritoneal Mesothelioma is diagnosed in a number of ways.

Abdominal mesothelioma can be diagnosed with imaging scans, blood tests, and biopsies.

  • Tumors can be visualized using imaging scans.
  • Certain biomarkers linked to cancer can be found in blood tests.
  • Cancerous cells can be identified through biopsy.

Patients will also have their medical and work histories reviewed, as well as their current physical condition.

A biopsy is the only way to confirm a peritoneal mesothelioma diagnosis, even though every test contributes to the diagnostic process.

To examine tumor tissue under a microscope in a laboratory, doctors use biopsy samples. Tests on the biopsy sample by pathologists reveal the types of cancerous cells present in the tumors. A pathology report summarizes the findings.

Rare Cell Types

  • Uncommon, with a lower risk of cancer, is well-differentiated papillary mesothelioma, which typically affects younger women.
  • It's common for multicystic mesothelioma to recur after surgery, but there is no conclusive link to asbestos exposure.
  • There can be nodules or a thickening of the peritoneum that appears mass-like, ascites, and disease of the lymph nodes in patients with desmoplastic mesothelioma.
  • Lymphohistiocytoid Mesothelioma: This variant is characterized by a dense lymphatic infiltrate.
  • Mesothelioma of the peritoneal cavity: Pure Sarcomatoid Mesothelioma is the most lethal and rarest form of peritoneal mesothelioma.

There is also an uncommon form of peritoneal mesothelioma found in the omentum, which surrounds the stomach and various other abdominal organs. The omentum is a layer of fatty tissue that influences immune function and metabolism.


Doctors unfamiliar with abdominal mesothelioma often misdiagnose patients with more common illnesses that share similar symptoms because of the disease's rarity. Misdiagnosis of peritoneal mesothelioma delays treatment.

A mesothelioma specialist can help you get an accurate diagnosis if you've been exposed to asbestos in the past. Peritoneal mesothelioma specialists have the training and equipment necessary to make an accurate diagnosis.

Mesothelioma of the Peritoneum: Various Stages

If you have peritoneal cancer, there is no standard staging system. Experts in the field of peritoneal mesothelioma had to spend decades adapting other staging systems to their needs.

Because of its more diffuse growth pattern, the TNM staging system for other cancers hasn't worked well for peritoneal mesothelioma patients in the past. On the other hand, according to a study published in 2020, oncologists should divide the TNM system into three stages when treating peritoneal mesothelioma.

Mesothelioma of the Peritoneum: Three Stages

  • Stage 1: Tumors are limited to the abdominal lining, and no cancer has spread to the lymph nodes.
  • Stage 2: As of yet, the tumors have not spread beyond their lining or into nearby lymph nodes.
  • Stage 3: Tumors are more numerous and may have spread to other organs, such as the peritoneum or the lymph nodes.

Adapted TNM stage 4 for peritoneal mesothelioma does not have a precise fourth stage. Stage 4 cancer, according to many medical professionals, is characterized by widespread tumors that have metastasized to other parts of the body.

Peritoneal Cancer Index

Using the Peritoneal Cancer Index, doctors can determine where and how far a tumor has spread in the abdomen. There is a lot of information that can be gleaned from this test.

This index is used to categorize the abdominal region into one of thirteen subgroups. On the basis of the largest tumor in that region, doctors assign each area a number (ranging from one to three). There are 13 regions that make up the Peritoneal Cancer Index score. The most a patient can get is a 39. (13 times three).

Patients with lower index scores may be eligible for surgery. A cancer index score of 20 or more indicates that the disease has spread too far and that surgery is unlikely to help the patient.

Treatments for Mesothelioma of the Peritoneum

Hyperthermic intraperitoneal chemotherapy, or HIPEC, is the most effective treatment for peritoneal mesothelioma. Peritoneal mesothelioma is most commonly treated with chemotherapy alone.

Because of the procedure's intensity, more than 60% of patients are ineligible for surgery with heated chemotherapy. In some cases, cytoreductive surgery can take several hours and require the removal of large sections of the intestine or the entire organ.


Systemic chemotherapy can be administered to patients who are not candidates for heated chemotherapy surgery. On the other hand, cancer can be slowed down and even slowed down with the use of chemotherapy drugs. Pemetrexed, cisplatin, carboplatin, and gemcitabine are some of the chemotherapy drugs that are effective in the treatment of peritoneal mesothelioma.

In 2013, Jim Madaris, a Navy pilot and peritoneal mesothelioma survivor, decided to undergo the HIPEC procedure. His gallbladder, spleen, and portions of his intestine were removed during the 14-hour procedure. When Madaris was given an extra year, he was able to enjoy the simple pleasures of life and watch his youngest child graduate from high school.

Treatments for the End of Life

Many peritoneal cancer patients also receive palliative care in addition to anti-cancer treatment in order to manage their symptoms and enhance their quality of life. Some peritoneal patients may require a paracentesis procedure to remove excess fluid from their abdomen.

Treatment for pain and side effects is provided by a palliative care specialist. Complementary and/or alternative therapies may be recommended in addition to traditional ones.

Life expectancy and prognosis in patients with peritoneal mesothelioma

Patients with peritoneal mesothelioma who do not qualify for surgery have a poor prognosis. Patients with peritoneal mesothelioma who receive chemotherapy alone have a 12-month life expectancy. Patients with untreated peritoneal mesothelioma have a six-month median survival time in most cases.

However, surgical candidates have a much better prognosis. A combination of surgery and heated chemotherapy can extend peritoneal survival by several years.

Peritoneal cancer sufferers can expect to live for at least five years after having their tumors removed and their chemotherapy heated.

Women with peritoneal mesothelioma tend to live longer than men, according to a study published in the American Journal of Surgical Pathology in 2020. Women who received cytoreductive surgery and heated chemotherapy at MD Anderson Cancer Center in Houston were found to have a 5-year survival rate of 77.8% in the study.

Women have a median lifespan of 13 months, while men have a median lifespan of six months when considering both short- and long-term survival.

Prognostic Factors

There is a longer life expectancy for patients with tumors that contain epithelial cells than for patients with sarcomatoid or biphasic cells. Chemotherapy works better on epithelial cells than on other types of cells.

  • Detection phase
  • Type of cellular organism
  • The grade of the tumor (how fast it grows)
  • Mutations in the DNA of sexes
  • Treatments are chosen.

The prognosis is also affected by the grade of the tumor. According to how abnormal the cells appear, tumor grades indicate how quickly tumors are likely to grow and spread.

Survivability Rates After Chemotherapy

The following are the advantages of cisplatin and pemetrexed in combination with systemic (whole-body) chemotherapy:

  • About 30 percent of the time.
  • Progression-free survival is estimated to be approximately 11.5 months.
  • About 13 months is the average life expectancy.

There is a greater 47 percent response rate to chemotherapy that is administered directly to the peritoneum without the need for surgery. A response rate of 84.6% is achieved when heated chemotherapy is administered during surgery.

Does Peritoneal Mesothelioma have a cure?

Peritoneal mesothelioma and other forms of mesothelioma are incurable. In contrast, peritoneal patients who are eligible for surgery and HIPEC tend to live longer than five years.

If a cancerous recurrence of mesothelioma occurs, some patients may be eligible for a second surgery with heated chemotherapy.

After cytoreductive surgery with heated chemotherapy, Dr. Paul Sugarbaker reported in 2017 that patients who received early post-operative chemotherapy and long-term chemotherapy had better survival.

A five-year median survival rate of 75% was achieved among the 29 patients who underwent HIPEC surgery, as well as post-operative chemotherapy and long-term chemo. There were no chemotherapy treatments administered intravenously or systemically in the study.

Patients with peritoneal mesothelioma frequently experience depression or feelings of isolation. Counselors and support groups are options for those in need of assistance. Quality of life can be improved by talking to a counselor or joining a support group.

To help patients and their loved ones cope with the challenges of living with mesothelioma, a number of organizations offer online support groups for patients and their families. An MS, LMHC licensed counselor named Dana Nolan is moderating our discussions. Karen Selby, a registered nurse and patient advocate, is also available to answer medical questions.


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