Exploring Meso, Part II: What is Peritoneal Mesothelioma?

‘Exploring Meso’ is a two-part series designed to give a comprehensive overview of the two most common types of mesothelioma—a rare but sadly terminal form of cancer that can affect any of four major organs by attacking the protective lining that surrounds it.

Part II discusses the causes, symptoms, diagnosis and treatment of peritoneal mesothelioma.

Peritoneal mesothelioma is the second most common form of a deadly cancer—though, it is still considerably less prevalent than the most common, pleural mesothelioma, which makes up more than 90 percent of cases nationwide. The American Society of Clinical Oncology reports that mesothelioma of the peritoneum—or abdominal cavity—comprises slightly over eight percent of all cases of mesothelioma that are diagnosed in the U.S. annually. The other two organs that can be affected by mesothelioma, in order of prevalence, are: the pericardium, which encases the heart, and the tunica vaginalis, which is the sac found within the male scrotum.

Though perhaps not quite as easily overlooked as the symptoms seen in the pleural variety, symptoms of peritoneal mesothelioma are also difficult to attribute. For one thing, symptoms do not usually begin to appear until the illness is already in its late stages. Even then, they include broad indicators—such as weight loss—that may be caused by a plethora of conditions (most not nearly as serious or life-threatening as mesothelioma). In fact, the most commonly presented symptom, abdominal pain, is general to a range of medical diagnoses—from the stomach flu to lactose intolerance.

Diagnosing peritoneal mesothelioma can be a challenging feat for physicians, who cannot rely on routine lab work or even abdominal radiographs to indicate its presence. Though CT scans and other imaging techniques may help to rule out other conditions, a biopsy is generally required to reach a conclusive mesothelioma diagnosis.

The fact that reaching a diagnosis can sometimes take a considerable amount of time only compounds the already-present issues of extended latency and indistinct symptomatology—cumulatively, resulting in difficulty administering effective treatment. Because most cases of mesothelioma are in their final stages by the time treatment begins, the purpose of said treatment is often more palliative than curative in nature. In other words, doctors frequently seek to enhance patient comfort through both traditional and non-traditional treatment methods but do not necessarily expect recovery or even considerable extension of life.

The primary cause of peritoneal mesothelioma is exposure to asbestos—a known carcinogen that, prior to the 1980s, was widely used in the production of consumer products ranging from construction materials to cosmetics. Asbestos enters the body when it is damaged and broken into pieces, thus releasing a fine powder that contains microscopic fibers into the air. When those tiny particles are inhaled or ingested, they become trapped in the tissue of affected organs. Over time (usually 10-40 years, or more), the crystal-like particles irritate the organ’s protective lining—eventually resulting in the development of tumors and, subsequently, cancer.

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