The latest developments in medical technology enable doctors to diagnose this disease earlier than ever. However, it can be difficult for experienced cancer doctors to diagnose it accurately. The process can actually take months.

Doctors have the ability to diagnose this disease earlier than ever due to the latest developments in medical technology. However, it can be difficult for experienced cancer doctors to diagnose it accurately. In fact, this process could take months

The diagnostic process of peritoneal mesothelioma is similar to other types of mesothelioma. It begins with a thorough examination of a patient’s career history, medical history, and overall physical condition. This is generally followed by a number of tests, including image scans and biopsies.

Regardless of if a doctor asks, it is imperative to mention, in depth, any known history of asbestos exposure. This includes the dates of the incidents, locations of the exposure, and the duration and length of the exposure.

This important information alerts doctors of a potential asbestos-related disease and assists in determining the next steps appropriate for a patient. The history of exposure to asbestos is important for directing diagnostic tests as vague abdominal discomfort can be nonspecific.

Quick fact:

It can take up to 20 to 50 years for peritoneal mesothelioma to develop after an individual’s first exposure.

Misdiagnosis of Peritoneal Mesothelioma

Because this cancer is so rare, mesothelioma patients may be misdiagnosed with more common diseases that share similar symptoms by doctors without significant experience. As a result of this serious misstep, patients are delayed vital treatment.

Many symptoms of peritoneal mesothelioma are shared with those that arise with other abdominal cancers or common diseases; these symptoms include abdominal swelling, hernias, and weight loss. The likely hood of a misdiagnosis is significantly increased as a result of symptom overlap.

With a history of asbestos exposure, an appointment with a specialist is the best way to make an accurate diagnosis. Doctors specializing in mesothelioma have the necessary equipment and knowledge to make a quick diagnosis. They can also explain the treatment options which are available to a patient and answer questions or concerns.

Imaging Scans for Peritoneal Mesothelioma

Doctors will likely request a chest x-ray, CT scan, or other forms of imaging scans for a patient that exhibits or experiences symptoms. While potential tumors and cancer spreading are monitored by these tests, they also help doctors to choose the most suitable location for biopsies.

Keep in mind that CT scans can diagnose ascites; fluid in the abdomen. It is extremely important to pursue the cause of ascites in the absence of liver disease.

Biopsies for Peritoneal Mesothelioma

A minor procedure in which fluid and tissue samples are extracted to be microscopically inspected is known as a biopsy. Only a biopsy confirms a diagnosis of peritoneal mesothelioma which makes this step extremely important for the diagnostic process.

In certain cases, a doctor may have to perform an invasive laparoscopic surgical biopsy. For both procedures, pathologists examine whether the results of the laboratory show cancer cells in the peritoneal fluid or tissue.

It is important to test biopsy samples with chemicals referred to as antibodies to confirm a mesothelioma diagnosis. Antibodies, such as calretinin and podoplanin, are used for peritoneal mesothelioma confirmation.

Although an increasing number of specialists have emerged as treatment leaders for abdominal cancer in recent years, the total number of peritoneal mesothelioma specialists remains small.

If there are no peritoneal malignant mesothelioma specialists nearby, you may consider one in a neighboring state.

Treatment for this type of mesothelioma includes surgery, chemotherapy and experimental therapies such as immunotherapy.

Doctors believe combining traditional treatments often works better than any single treatment. A combination of one or more treatments is called multimodal therapy. Research shows that a multimodal treatment approach usually offers the best improvement in terms of survival.

The most promising peritoneal mesothelioma treatment is cytoreductive surgery combined with heated intraperitoneal chemotherapy (HIPEC).

While doctors only perform surgery with HIPEC on a case-by-case basis, it has extended survival and improved quality of life. In studies on small groups of patients, around half lived five years or longer.

To qualify for surgery with HIPEC, a patient’s cancer must be limited enough for doctors to completely remove with surgery and not have spread beyond the abdomen.

In addition, qualifying patients must be physically fit in order to tolerate the stress of anesthesia and surgery.

Surgery for Peritoneal Mesothelioma

Surgery is the most promising traditional treatment option for peritoneal mesothelioma in the abdomen, but it is only effective for early-stage cancer. Because doctors most commonly diagnose asbestos-related diseases after cancer has spread, most surgeries only attempt to remove sections of the tumor.

Surgery can be curative or palliative. Curative surgery aims to remove as much of the tumor as possible in hopes of curing the cancer. Otherwise, doctors may perform palliative surgery, which aims to remove parts of the tumor to relieve symptoms, including bowel obstruction, extend survival and improve quality of life. Palliative therapies do not stop cancer.

Tumor spread is usually too vast once it reaches beyond the abdomen for surgery to completely remove cancer. Surgery with curative intent is not recommended after cancer has spread. However, surgery to remove the majority of tumors may be performed to alleviate pain and improve symptoms such as abdominal distention and pain.

Typical surgeries include peritonectomy and cytoreductive surgery, bowel resection and removal of some organs.

Another minor surgical procedure, known as paracentesis, is commonly used on peritoneal mesothelioma patients. A small incision in the abdomen is made to withdraw excess peritoneal fluid, called ascites. This procedure reduces abdominal swelling and pain.

Chemotherapy for Peritoneal Mesothelioma

Chemotherapy drugs can shrink peritoneal tumors and slow the growth and spread of cancer. It can be given before, during or after surgery. In some cases, doctors offer chemotherapy as the only treatment option. Chemotherapy drugs considered effective against peritoneal mesothelioma include pemetrexed, cisplatin, carboplatin and gemcitabine.

In 2017, Dr. Paul Sugarbaker reported improved survival among patients who received early post-operative chemotherapy and long-term chemotherapy after cytoreductive surgery with HIPEC. All chemotherapy was intraperitoneal chemotherapy, meaning it was applied only to the peritoneum. No systemic chemotherapy was used in the study. Of the 29 patients who had surgery with HIPEC, post-operative chemotherapy and long-term chemotherapy, 75 percent lived longer than five years.

In appropriate patients, the main treatment will be cytoreductive surgery with HIPEC. The surgical part removes all gross tumors with residual deposits smaller than 2 mm. The HIPEC treats the residual tumor and microscopic cancer cells the surgeon can’t see.

Radiation Therapy for Peritoneal Mesothelioma

Some studies show radiation therapy can improve peritoneal mesothelioma survival slightly when combined with surgery and chemotherapy. However, doctors tend not to recommend radiation for these patients.

Even though targeted radiation can shrink tumors and slow cancer growth, the procedure is risky because of the location of these tumors. The peritoneum wraps around the stomach, liver and intestines. Aiming radiation at nearby tumors could harm these organs and cause life-threatening damage.

Alternative Treatments for Peritoneal Mesothelioma

Alternative treatments and emerging therapies are available, but these treatments have less predictable outcomes. Immunotherapy boosts the body’s immune system to help fight cancer. Research on this emerging therapy mainly focuses on the treatment of pleural mesothelioma, which develops in the lining of the lungs.

Many patients find hope in clinical trials, which are medical studies that test new and experimental treatments. Research from clinical trials helps improve treatment outcomes for future patients.