Peritoneal Mesothelioma Prognosis Options

If you have been given a peritoneal mesothelioma prognosis your next step is to learn everything you can about the disease. This cancer attacks the lining of the abdominal cavity, and accounts for about a third of all mesothelioma cancers. Slightly more men get it than women. The usual cause is asbestos exposure, and unfortunately, you usually do not see any symptoms for twenty or thirty years. In the rare cases that have nothing to do with asbestos, it may not show up until your late sixties.

The symptoms become chronic quickly once they begin to appear. Increased abdominal girth, abdominal masses, abdominal pain, and abdominal distention, caused by fluid retention in the abdomen may occur. Digestive problems, weight loss, anemia, fatigue, and fever can be expected with a peritoneal mesothelioma prognosis. This usually starts being noticeable anywhere from two years to six months before you actually are diagnosed.

Exacerbating the difficulty of diagnosing this condition is the fact that many other conditions have similar side effects. You might think you have a hernia, or gallbladder problems, or, if you are a woman, female problems or cancers. You finally go to the family doctor, and instead, mesothelioma is found. Late-stage peritoneal mesothelioma symptoms include bowel obstruction and increased tendency of the blood to clot. Blood tests show increased platelet count in half of peritoneal patients, although this is of little use in diagnosis because it can be caused by so many disorders. Anemia and low albumin levels are also found.

Expect imaging tests such as the CT scan to be requested. These can help to determine an accurate prognosis for peritoneal mesothelioma, since it can be one of two clinical types. Wet peritoneal mesothelioma will show many small modules, no dominant mass, and fluid retention distending the abdomen. The Dry type will show either one large mass or multiple small ones, with very little or no fluid buildup.

Paracentesis, a procedure that removes the fluid may be called for if you have the wet variety of this disease. Analysis of this fluid does not always give you a definite peritoneal mesothelioma prognosis. In that case, a tissue biopsy is the next step. It is done with a laparoscope, and will give definite conclusions.

Treatment may include a combination of chemotherapy, surgery, radiation, alternative treatments, special diets, and immunotherapy. Alimta and Cisplatin, used in combination, is a hopeful new treatment being used in clinical trials. Surgery alone has been ineffective, and is usually used for palliative therapy (to make the patient more comfortable and slow down the disease, with no hope of curing it). Finding ways to diagnose this condition sooner is the only sure way to improve the peritoneal mesothelioma prognosis.

I can't go into all of the information that's available about Peritoneal Mesothelioma will be good for you and available in your area in this article.

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Peritoneal Mesothelioma Cancer

The cancer of the lining of the abdominal cavity is called peritoneal mesothelioma. It is not as common as pleural form; it comprises an estimated one fifth to one third of all diagnosed mesothelioma cases. This report of the Surveillance, Epidemiology and End Results (SEER) approximates the number as 54.7% male and 45.3% female, with the age ranging from 65 to 69. The period of latency is shorter for patients exposed in asbestos, the symptoms appearing after 20 to 30 years from exposure; the usual latency period for pleural mesothelioma is 30 to 40 years.

Peritoneal Mesothelioma Symptoms

At the time of presentation, symptoms of peritoneal mesothelioma includes abdominal mass, abdominal pain, enlarged abdominal girth, fluid in the abdomen (ascites), distention of the abdomen, weight loss, fever, anemia, fatigue and digestive disturbances. For a few months before a confirmed diagnosis, some patients even complain of symptoms that are non-specific. Incidentally, peritoneal mesothelioma is found in a percentage of cases once the patient has other health complaints such as hernia, gallbladder or pelvic mass.

Doctors who have experiences in this field have noted that typically, patients have these symptoms six months to two years prior to the diagnosis. Men often come to the doctor complaining of a bulge in the groin (hernia) or around the belly button (umbilical hernia). For women, the first sign of a problem often occurs after a pelvic test when a tumor mass have been discovered.

In later stages of peritoneal mesothelioma, among the symptoms are increased occurrences of blood clots and obstruction of the bowel. There is a noticeable increase on the platelet count for 50% of peritoneal patients but this may be caused by various disorders, so this is actually of little help in the diagnosis. Low albumin level and anemia can also be among the symptoms.

Peritoneal Mesothelioma Diagnosis

Peritoneal mesothelioma has two clinical types which can be differentiated with the help of CT findings, the "dry" type and the "wet". It is classified as "dry" when there are multiple tiny masses or one dominant localized mass and generally little or no ascites. The "wet" type has widespread small nodules, no dominant mass and a presence of ascites.

If fluid is found, the process of eliminating it is through paracentesis; however the analysis of this fluid has limited diagnostic significance. Normally, a definitive diagnosis may be obtained through tissue biopsy.

Staging

As there is currently no staging system for peritoneal mesothelioma, the most popular system for general cancer staging (TNM system) is used. TNM system has the following criteria: (T) status of the tumor, (N) lymph nodes and (M) metastases. Other general categories may also be helpful in order to determine the stage.

Category 1 - with a localized lesion that can entirely be removed (resected)

Category 2 - the disease is located inside the abdominal cavity on peritoneal or organ surfaces where there is a probability of removing as much tumor as possible (debulking)

Category 3 - the disease is located inside the abdominal cavity and invades organs such as liver or colon.

Category 4 - the disease extends outside of the abdominal cavity

Peritoneal Mesothelioma Treatment

In the past years, the effectiveness of surgery alone or intraperitoneal chemotherapy in the treatment of peritoneal mesothelioma were not proven, that is why multimodality treatment is becoming more popular. Debulking (cytoreductive) surgery is removing all or nearly all visible tumors and may be combined with IPHC (Intra-Peritoneal Hyperthermic Chemotherapy), intraperitoneal chemotherapy and radiation.

Removing all tumors is not always probable; the prognosis for survival can then be in accordance with the completeness of cytoreduction which is established by these criteria:

• Complete cytoreduction

(CC-0): No peritoneal seeding is found within the operative areas

(CC-1): Nodules less than 2.5 cm carries on after cytoreduction which can be penetrated by intra-cavity chemotherapy; thus the process is termed complete.

• Incomplete cytoreduction

(CC-2) Nodules with sizes of 2.5 to 5 cm carry on after cytoreduction

(CC-3) Nodules that are larger than 5 cm are found; or there is a merging of tumor nodules that are unresectable at any area within the pelvis or abdomen.

Some patients may have widespread disease where surgery is not considered as "potentially curative", palliative treatment may be done by debulking. Take note that specialized treatments should only be administered by seasoned doctors because peritoneal mesothelioma is a rare malignant disease.

Recently, a clinical trial discovered Alimta (pemetrexed) to be effective as chemotherapy agent on treating peritoneal mesothelioma, either on its own or combined with cisplatin or any platinum-based drug. This reflects the previous findings regarding pemetrexed medication of pleural mesothelioma.

For more information on Peritoneal Mesothelioma or any other type of Mesothelioma Cancer a good information site is Mesothelioma Symptoms, where all releavant topics are discussed. Some example topics include Mesothelioma treatment, Mesothelioma Compensation, Mesothelioma statistics, coping with Mesothelioma and causes of Mesothelioma. A forum is also availble to discuss any topics with our experts.

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