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Cancer is cancer. At the end of the day, there’s understandably a lot of fear, anxiety, and even anger involved when you receive a cancer diagnosis. And when it comes to peritoneal mesothelioma, there’s often a considerable amount of confusion. 

What does this mean? What treatment options exist? What’s my prognosis and outlook? 

These are all valid questions and concerns, and in this article, we’re going to explore some answers as best as possible.

What is Peritoneal Mesothelioma?

Peritoneal mesothelioma is a very fast-spreading form of cancer that can quickly spread throughout the abdomen. And while it’s not nearly as common as pleural mesothelioma (which makes up about 80 percent of mesothelioma diagnoses), it’s equally as dangerous. Roughly 10 to 20 percent of mesothelioma diagnoses are of the peritoneal variety, with about 400 to 1,000 new cases diagnosed in the United States every year.

Technically, anyone can be affected by peritoneal mesothelioma, though it’s extremely rare for children or young people to be affected. Typically, people get diagnosed in their 50s or 60s.

Peritoneal mesothelioma causes abnormal mesothelial cells to divide uncontrollably. These fast-growing cells form clumps of cells called tumors, which affect the surface and organs inside the abdominal cavity.

These mesothelioma tumors can be malignant, which means they are cancerous. (This includes tumors such as sarcomatoid and epithelioid.) They can also be benign, which means they are not cancerous.

Diagnosing peritoneal mesothelioma typically involves a combination of medical history review, physical examinations, imaging tests (CT scans, MRIs), and a biopsy. A biopsy involves the removal of a small tissue sample for examination under a microscope to confirm the presence of mesothelioma cells.

Understanding the Symptoms of Peritoneal Mesothelioma

Peritoneal mesothelioma symptoms often mimic those of other abdominal conditions, making it challenging to diagnose. Common symptoms include abdominal pain or swelling, unexplained weight loss, changes in bowel habits, and fatigue. 

The challenging thing is that many of these symptoms mimic symptoms of other digestive conditions, diseases, and illnesses. And because of the rarity of peritoneal mesothelioma, doctors certainly aren’t proactively looking for it. This means many symptoms go on for months or years before being traced to mesothelioma.

Treatment Options for Peritoneal Mesothelioma

Early detection is crucial for effective treatment of peritoneal mesothelioma. But even then, the options are limited. Here are the most common treatment approaches:

1. Heated Intraperitoneal Chemotherapy (HIPEC)

HIPEC is used to treat different types of abdominal cancer using a combination of heat and chemotherapy, which are designed to work in tandem to kill off cancer cells.

According to MesotheliomaGuide.com, “The chemotherapy solution is directly pumped into the abdominal cavity, allowing for the use of high doses of chemotherapy. This chemotherapy technique helps to kill cancer cells remaining after cytoreduction without the side effects that are typically associated with traditional chemotherapy.”

According to doctors involved in this procedure, the overall median survival with this treatment is 53 months, which far exceeds the life expectancy without treatment.

2. Immunotherapy

Immunotherapy drugs, often referred to as immune checkpoint inhibitors, assist the immune system in identifying and killing cancer cells. They’re considered highly effective in treating pleural mesothelioma, but can also be prescribed for those dealing with peritoneal mesothelioma.

3. Targeted Therapy

In some cases, people with peritoneal mesothelioma have genetic changes in tumor cells that can be treated with targeted therapies. These therapies target these genetic changes that are turning otherwise healthy cells into cancer cells. Generally, these targeted therapies are available through clinical trials and studies, so you’ll have to find a treating oncologist who has access to them.

4. Palliative Care

While not necessarily a treatment, palliative care is another option when you just want to treat the symptoms and make yourself as comfortable as possible. This is usually used for elderly people or those who aren’t healthy enough for chemotherapy, immunotherapy, or targeted therapy. 

Prognosis, Challenges, and Outlook

The prognosis for peritoneal mesothelioma varies based on factors such as the stage at diagnosis, overall health, and how well the cancer responds to treatment. Early detection and a comprehensive treatment plan can improve the chances of a more favorable outcome. However, the rarity of the disease and its often late-stage diagnosis pose significant challenges.

Doctors use the PCI cancer-staging system to assign levels of severity to peritoneal mesothelioma cases. 

“The peritoneal cancer index (PCI) classifies your cancer by dividing your abdomen into 13 sections and assigning a number from 0 to 3 to each section,” Cleveland Clinic explains. “Zero means no cancer, while 3 means cancer has overtaken an area. Your provider adds the numbers for each section to determine the cancer stage. Stage 1 is the least advanced. Stage 4 is the most advanced.”

While a lot obviously depends on the PCI stage, the five-year survival rate for all cases of peritoneal mesothelioma is 65 percent. However, this is highly dependent on treatment, as the median survival for people who decide against treatment is just six months.

Fighting Back Against Peritoneal Mesothelioma

At the end of the day, a diagnosis of peritoneal mesothelioma isn’t the end of the road. There are treatment options for those who are willing and able to fight back. Plenty of people live for years after receiving a diagnosis. Now it’s your term to fight!