What Is Peritoneal Mesothelioma?
Malignant peritoneal mesothelioma is a type of cancer that develops in the peritoneum, the thin membrane covering the abdominal cavity.
It is the second most common type of mesothelioma and makes up 10-15% of all diagnosed cases. The most common type is pleural mesothelioma, which affects the lining of the lungs.
While it develops in the abdomen, peritoneal mesothelioma can spread to other parts of the body, including nearby organs like the liver and intestines.
Peritoneal mesothelioma is the second-most common type of this cancer and forms in the abdominal lining 10-50 years after exposure. Surgery and heated chemotherapy can help many patients live longer. View Transcript.
Duration: 1 min 28 sec
Malignant peritoneal mesothelioma is a rare and aggressive cancer that develops in the lining of the abdomen also known as the parium. It is strongly associated with exposure to asbestos. What are the symptoms of this rare cancer watch out for belly pain, persistent bloating, and the accumulation of fluid in the abdomen. These are all signs that can indicate the presence of malignant peritoneal mesothelioma. Over the years, advancements in medical research and treatment options have offered new possibilities. In particular, a specific procedure that involves tumor debulking surgery followed by heated chemotherapy, has shown to extend survival time and improve quality of life for many
patients. Malignant peritoneal mesothelioma is often challenging to treat and the prognosis is usually 6 months to 1 year without treatment. However, there is hope, some patients have defied the odds to becoming long-term survivors living for more than 15 years with the help of
Specialists. Emerging treatment such as immunotherapy and gene therapy are also showing promise for peritoneal mesothelioma patients in clinical trials. If you or someone you know is facing malignant peritoneal mesothelioma, remember that you’re not alone. Mesothelioma Hope offers free resources to support your family during this difficult time. Contact our team today to learn more about your diagnosis. Connect with top doctors and explore options that can help you pay for treatment.
Key Facts About Mesothelioma in the Abdomen
- It can take 10-50 years to develop after asbestos exposure.
- Women are more likely than men to get this cancer.
- It has the highest life expectancy of all mesothelioma types.
- It can be misdiagnosed as gallstones or other less serious conditions.
Patients with peritoneal mesothelioma usually notice a range of subtle, non-specific symptoms like loss of appetite at first. As the disease spreads, stomach pain, constipation, and other warning signs of this cancer become more noticeable.
Download our Free Peritoneal Mesothelioma Guide to learn more about peritoneal mesothelioma and the latest treatment options available to help you live longer.
Causes of Abdominal Mesothelioma Cancer
Asbestos exposure is the main cause of peritoneal mesothelioma. When asbestos fibers are inhaled or swallowed, they can harm normal, healthy tissue over time.
The following steps show how asbestos causes peritoneal mesothelioma:
- Exposure: The patient inhales or swallows microscopic asbestos fibers.
- Buildup: These fibers become trapped in the tissue of the abdominal lining and begin to irritate healthy cells.
- Damage: Cell DNA mutations cause cancerous mesothelial cells to grow. The peritoneum begins to thicken, and fluid starts to build in the abdominal cavity.
- Cancer: Mesothelial cells grow and spread, eventually causing cancerous tumors to form in the peritoneum.
Mesothelioma Peritoneal Cancer Symptoms
Peritoneal mesothelioma symptoms may not appear until 10 to 50 years after a person was first exposed to asbestos.
Common symptoms include:
- Abdominal fluid buildup (peritoneal ascites)
- Abdominal (belly) pain
- Bloating (abdominal distention)
- Constipation or bowel blockage (obstruction)
- Fever or night sweats
- Loss of appetite
- Nausea and vomiting
- Unexplained weight loss
“It got to the point where if I sat, I couldn’t stand up straight. It was like my insides were glued.”
If you have been exposed to asbestos and are experiencing any of these symptoms, contact a doctor as soon as possible. The sooner you get a diagnosis, the sooner you can get potentially life-extending treatment.
Use our Free Doctor Match service so we can help you connect with experienced mesothelioma specialists right now.
Getting a Peritoneal Mesothelioma Diagnosis
Peritoneal mesothelioma is diagnosed through a series of tests. Common mesothelioma diagnosis methods include imaging scans, blood tests, and biopsies.
A computed tomography (CT) scan is often the first imaging test used to diagnose mesothelioma of the abdomen. Many mesothelioma doctors will order CT scans to check for abnormalities when a patient first complains of stomach issues.
However, a biopsy is the only way to confirm a peritoneal mesothelioma diagnosis. This involves examining a tissue or fluid sample under a microscope to see if it contains cancer cells.
Contact our Patient Advocates for help getting an accurate diagnosis or second opinion. They can recommend local peritoneal mesothelioma specialists and assist in scheduling your first appointment.
Peritoneal Mesothelioma Staging
Mesothelioma staging refers to how far the cancer has spread from where it initially formed.
Peritoneal mesothelioma does not have a formal staging system like pleural mesothelioma does. However, doctors can use the peritoneal cancer index (PCI) to analyze this cancer.
The PCI divides the abdomen into 13 sections, giving each section a score of 0-3. Zero means there is no cancer, while 3 indicates cancer is present.
The 4 PCI Stages
- Stage 1: PCI score of 1-10
- Stage 2: PCI score of 11-20
- Stage 3: PCI score of 21-30
- Stage 4: PCI score of 31-39
PCI scores provide a standard for oncologists (cancer doctors) to measure the extent of the cancer and tailor treatment plans to each patient.
What Is the Prognosis for Peritoneal Mesothelioma?
The average peritoneal mesothelioma prognosis is 53 months after surgery with heated chemotherapy.
Doctors use the word “prognosis” to estimate the overall survival of patients with peritoneal mesothelioma. It’s based on survival times researchers have seen over the years in patients diagnosed with this cancer.
If you’ve been diagnosed with peritoneal mesothelioma, your prognosis will depend on several factors, such as your age, overall health, and cancer stage.
Peritoneal Mesothelioma Survival Rate and Life Expectancy
There are two ways to measure peritoneal mesothelioma prognosis:
- Survival rate is the percentage of patients who are still alive at a certain time after diagnosis or treatment.
- Life expectancy is the average length of time patients live after a diagnosis.
The chart below provides the 1-, 3-, and 5-year survival rates for peritoneal mesothelioma.
| Time After Diagnosis | Survival Rate |
|---|---|
| 1 year | 92% |
| 3 years | 74% |
| 5 years | 65% |
| 10 years | 39% |
It’s important to remember that these numbers are averages that don’t reflect every patient’s individual experience. There are mesothelioma survivors who’ve lived 15 years or more after being diagnosed with peritoneal mesothelioma, becoming symbols of hope and resilience for others battling this cancer.
Take Julie Gundlach, for example, who was diagnosed in 2006 and is still thriving today — far outliving her original prognosis of 6 months to a year.
“That is, without a doubt, a miracle. Getting to see a life that I never thought I’d see.”
Treatment for Malignant Peritoneal Mesothelioma
Doctors can treat peritoneal mesothelioma in a variety of different ways, from performing surgery to prescribing chemotherapy and immunotherapy infusions.
Learn more about the top treatment options for peritoneal mesothelioma below.
Cytoreduction With HIPEC
The gold standard treatment for peritoneal mesothelioma is cytoreduction with HIPEC (hyperthermic intraperitoneal chemotherapy). HIPEC is also referred to as heated chemotherapy.
Cytoreductive surgery with HIPEC involves:
- Surgically removing visible tumors from the abdomen
- Applying a heated chemotherapy solution directly to the abdominal cavity to kill remaining cancer cells
Administering heated chemotherapy during surgery allows for a higher concentration of the drugs to reach the cancer with fewer side effects than standard chemotherapy.
The entire procedure takes between 8-12 hours. Most patients stay in the intensive care unit for 1-2 days to recover.
Chemotherapy
Chemotherapy is used to shrink abdominal tumors and kill cancerous cells. Patients who can’t undergo cytoreduction with heated chemotherapy often receive systemic chemotherapy (chemotherapy that travels throughout the body).
The chemotherapy drug Alimta® (pemetrexed) administered alone or combined with another type of chemotherapy called cisplatin gives peritoneal mesothelioma patients the best chance of long-term survival and remission. Mesothelioma remission is when no cancer is detectable in the body.
One woman with advanced peritoneal mesothelioma achieved full remission after chemotherapy and immunotherapy, according to a 2023 study published in BMJ Case Reports. She received 18 rounds of chemotherapy with pemetrexed and the immunotherapy drug bevacizumab (Avastin®) over 13 months.
Immunotherapy
Immunotherapy works by harnessing the power of the immune system to target and destroy cancer cells. The role of immunotherapy in peritoneal mesothelioma treatment is evolving as doctors learn from its success in treating pleural mesothelioma.
Clinical trials have shown that combining the two immunotherapy drugs Opdivo® (nivolumab) and Yervoy® (ipilimumab) helps pleural mesothelioma patients live longer than chemotherapy.
Keytruda® (pembrolizumab) is another immunotherapy drug that’s already approved for pleural mesothelioma and could one day become a standard peritoneal mesothelioma treatment.
A study in the March 2023 edition of Oncology reported on 24 peritoneal mesothelioma patients treated with Keytruda. Five of the patients had their tumors shrink, and more than half had their cancer stabilize (meaning their tumors didn’t grow or shrink).
Palliative Care to Manage Symptoms
Peritoneal mesothelioma patients can receive pain medications and other types of palliative care at any time during treatment to manage symptoms and improve their quality of life.
Another palliative care option is paracentesis, which is a minor surgical procedure that drains painful fluid buildup from the abdominal cavity.
Learn more about which peritoneal mesothelioma treatment options may be right for you in our Free Peritoneal Mesothelioma Guide.
Clinical Trials and Emerging Therapies
Clinical trials offer peritoneal mesothelioma patients access to cutting-edge treatments that are not widely available to the public. Participating in a clinical trial also provides an opportunity to benefit from the latest advancements in cancer therapy at no cost.
Various emerging treatments are being studied for peritoneal mesothelioma:
- Gene therapy involves modifying a mesothelioma patient’s genes to fight cancer. Scientists are exploring ways to correct mutations in the BAP-1 tumor suppressor gene and introduce new genes that can improve the body’s ability to attack mesothelioma.
- Targeted therapy focuses on specific genetic mutations or proteins that drive cancer growth. It is designed to attack cancer cells without harming healthy tissue, which means the side effects are usually less severe than with chemotherapy.
- Vaccines can stimulate the immune system to recognize and attack mesothelioma cells. These vaccines are designed to boost the body’s natural defenses against cancer.
Contact us today to get help finding active peritoneal mesothelioma clinical trials where you live.
Peritoneal Mesothelioma Doctors
One of the best ways to improve your prognosis is to see a peritoneal mesothelioma doctor for treatment. These specialists have decades of experience helping patients live longer, fuller lives.
A few of the country’s top peritoneal mesothelioma specialists are highlighted below. Use our Free Doctor Match service to get help connecting with a specialist near you.
Dr. James Pingpank
15+ years of experienceSurgical Oncologist at the University of Pittsburgh Medical Center in Pittsburgh, PA, and Associate Professor of Surgery for the University’s School of Medicine
Dr. Hedy Lee Kindler
25+ years of experienceDirector of the Mesothelioma Program and Medical Director of Gastrointestinal Oncology at the University of Chicago Comprehensive Cancer Center
Dr. Richard Alexander
25+ years of experienceChief Surgical Officer at Rutgers Cancer Institute in New Brunswick, NJ, and System Director of Surgical Oncology at RWJBarnabas Health in West Orange, NJ
Dr. Mecker Möller
15+ years of experienceLeads the Regional Therapies (HIPEC) Program at the University of Chicago Comprehensive Cancer Center
Financial Assistance for Peritoneal Mesothelioma Cancer
A peritoneal mesothelioma diagnosis can leave you concerned about your finances, especially if you’re on a fixed income.
Fortunately, mesothelioma financial assistance can help you pay for treatment, travel, and out-of-pocket expenses. Learn more about your options below.
Mesothelioma Lawsuits
Filing a lawsuit allows you to seek justice for yourself or a loved one who developed peritoneal mesothelioma after exposure to asbestos products.
Nearly all mesothelioma lawsuits are settled out of court, with an average settlement between $1 million and $1.4 million, allowing you to receive compensation without going to trial.
Some notable peritoneal mesothelioma settlement awards include:
- $11.9 million for a New York real estate investor
- $6.4 million for the family of a North Carolina patient
- $5.8 million for a Florida man who worked as a mechanic
- $4.3 million for a Missouri electrician
- $3.8 million for a U.S. Navy veteran from Illinois
A mesothelioma lawyer can handle every step of the legal process on your behalf while you focus on your health and well-being.
Asbestos Trust Funds
Starting in the late 1980s, many asbestos product manufacturers declared bankruptcy to avoid mesothelioma lawsuits. The U.S. court system required these companies to establish special trusts to compensate victims of peritoneal mesothelioma and other asbestos-related diseases.
Over $30 billion is already set aside and currently available in asbestos trust funds. If you or a loved one has been diagnosed with peritoneal mesothelioma, you may be eligible to access some of this money.
Asbestos victims are usually able to file claims with multiple trusts, with many receiving their first payouts within 90 days.
VA Disability Compensation
Military veterans with peritoneal mesothelioma can file for VA benefits through the U.S. Department of Veterans Affairs (VA).
These benefits include tax-free VA disability payments of almost $4,000 per month as well as free or reduced-cost treatment through the VA health care system.
Filing a legal claim doesn’t impact your eligibility for veterans benefits — you can pursue both at the same time.
Get Help for Peritoneal Mesothelioma Today
If you or your loved one has recently been diagnosed with peritoneal mesothelioma, there’s a lot to consider — and you may not know where to start.
We can help you:
- Understand your diagnosis and pathology report
- Find a specialist for treatment
- Navigate your options for financial assistance
- Connect with a support group or peer mentor
It’s always free to speak with us. Call (866) 608-8933 or fill out our contact form right now.
Peritoneal Mesothelioma Cancer FAQs
What can cause peritoneal mesothelioma?
Asbestos exposure is the primary cause of malignant peritoneal mesothelioma.
When people inhale or swallow asbestos, the fibers can become embedded in stomach tissue and irritate healthy cells.
Over time, the damage can cause cancerous cells to grow in the abdominal lining and spread to nearby organs and tissues.
How do you test for peritoneal mesothelioma?
Testing for peritoneal mesothelioma typically involves these steps:
- Imaging scans: Doctors can use CT scans, MRI, or PET scans to look for abnormalities in the abdomen.
- Blood tests: These may detect certain biomarkers (substances in the blood) that indicate a patient may have mesothelioma.
- Biopsy: A sample of fluid or tissue is taken from the abdomen and examined under a microscope to determine if cancer cells are present.
These tests and procedures help doctors confirm a peritoneal mesothelioma diagnosis and determine if the cancer has spread.
How do you treat abdominal mesothelioma?
Doctors treat abdominal mesothelioma by performing cytoreductive surgery to remove as much of the tumor as possible, often followed by heated intraperitoneal chemotherapy (HIPEC) directly applied to the abdominal cavity.
Chemotherapy can also be used before surgery to shrink tumors or after surgery to kill any remaining cancer cells.
What are the new treatments for peritoneal mesothelioma?
Pegargiminase (ADI-PEG20) is an innovative new drug that starves mesothelioma tumors of the nutrients they need to grow. When combined with chemotherapy, it has improved patient survival times in clinical trials.
Combining immunotherapy drugs like Tecentriq® (atezolizumab) and Avastin® (bevacizumab) has also shown promising results. These drugs help the immune system fight cancer and prevent the growth of new blood vessels that tumors need to survive.
What is the survival rate of peritoneal mesothelioma?
Peritoneal mesothelioma has a 5-year survival rate of 65%, according to Moffitt Cancer Center. This means 65% of patients are still alive 5 years after being diagnosed.
The 5-year survival rate increases to 80% when patients get long-term regional chemotherapy with pemetrexed and cisplatin after cytoreductive surgery.
What is the progression of peritoneal mesothelioma?
Peritoneal mesothelioma typically progresses through these stages:
- Asbestos exposure: Asbestos fibers are breathed in or swallowed and get trapped in the abdominal lining (peritoneum).
- Latency period: Peritoneal mesothelioma has a long latency period, often taking 10-50 years for symptoms to appear after asbestos exposure.
- Early stage: Early symptoms may include abdominal pain, swelling, and digestive issues. At this stage, the cancer is still contained within the peritoneum.
- Advanced stage: As the disease progresses, tumors spread to other organs and tissues within the peritoneum, leading to significant fluid buildup and weight loss.
Understanding the progression of peritoneal mesothelioma is crucial for getting a timely diagnosis and treatment to improve your prognosis and quality of life.
How long can you live with peritoneal mesothelioma?
Peritoneal mesothelioma patients live 53 months on average with cytoreductive surgery and HIPEC. However, some patients — like peritoneal mesothelioma survivor Julie Gundlach — have lived over 15 years after being diagnosed.
Early diagnosis and treatment can significantly improve your life expectancy. If you or someone you know has been diagnosed with peritoneal mesothelioma, make sure to visit a specialist as soon as possible to discuss your treatment options.
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