Peritoneal Mesothelioma
Lining of the abdomen (peritoneum) — Approximately 20% of all mesothelioma cases
Overview
Peritoneal mesothelioma develops in the peritoneum, the thin membrane lining the abdominal cavity. It is the second most common form of mesothelioma and is linked to asbestos exposure, either through ingesting asbestos fibers or through fibers that migrate from the lungs to the abdomen.
The peritoneum is a serous membrane that lines the abdominal cavity and covers most abdominal organs. Asbestos fibers can reach the peritoneum through several pathways: direct ingestion of fibers, migration from the lungs through the lymphatic system, or translocation through the diaphragm. Once embedded in the peritoneal tissue, the fibers cause chronic inflammation and eventually malignant transformation.
Peritoneal mesothelioma has seen some of the most promising treatment advances in recent years. The combination of cytoreductive surgery (which removes visible tumors and affected peritoneal surfaces) with HIPEC (which bathes the abdominal cavity in heated chemotherapy) has significantly improved survival rates. Specialized cancer centers with experience in this procedure have reported median survival times exceeding four years.
Symptoms
- • Abdominal pain and swelling
- • Ascites (fluid buildup in the abdomen)
- • Unexplained weight loss
- • Nausea and vomiting
- • Loss of appetite
- • Bowel obstruction or changes in bowel habits
- • Fatigue and weakness
- • Abdominal lumps or masses
Diagnosis
- • CT scan of the abdomen and pelvis
- • PET scan to identify cancer spread
- • Laparoscopy (camera-guided examination of the abdominal cavity)
- • Peritoneal biopsy — required for definitive diagnosis
- • Blood tests including CA-125 and SMRP markers
- • MRI for detailed imaging of abdominal structures
- • Paracentesis (fluid removal for analysis)
Prognosis
Peritoneal mesothelioma has shown improved outcomes with HIPEC treatment. Median survival is approximately 53 months with cytoreductive surgery and HIPEC, compared to about 12 months with chemotherapy alone. Some patients have achieved long-term survival of 7+ years with aggressive treatment. The epithelioid cell type responds best to treatment.
Treatment Options
- • Cytoreductive surgery (CRS) with heated intraperitoneal chemotherapy (HIPEC) — the gold standard treatment
- • Debulking surgery to remove as much tumor as possible
- • Systemic chemotherapy with pemetrexed and cisplatin
- • Immunotherapy for unresectable disease
- • Intraperitoneal chemotherapy delivered directly into the abdominal cavity
- • Radiation therapy in selected cases
- • Clinical trials for novel treatments
- • Palliative care including paracentesis for fluid management
Legal Considerations
Peritoneal mesothelioma may result from swallowing asbestos fibers or from fibers that travel through the lymphatic system after inhalation. Cases may involve occupational exposure, environmental contamination, or secondary exposure through contaminated clothing. The connection to asbestos exposure is well-established in medical literature.
Average Settlement Range
$1 million – $2.5 million