Abdominal mesothelioma, also known as peritoneal mesothelioma, makes up only about 35% of all mesothelioma cases.
The mesothelium is the tissue that surrounds and covers the organs in the chest cavity and abdomen. The mesothelium allows all of the internal organs, the lungs and heart, on down to the stomach and colon, to move and perform their individual life-sustaining dances. This mesothelium tissue extends from the upper chest to the bottom of the pelvis. The more common form of mesothelioma originates in the upper part of the mesothelium, generally affecting the tissue around the lungs and heart, and is referred to as pleural mesothelioma. Abdominal mesothelioma originates in the lower part of the mesothelium, in the abdominal cavity. The mesothelium in the abdominal cavity is referred to as the peritoneum, hence the name peritoneal mesothelioma.
Only 100 to 500 cases of abdominal or peritoneal mesothelioma are reported in the United States each year. The cause of this cancer is widely attributed to exposure to asbestos. Some sources say that exposure to asbestos is the only known cause of malignant mesothelioma, while other sources mention the asbestos connection in a more non-committal way. In cases where asbestos has been identified as a contributing factor, the lag between the time of exposure to asbestos and the inception of the disease can be one or more decades.
Asbestos is a mineral and has been used for hundreds of years as a building material and substance in fabric. Its chief claim to fame is that it is fire retardant. Asbestos has also been recognized as a health hazard for nearly as long. The Greeks noted that the slaves who wove asbestos into cloth suffered lung damage. So, it’s interesting that it became a popular building material during the industrial revolution in the 1860s, used to insulate and provide safety from the threat of fire. It wasn’t until 1918 that a Prudential company official noted that insurance companies refuse to cover workers who are regularly exposed to asbestos because of the heath factor.
The highest risk people are construction and shipyard workers. The use of asbestos still occurs, but is highly regulated. Most contact is made by construction crews who must remove asbestos in buildings being renovated. The Occupational Safety and Health Administration (OSHA) has addressed the exposure to asbestos in policies related to general industry, shipyard employment, and the construction industry. OSHA’s general duty clause requires employers to “furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees.”
Asbestos is a mineral with long fibers. These fibers are either ingested or inhaled into the body, where they may work themselves into the peritoneal cavity. The cells in the mesothelium produce liquid to enable the intestines to slide over one another. Once the asbestos fibers settle in, they cause the cells in the mesothelium to over-produce fluid used to keep the intestines slick and moist. Mesothelioma occurs when the cells within the mesothelium become abnormal and start to divide uncontrollably. Once it takes hold, mesothelioma is extremely aggressive. If not caught early, the cells metastasize and spread to other organs throughout the body.
Symptoms and diagnosis
The symptoms of mesothelioma are not unique or remarkable in any way, which can cause it to be difficult to diagnose. Symptoms include shortness of breath, chest pain, weight loss, coughing, possibly coughing up blood, fatigue, hoarseness, difficulty swallowing, or there may be no symptoms at all. Cases of mesothelioma can go undetected or be misdiagnosed. For those who may be at risk, it is imperative to share one’s case history and work experience with one’s physician.
The physician usually starts with an x-ray, CAT Scan or MRI of the chest and abdomen. Even if peritoneal mesothelioma is the chief concern, the doctor needs to rule out that the origin isn’t higher up. Plural mesothelioma is more common and will spread into the abdominal cavity if given the time to do so. If the results of these tests warrant, the doctor will look inside the abdomen with a peritoneoscope. The test with the peritoneoscope is done in the hospital with a local anesthetic. The scope is inserted through an opening made in the abdomen, and the mesothelium tissue is examined. If the tissue cells appear abnormal, a sample of the tissue will be collected for viewing under a microscope for malignancy.
Many treatments are available and practiced for abdominal mesothelioma. The usual treatments of surgery, radiation and chemotherapy are at the top of the list. Most mesothelioma treatment plans include a combination of methods. Utilizing multiple treatment methods is termed the multimodality approach.
The actions taken with surgery depend on the disposition of the disease. A surgeon may remove part of the mesothelium lining in the abdomen, he or she may remove part of the diaphragm. In severe cases, a doctor might need to remove all or portions of organs.
Radiation treatment or chemotherapy are frequently coupled with surgery. Radiation treatment uses high-energy x-rays to burn cancer cells and reduce tumors. With chemotherapy, the patient is injected with chemicals to kill the cancer cells.
Other types of treatment are Intraoperative photodynamic therapy, which is a new form of treatment. A chemical is injected into the patient several days before surgery. The chemical makes cancer cells more sensitive to light. During surgery, a special light is shone into the abdominal cavity to destroy cancer cells.
Studies in the United States show that men are more at risk of developing peritoneal mesothelioma, probably because more men work in the construction field. Women, however, have been found to be more vulnerable to the spreading of the disease once it is contracted. Because the disease is so aggressive, survival rates are poor. The chances of recovery depend on the size and range of the cancer and the stage of its development when treatment commences. This is why early detection is so crucial.
See also our page on benign mesothelioma, the non-cancerous form of mesothelioma.
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