Given its rarity, there are no established guidelines for
the treatment of peritoneal mesothelioma. The modern approach to malignant
peritoneal mesothelioma includes cytoreductive surgery, hyperthermic
intraperitoneal chemotherapy (HIPEC), intraperitoneal chemotherapy, and
intravenous chemotherapy. These are often used in conjunction and in a
complementary fashion, and this multifaceted approach has significantly
improved outcomes when compared to intravenous chemotherapy alone. For
instance, the reported median survival time for patients with stage IV
mesothelioma as reported by the American Cancer Society is 12 months; however,
with adequate cytoreduction, intraperitoneal, and intravenous chemotherapy
combined, some authors report 10-year survival rates projected at nearly 75%.
With peritoneal mesothelioma, fluid may collect inside your abdomen (this is
called ascites). If too much fluid collects, it makes your abdomen swell. This
can be uncomfortable and heavy.
The latest advances in medical technology allow doctors to diagnose this
disease earlier than ever before, yet experienced cancer doctors can struggle
to diagnose it accurately. In fact, the process can take months.
Recent international data on the incidence of peritoneal mesothelioma are
available from Eurocim, a collaboration of European population-based cancer
registries , and from the SEER program of the United States . Only sparse data
are available from the other countries. Figure 1 reports the most recent data
from selected nationwide European cancer registries and the SEER registries; at
this level of aggregation, age-standardized incidence rates among men range
from 0.5 to about three cases per million population. However, higher rates are
reported in smaller areas with widespread past use of asbestos, such as the
harbor city of Genoa, Italy (age-standardized rate in men in 1995, 5.5 per
million). In most populations, rates among women are in the range 0.2–2 per
million and are lower than in men; although in some countries, such as Sweden,
rates are comparable in the two sexes. A correlation in incidence rates exists
between the two sexes (correlation coefficient of 1991–1995 rates on the basis
of 41 European and nine USA populations covered by cancer registry, 0.41; P =
0.003).
Early symptoms of peritoneal mesothelioma can include abdominal pain or
swelling, and diarrhea or constipation. Unfortunately, some patients don’t
experience any symptoms until tumors spread. This scenario makes treating the
disease hard and surviving it even harder.
What patients will have to pay out-of-pocket for treatment will largely depend
on their insurance coverage and where they are treated. Even with good
coverage, it can still be difficult to keep up with all the bills with any
secondary expenses, continued care after treatment, and the loss of income many
patients face as they can no longer work.
Since asbestos is the only known cause of mesothelioma, people diagnosed with
peritoneal mesothelioma or their surviving family members may be eligible to
file a claim and possibly receive compensation to use towards medical costs and
lost income. It’s important to speak with a mesothelioma lawyer to learn about
your legal rights as soon as possible, as there is a limited statute of
limitations in most states.
In this article we report a case of a 77 year old man who presented with a one
week history of breathlessness and a right pleural effusion. An incidental
right upper quadrant abdominal mass was noted leading to ultrasound and
subsequent CT scans. A large subhepatic mass was identified, in addition to
pleural calcification and thickening. Biopsy and histological examination of
the abdominal mass suggested a spindle cell tumour, most likely a mesothelioma.
Thoracocentesis and cytology of the pleural fluid confirmed the diagnosis of a
malignant mesothelioma. Our patient is a retired dairy farmer. A detailed
occupational history revealed likely asbestos exposure when he worked as a
plumber, approximately 50 years ago.
The process of diagnosing peritoneal mesothelioma is similar to other types of
mesothelioma. It starts with a thorough examination of your medical history,
occupational history and overall physical condition. A series of tests,
including imaging scans and biopsies, usually follows.
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