Peritoneal Mesothelioma Surgical Procedures

Peritoneal Mesothelioma is considerably rare, accounting for only between 10% and 20% of all Mesothelioma cases. Peritoneal Mesothelioma is a cancer caused by asbestos exposure that affects the abdominal tissue, more specifically the lining in the abdominal wall. Peritoneal Mesothelioma is most often deadly, although treatment options are becoming increasingly more sophisticated and the survival rate is ever so slowly creeping upward.

Surgical options for a patient that has been diagnosed with peritoneal mesothelioma include a procedure known as paracentesis and a procedure called peritonectomy. A paracentesis is a procedure that removes the fluid build up from between the lining of the abdominal cavity and the abdomen. 

A paracentesis is usually opted for prior to a peritonectomy. A paracentesis may relieve the fluid pressure for awhile, although some patients get lucky and the fluid does not return to the extent of having to perform the procedure again. However, if a paracentesis is done and the fluid quickly returns, a peritonectomy is typically recommended. This means the removal of the abdominal wall lining, which will prevent future build up of fluid permanently.

Because surgical procedures are stressful even on a healthy body, some patients opt for a peritonectomy immediately and skip the more conservative procedure, the paracentesis. This means one surgery that is guaranteed to prevent the future build up of fluid, however there are risk factors with a peritonectomy. 

The risk of infection in the post operative period is quite high, as the body is already in a weakened state from the cancer. Most physicians will perform a peritonectomy with the intention of making the patient more comfortable, as most cases of peritoneal mesothelioma are diagnosed well past the point that the cancer can be surgically removed. A paracentesis or a peritonectomy are purely for the sake of making the patient comfortable. 

However, some patients opt for procedures like a paracentesis or a peritonectomy in the hopes of gaining a chance on the slim possibility of a cure. Peritoneal mesothelioma has a very low survival rate, and patients find themselves in the unenviable position of having to choose between procedures that will make them most comfortable and procedures that may extend their life and offer them a small chance at being cured. This of course is a very difficult place to be after being diagnosed with peritoneal mesothelioma.

The physician that a patient chooses after being diagnosed with peritoneal mesothelioma is likely to direct their course of treatment. Some physicians opt for surgical procedures like a paracentesis or a peritonectomy while other physicians do not feel the trade off and side effects of surgery are optimal in the face of a disease like peritoneal mesothelioma. 

Treatment options such as a paracentesis or a peritonectomy are intrusive procedures that will weaken the body even more. However, a paracentesis or a peritonectomy often provide relief from the painful pressure of fluid build up that prevents patients with peritoneal mesothelioma from being able to participate in life. Each case is different and each case can only be evaluated on its individual merits. 

There is of course no easy answer, and a patient with peritoneal mesothelioma will require a great amount of care to retain any amount of quality of life, and the decisions regarding surgical procedures such as paracentesis and peritonectomy are not easy decisions to make. Peritoneal mesothelioma patients face many decisions along the way, and unfortunately none of them ultimately leads to a cure. 

Patients of peritoneal mesothelioma do fair better when they enter cancer programs that have a mesothelioma specialty as well as an entire approach to medicine, including nutritional therapies and emotional therapies. 

There are no easy answers when faced with the decision to have a paracentesis performed or the option of peritonectomy, or the alternative option of foregoing surgical procedures altogether. Of course, the stronger and more informed a peritoneal mesothelioma patient's support system, the more equipped he or she will be to make these difficult decisions.

Unfortunately, treatment for peritoneal mesothelioma, including procedures such as peritonectomies and paracentesis are relatively expensive, and factoring the cost of the more conservative approaches to treating this form of cancer such as radiation, chemotherapy, and other therapies, treating peritoneal mesothelioma can be outrageous even with medical insurance. 

There is help for those who need it, and patients and family members can be proactive in finding the help they need and deserve. This may mean asking a lot of questions until the right person for the question is found, but there is no reason for a victim of peritoneal mesothelioma or their family members to have to face this disease alone.

Asbestos and the Risk of Peritoneal Mesothelioma

Asbestos is a natural mineral that was once used in the construction and home improvement industries. It was put on ceilings when it was mixed with aertex, it was used to make surfaces semi flame resistant and it was also mixed with cement as it is very strong. At one point asbestos was seen as a revolution for these industries as it was just so versatile – it was also deadly. No one realised at the time that every time they were exposed to asbestos that they were taking their life in their hands and putting themselves in grave danger. Asbestos is now banned but its legacy lives on in the thousands of people who are feeling the after effects of being exposed to it over the years. 

Exposure to asbestos is directly related to certain types of cancer, including peritoneal mesothelioma which is cancer of the membranes in the abdominal cavity. Peritoneal mesothelioma is the second rarest form of mesothelioma and each year it is responsible for around 20% of the cases of diagnosed mesothelioma. As exposure to asbestos is the only known cause of peritoneal mesothelioma there are two main ways that doctors believe that it can actually reach the abdominal wall. One way is through the digestion of asbestos fibres which is actually easy than most might think. Once in the digestive system the asbestos fibres get stuck in the peritoneum and over time this can result in peritoneal mesothelioma. The second way that asbestos gets to the abdomen is through the lymph nodes and lungs when asbestos is inhaled. In some cases pleural mesothelioma will result in peritoneal mesothelioma ad the asbestos moves through the lungs and into the abdominal cavity if left untreated and undiagnosed for some months. 

Suspicion of peritoneal mesothelioma is usually made when a patient exhibits signs such as pain in the abdomen, chest or stomach and many suspect hernias are actually created by a tumour caused by peritoneal mesothelioma. Often a misdiagnosis that does not include peritoneal mesothelioma can be made and this can have severe repercussions on the life expectancy of a patient. It is usual for someone who is thought to have peritoneal mesothelioma to have to undergo many tests to get a correct diagnosis and these tests are imaging scans and tissue biopsies. 

Patients who are found to have peritoneal mesothelioma do not have a good prognosis. However if a diagnosis of peritoneal mesothelioma is made early enough they could have surgery to remove the disease and some cases it can extend a patient’s life span for a few more years. If surgery is not an option then chemotherapy or radiotherapy can help although there is no guarantee that this will make much of a difference. It is essential that a person with peritoneal mesothelioma gets the right kind of treatment for any pain that they experience so that they are as comfortable as they can be. Peritoneal mesothelioma, like the other forms of mesothelioma is highly unpleasant and hard to live with.