Peritoneal mesothelioma is a rare cancer that affects approximately 400 to 500 patients a year in the United States. It strikes both women and men; the incidence of peritoneal mesothelioma has been stable over the past 30 years. It is an aggressive cancer that comes from the lining of the peritoneum and spreads due to disease progression within the abdominal cavity.
Peritoneal mesothelioma presents in various ways. Some of the common complaints are abdominal distension which is present in 30 to 80 percent of patients, increasing abdominal girth, pain, nausea, anorexia, and weight loss. These symptoms can be the presenting symptoms in a lot of common conditions and sometimes the diagnosis of peritoneal mesothelioma is made after the disease has progressed.
Due to the small number of people affected by this disease randomized clinical trials are difficult to conduct. According to the reference www.uptodate.com there is no consensus as to the optimal treatment for malignant peritoneal mesothelioma. Most of the available clinical information is from information from single centers and done on a retrospective single-center study.
Since this is a rare cancer the optimal treatment for peritoneal mesothelioma is from centers that have treated a number of the patients diagnosed. The course of the disease seems to be different for men and women. Historically the treatment has been a combination of systemic chemotherapy, surgery to relieve the symptoms, and some radiation to the abdomen. This led to patients surviving less than one year with treatment and less than six months without treatment.
The male to female ratios for peritoneal mesothelioma and mortality and incidence are quite similar. One reason for the lower gender ratio could be misclassification of diagnosis. Asbestos mesothelioma affects the pleura more often than the peritoneum at a ratio 6:1. This again is a very difficult cancer to diagnose. Peritoneal Mesothelioma has a specific code in the International Classification of Diseases (ICD 10) whereas the ICD9 code classifies a generic code of malignant tumors of the peritoneum. In some countries, these codes have just been recently adopted as early as 2010, so therefore diagnosis can be difficult as well as reviewing older case studies.
One of the treatment modalities that is used in the treatment of malignant peritoneal mesothelioma is surgery and during surgery intra –op chemotherapy. This treatment has proven successful in the treatment of this rare and potentially fatal abdominal diseases including peritoneal mesothelioma.
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