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A Case of Malignant Mesothelioma Peritoneal Showed Complete Remission with Chemotherapy Malignant Mesothelioma Peritoneal (MMP) is a rare and aggressive tumor of the peritoneum (the tissue that surrounds the abdomen) and is considered a universally fatal disease. Of all types of mesothelioma, only 20% to 33% arise from the peritoneum itself. Most mesotheliomas commonly originate in the pleura. When the peritoneal cancer spreads, doctors call it diffuse peritoneal mesothelioma. Peritoneal Mesothelioma Causes Malignant Mesothelioma Peritoneal starts when an individual breathes in asbestos fibers, usually as part of their job. Asbestos is a natural mineral that is resistant to heat, fire, and electricity. Until the late 1970s, asbestos was widely used in the automotive, building, fireproofing, roofing, and shipbuilding industries. Adhesives, ceiling tiles, floor tiles, paint, and numerous plastics contained asbestos. Malignant Mesothelioma Peritoneal.Easily released into the air, asbestos fibers are very small, which makes it very easy for workers to breathe them into their lungs. Today’s industries no longer use asbestos. The asbestos fibers get into the body and move to the digestive system, slicing through the stomach and intestines. In peritoneal mesothelioma, the asbestos fibers puncture the abdominal lining, which is responsible for secreting lubrication for the organs to process food. When this happens, a cancerous growth forms in the abdominal lining. The incubation period for mesothelioma can be up to fifty years, with symptoms remaining dormant after exposure to asbestos. By the time symptoms appear, the peritoneal mesothelioma has usually already progressed and spread throughout the body. Adding difficulty in detecting Malignant Mesothelioma Peritoneal is the fact that its symptoms are common and mimic other conditions (some of which are minor conditions), and with such a long incubation period after exposure, a physician may treat a patient for the wrong illness, such as indigestion or heartburn. Peritoneal Mesothelioma Symptoms Individuals with Malignant Mesothelioma Peritoneal typically have symptoms such as swelling in the abdominal area, sudden loss of weight and appetite, nausea, constipation, and pain in the abdominal region. Other common symptoms of peritoneal mesothelioma include abdominal lumps, anemia, blood clots, chest pain, coughing, difficulty breathing, difficulty swallowing, fever, fluid retention in the abdominal cavity, constipation, hernia, nausea, and obstructions of the bowel. Because these symptoms mimic other conditions and are not specific to peritoneal mesothelioma, sometimes malignant peritoneal mesothelioma is not diagnosed, especially if the patient has no idea or does not recall being exposed to asbestos. Malignant Mesothelioma Peritoneal Diagnosis When the doctor suspects that a patient may have Malignant Mesothelioma Peritoneal, a magnetic resonance imaging (MRI) or computed tomography (CT) scan will usually be ordered - so they can check for abdominal anomalies. If they do find abdominal anomalies, a biopsy is also ordered to find out what kinds of cells exist within the tissue. CT scan findings of peritoneal mesothelioma are usually non-specific and insufficient to establish a diagnosis. However, CT scan is useful for detecting, characterizing, staging, and guiding biopsy of peritoneal masses. Based on CT scan appearances, peritoneal masses are categorized into three types: The "dry-painful" type is the most common, in which CT shows a single large mass or multiple small peritoneal masses in one abdominal quadrant, with no signs of ascites. The "wet" type is associated with intestinal distension and ascites, widespread small nodules and plaques, and no solid masses. Then there is the "mixed" type, which has the characteristics of both the dry and wet types. A definite diagnosis based on imaging results alone is usually impossible. Additionally, distinguishing a benign mass from a malignant mass, as well as a primary from a metastatic mass is also challenging. Therefore, the definitive diagnosis of peritoneal mesothelioma is dependent on histologic and immune-histochemical examination. Cytologic analysis of ascites (fluid in the abdominal cavity) may also be performed, although it has a low diagnostic potential. When either imaging scans and cytologic findings are inconclusive (or ascitic fluid is absent), tumor biopsy is performed and this typically results in a conclusive diagnosis. Peritoneal Mesothelioma Treatment Options Treatment options for peritoneal mesothelioma are dependent on the extent of which the cancer has progressed. Other factors include the patient’s age, health, and medical history. Typical treatment options include: Chemotherapy - The most common treatment for peritoneal mesothelioma, chemotherapy may kill cancerous cells. Radiation - Radiation therapy may shrink a peritoneal mesothelioma tumor and kill cancer cells. Surgery - Surgery for peritoneal mesothelioma involves removing portions of the abdominal lining, tumor, and possibly parts of the diaphragm. New treatments for peritoneal mesothelioma include dual therapy, triple therapy, intraoperative photodynamic therapy, immunoaugmentative therapy, gene therapy, and alternative medicine. Should You Get Tested? If you have been exposed to asbestos in the past, it is recommend that you get tested immediately for the three types of mesothelioma: Peritoneal mesothelioma (cancer of the abdominal lining) Pleural mesothelioma (cancer of the lung lining) Pericardial mesothelioma (cancer of the heart lining) Mesothelioma is treatable if detected early enough. Introduction Mesothelioma is a rare form of cancer in which malignant (cancerous) cells are found in the mesothelium, a protective sac that covers most of the body’s internal organs. The incidence of malignant peritoneal mesothelioma (MPM) is approximately 2 to 2.6 cases per million annually. Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles. The mesothelium is a membrane that covers and protects most of the internal organs of the body. It is composed of two layers of cells: One layer immediately surrounds the organ; the other forms a sac around it. The mesothelium produces a lubricating fluid that is released between these layers, allowing moving organs (such as the beating heart and the expanding and contracting lungs) to glide easily against adjacent structures. The mesothelium has different names, depending on its location in the body. The peritoneum is the mesothelial tissue that covers most of the organs in the abdominal cavity. Mesothelioma (cancer of the mesothelium) is a disease in which cells of the mesothelium become abnormal and divide without control or order. They can invade and damage nearby tissues and organs. Cancer cells can also metastasize (spread) from their original site to other parts of the body. Most cases of mesothelioma begin in the pleura or peritoneum. Although reported incidence rates have increased in the past twenty years, mesothelioma is still a relatively rare cancer. About 2,000 new cases of mesothelioma are diagnosed in the United States each year. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. Symptoms Symptoms of Malignant Mesothelioma Peritoneal include weight loss, and abdominal pain and swelling due to a buildup of fluid (effusion) in the abdomen. Other symptoms may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face. These symptoms may be caused by mesothelioma or by other, less serious conditions. It is important to see a doctor about any of these symptoms. Only a doctor can make a diagnosis. Diagnosis Diagnosing mesothelioma is often difficult because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient’s medical history, including any history of asbestos exposure. A complete physical examination may be performed, including x-rays of the chest or abdomen. A CT (or CAT) scan or an MRI may also be useful. A CT scan is a series of detailed pictures of areas inside the body created by a computer linked to an x-ray machine. In an MRI, a powerful magnet linked to a computer is used to make detailed pictures of areas inside the body. These pictures are viewed on a monitor and can also be printed. A biopsy is needed to confirm a diagnosis of mesothelioma. In a biopsy, a surgeon or a medical oncologist (a doctor who specializes in diagnosing and treating cancer) removes a sample of tissue for examination under a microscope by a pathologist. To do this the doctor may perform a peritoneoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument called a peritoneoscope into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary. Staging If the diagnosis is mesothelioma, the doctor will want to learn the stage (or extent) of the disease. Staging involves more tests in a careful attempt to find out whether the cancer has spread and, if so, to which parts of the body. Knowing the stage of the disease helps the doctor plan treatment. Malignant Mesothelioma Peritoneal is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, or abdominal organs. Treatment Treatment for mesothelioma depends on the location of the cancer, the stage of the disease, and the patient’s age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined. Surgery is a common treatment for mesothelioma. The doctor may remove part of the lining of the abdomen and some of the tissue around it. Radiation therapy, also called radiotherapy, involves the use of high-energy rays to kill cancer cells and shrink tumors. Radiation therapy affects the cancer cells only in the treated area. The radiation may come from a machine (external radiation) or from putting materials that produce radiation through thin plastic tubes into the area where the cancer cells are found (internal radiation therapy). Malignant Peritoneal Mesothelioma Chemotherapy is the use of anticancer drugs to kill cancer cells throughout the body. Most drugs used to treat mesothelioma are given by injection into a vein (intravenous, or IV). Doctors are also studying the effectiveness of putting chemotherapy directly into the abdomen (intracavitary chemotherapy). To relieve symptoms and control pain, the doctor may use a needle or a thin tube to drain fluid (effusions) that has built up in the abdomen. Removal of fluid from the abdomen is called paracentesis. Radiation therapy and surgery may also be helpful in relieving symptoms, Malignant Mesothelioma Peritoneal. Pericardial Mesothelioma is an extremely difficult cancer to treat and presently, all treatment methods used have a poor success rate. The chances of a patient’s survival depend largely on how early and how aggressively the cancer is treated. If pericardial mesothelioma is treated when it has fully matured and developed then the chances of survival are very slim and the prognosis for a patient could be only a couple of months. The latency period of pericardial mesothelioma (30-50 years), and its symptoms which are ordinary of other more common diseases such as pneumonia, make it extremely difficult to diagnose and therefore difficult to treat in its early stages. In this way, a lot of pericardial mesothelioma treatments do not aim to cure patients but instead focus on reducing the symptoms. Before a patient is treated, a doctor will evaluate him or her, and afterwards decide which treatment method is most suitable for the patient’s situation. The patient’s age, medical history, general well being and even weight are taken into account before the doctor will decide which of the three treatments are most appropriate. These treatments are surgery, chemotherapy and radiation therapy. Surgery : There are two different types of surgery that can be used one of which is called aggressive surgery. This is the most dangerous of all the treatment methods available and only the fittest of people are deemed strong enough to undergo this. Aggressive surgery consists of removing large chunks of cancerous cells from inside the patient. This is extremely dangerous in the case of pericardial mesothelioma seeing as the cancerous cells are in extremely close proximity to vital organs such as the heart and lungs. Extremely skilled surgeons are needed to perform this operation. The second type of surgery is palliative procedures and this type of surgery is used only for the purpose of reducing the symptoms of the cancer. Palliative procedures are performed when pericardial mesothelioma is in its latest stages and is practically impossible to cure. Chemotherapy : Chemotherapy is the most well known cure of cancers and involves using drugs to kill of cancerous cells. However, many of the drugs used do not have a high success rate although researchers are discovering new combinations of drugs that work more effectively. Many pharmaceutical companies are also endeavouring to find new drugs. Researchers predict that they will soon discover a drug with a significantly improved success rate. Radiation Therapy : This form of treatment uses doses of radiation to kill cancerous cells. However, in the case of pericardial mesothelioma this is extremely difficult because as well as damaging cancerous cells, the radiation also damages vital organs such as the heart and lungs. This makes using radiation therapy most effectively extremely difficult. The dose of radiation is usually too weak to make a significant impact on curing pericardial mesothelioma. Dual Therapy : Dual therapy is just a combination of surgery, chemotherapy and radiation therapy. This consists of using surgery to remove the majority of the cancer cells and then using chemotherapy and radiation therapy to kill off any remaining cells. This has proved to be an effective treatment method however also very dangerous. Only the fittest young people are able to undergo this treatment.

Asbestos is known to be hazardous to our health and it can be found almost everywhere in our surroundings. Inhaling too much of it may result in contracting Mesothelioma which could be fatal. Asbestos contains fibers, which are easily inhaled but are also a problem for our lungs to remove instead. Mesothelioma from exposure to asbestos is the most common way to contract this often-deadly disease. The contamination all depends on the environment, level and duration of exposure as well as your age when you were exposed to these particles. These asbestos fibers each have different physical characteristics which plays a different role in the risk of the disease. The longer and thinner it is, the easier for it to become lodged in your lungs while those curly fibers would be more unlikely to attach themselves. Contracting this disease is not an overnight issue, as the effect would only take place after many years (on some rare cases only a few years) of exposure. You could be exposed directly to the asbestos through places or buildings or things but also from individuals who were exposed to asbestos before. The most common places to be exposed to asbestos are industrial sites. It is also possible to be exposed when working with older insulation in any building, as older types of insulation are known to contain asbestos. Plumbers working in small, unventilated compartments in ships welding pipes together or plasterers working in fireproofing spray on steel beams can also be exposed and risk the contraction of Mesothelioma from exposure to asbestos. It is also common for shipyard workers and Navy personnel to be exposed as well as maintenance and steel workers. There are a lot of materials and buildings in our surrounding contain asbestos. In a building, the pipes and boilers would contain insulation which is made of asbestos. So are the cements and plasters that came in powder. Most importantly, many roof and floor tiles also contain asbestos. Brakes and clutches in your vehicle may also contain asbestos. Workers doing demolition work, especially in older buildings need to be careful so as not to contract Mesothelioma from exposure to asbestos. These workers should use respirators to filter the air and ensure the demolition areas are being sealed so that there would be lesser asbestos dust released to the public area.