Friday, February 4, 2011

Peritoneal Mesothelioma

Peritoneal mesothelioma is a rare form of cancer caused by asbestos exposure. It refers to cancer of the serous membrane that forms the lining of the abdominal wall (called the “peritoneum”). Peritoneal mesothelioma may result from coughing up and swallowing inhaled asbestos fibers. Peritoneal mesothelioma is the second most common form of mesothelioma, accounting for approximately 10%-20% of mesothelioma diagnoses.

Symptoms of peritoneal mesothelioma may include swelling, pain due to accumulation of fluid in the abdominal cavity (called ascites), weight loss, and a mass in the abdomen. Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia (a lowered red blood cell count), and fever. Keep in mind that these syptoms may be caused by mesothelioma or by other less serious conditions. Only a doctor or mesothelioma specialist can make a definitive diagnosis.

It can be difficult to diagnose mesothelioma because many of the mesothelioma symptoms are similar to those of a number of other conditions, including stomach cancer and other types of cancers. If mesothelioma is suspected, a doctor will typically do a physical examination and ask the patient for a complete a medical history which will include the possibility of prior exposure to asbestos. At this point, the most effective way to make a positive peritoneal mesothelioma diagnosis is for a mesothelioma specialist to examine tissue from the abdominal cavity via a laparoscopy or mediantinoscopy. There are several additional tests that can be used to assist in confirming the diagnosis of peritoneal mesothelioma including x-ray, CT scan, MRI scan or PET scan.

In this procedure, a small incision is made in the front of the abdomen and a flexible tube which is connected to a video camera, is inserted in the area of the tumor. A doctor can then view the tumor and/or take a tissue (called a biopsy) or remove fluid at this time.

In a mediastinoscopy, a small incision is made just above the sternum and a lighted tube is placed behind the breast bone, allowing the doctor to view the lymph nodes which can provide clues about the body’s immune system. A tissue sample may be removed at this time for later analysis under a microscope.

X-ray machines use radiation to take a picture of the affected area. An x-ray may reveal several types of abnormalities including buildup of fluid in the abdominal cavity. These abnormalities may indicate asbestos exposure and the development of mesothelioma.

CT Scan
Type of x-ray procedure that produces detailed cross-sectional images of the body. Unlike a traditional x-ray that takes a single picture, a CT scanner takes many pictures as it rotates around you. A computer then combines these images to create a cross-sectional “slice” of the body. A radiocontrast agent or “dye” may be injected into patient intravenously, which helps define the structures of the body and may help in determining the extent to which the cancer has spread.

Magnetic Resonance Imaging - RI Scan
This scan uses radio waves, strong mangnets and a computer to produce a cross-sectional image of the body. The energy from the radio waves and magnets are absorbed and released by the different tissues in the body. In this procedure the patient may be injected with a radiocontrast agent prior to being positioned in the tunnel of the MRI machine.

Positron Emission Tomography Scan
This scan uses radioactive glucose (sugar) to determine the spread of cancer. Cancer tissue consumes glucose at a much faster rate than normal tissue. When radioactive glucose is injected intervenously into the patient the diseased tissue takes up higher levels of the radioactive material and when scanned, can provide insight into the stage and spread of the cancer.

Treatment options may include chemotherapy, surgery, radiation, participation in a clinical trial or a combination of several therapies.