Mesotheliomas of the peritoneum, the layer of cells that lines the abdomen, intestines, and organs, is usually far advanced when it is diagnosed. The cancerous cells can grow in the abdomen undetected, until there are tumors large enough to cause symptoms by blocking the intestines or by causing fluid build-up in the abdominal cavity. There can be multiple tumors inside the abdomen.
If any surgery is done, it is usually a debulking surgery, called cytoreductive surgery, in which surgeons attempt to remove as much cancer as they can from everywhere inside the abdomen. They will also free up any organs that have tumors pressing on them. The surgeons will then instill a chemotherapeutic agent into the peritoneal cavity. This works even better if the treatment fluid is heated, which is called hyperthermic intraperitoneal chemotherapy (HIPEC).When it goes into the abdominal cavity, it is bathing the area of the mesothelioma cells with anti-cancer medication, without putting a high concentration into the general circulation of the patient’s body. This combination is often effective at prolonging life and reducing symptoms. One trial using the combination of cytoreductive surgery and HIPEC showed a 5 year survival rate of 63% for patients undergoing the two procedures. In another study, the median survival rate was 87.2 months.
There are continuing trials of treatments for peritoneal mesothelioma, and patients are encouraged to look for trials that may help treat their disease.