What is peritoneal mesothelioma?
This is a rare aggressive form of cancer which attacks the ‘peritoneum’, a thin protective membrane surrounding the stomach and upper abdomen which helps to keep the abdominal organs in place. The peritoneum is made up of two layers, an inner and outer layer and when mesothelioma develops the layers thicken and fluid collects within the space. Peritoneal mesothelioma is the second most common form of mesothelioma, accounting for 20% of all mesothelioma cases which is most common in men between the ages of 50 – 69 years.
How is peritoneal mesothelioma caused?
In almost all cases the cause is attributed to exposure to asbestos fibres which are inhaled albeit there is growing belief swallowing asbestos could also be a link. Other factors which can increase the risk of developing peritoneal mesothelioma include genetics and body types.
Once asbestos fibres enter the body, its defence mechanism attempts to filter and remove them but due to some of the fibres being sharp and irregular in shape they become lodged in the peritoneum. Over a long period of time this causes inflammation and irritation which leads to genetic change in the cells and formation of a malignant tumour.
Statistically, men are five times more likely than women to develop mesothelioma due to the work related nature of this disease.
Who is most at risk of developing mesothelioma?
There are various ways to measure risk in developing a disease like mesothelioma but this does not always mean a disease or cancer will develop. Certain types of cancer have different risk factors and with mesothelioma the risk is higher in people exposed to asbestos before the age of 30.
It is estimated that almost 6% of British men born in the 1940’s who worked in carpentry for more than 10 years before the age of 30 develop mesothelioma. A high risk group would typically include those who have worked in manufacturing asbestos and those who have used asbestos materials and products in one or more of the following industries;
- Building industry
- Power stations motor industry
- Plumbing & heating
- Insulation (‘Laggers’)
- Telephone exchanges
Common symptoms of peritoneal mesothelioma
Asbestos was widely used after the Second World War (post 1945) across many industries and given mesothelioma develops slowly, between 15 – 60 years after exposure, symptoms are generally experienced late in the day often when the condition is advanced which inevitably has an impact upon the outcome of any treatments.
As in most cancer cases early diagnosis and intervention can produce the most favourable outcomes.
Common symptoms include;
- Swelling in the stomach (abdomen)
- Abdominal pain
- Loss of appetite
- Weight loss
- Feeling sick
- Changes to normal bowel pattern ie. constipation or diarrhoea
How is peritoneal mesothelioma diagnosed?
If you have any health concerns and have been exposed to asbestos in your working life you should discuss these with your GP at the earliest opportunity. It might be nothing at all but you are likely to feel better raising the issue now rather than later on.
Your GP will examine you and discuss aspects of your general health, family history and in particular any symptoms or other concerns you might have. It is important you outline details of your earlier exposure to asbestos.
Peritoneal Mesothelioma can be difficult to diagnose and a number of diagnostic investigations can be carried out which include;
A blood test in itself will not detect mesothelioma but it is recognised that people with mesothelioma have higher concentrations of certain proteins in their blood and tests can help determine how advanced a cancer is.
Researchers in Japan are developing advanced blood tests using an enzyme-linked system to detect a protein biomarker (N-ERC/mesothelin) which could enable earlier diagnosis of mesothelioma. Early diagnosis and early intervention offers a more favourable outcome in terms of treatment options and survival periods.
An x-ray in many cases will highlight abnormalities in the abdomen such as fluid and thickening in the peritoneum and if found you will have further tests to identify the cause which could be totally unrelated.
A chest x-ray might be required to examine the lungs for abnormalities.
CT Scan (computerised tomography)
Essential to any diagnosis of peritoneal mesothelioma will be a CT Scan of the abdomen which is a painless process involving a series of x-rays which produce a 3D image. A CT Scan can help differentiate malignant from benign disease and will provide reliable information regarding the location and thickness of any tumours in the abdomen and show if mesothelioma has affected other organs.
The result of the CT Scan is not always conclusive and further investigation is often necessary.
MRI Scan (magnetic resonance imaging)
An MRI scan produces high-resolution cross-sectional images of bones and body tissues to help in the diagnosis of peritoneal mesothelioma but can also indicate if the mesothelioma has metastasized (spread) to other areas.
PET Scan (positron emission tomography)
A PET Scan is a specialised imaging test which can help to identify cancer cells not detected by other tests and determine if the mesothelioma has spread into the lymph nodes or other parts of the body.
This involves obtaining a sample of fluid or tissue from the abdomen to enable microscopic examination (normally by a Pathologist) of the cell type present to determine if any tumour is mesothelioma and, if so, what type of cells are present, ie. epithelioid, sarcomatoid or biphasic.
Where there is an accumulation of fluid in the abdomen (ascites) in the first instance this will normally be drawn off into a syringe and examined by a Pathologist. This procedure can also provide pain relief to the patient.
A biopsy is the only definitive method of diagnosing mesothelioma and several methods can be used. The type of biopsy to be used in each particular case will be determined by the imaging reports, blood tests and location of the tumour.
Methods of biopsy
- The least invasive non-surgical procedure is referred to as fine needle aspiration where fluid is drawn away from the abdomen using a hollow needle and syringe. This can be undertaken as an out-patient.
- Camera-assisted surgical biopsies – ‘Laparoscopy’ is a procedure undertaken using a small camera attached to a thin tube which is inserted into the abdominal cavity through a small incision in order to collect samples. Recovery time from laparoscopy is shorter than that required following laparotomy.
- Surgical biopsy – Under general anaesthetic abdominal exploration and removal of fluid and/or tissue sample is obtained during a procedure known as ‘laparotomy’.
Factors to consider following a diagnosis of peritoneal mesothelioma
Initial diagnosis of mesothelioma can be overwhelming, both physically and emotionally, not only for the sufferer but their loved ones and friends and the enormity and implication of such a diagnosis cannot be overstated. Given the prognosis, sufferers might feel burdened by the responsibility of getting their affairs in order and coping with the knowledge of a reduced life-expectancy.
Sufferers will deal with their diagnosis in different ways but in most instances there will be fundamental steps one could take to make dealing with their situation that much easier.
- Consider a second opinion – A second opinion is very important not only to ensure your original diagnosis is correct but also to ensure you receive the most appropriate treatment and you should discuss this with your existing consultant who will appreciate and understand your position. Ensure any second opinion is obtained from a specialist who is conversant in all available treatments of peritoneal mesothelioma.
- Consider your treatment options – living with mesothelioma will require decisions in terms of lifestyle changes and understanding more of the various treatment options, prognosis and availability of clinical trials which you should discuss with your specialist.
- Decide on a treatment plan – Your ultimate treatment options are likely to be decided by the stage of your mesothelioma, your state of health and quality of life issues. Deciding upon any treatment plan is likely to involve many questions being asked of your specialist, such as, which treatment will extend your life the longest? What are the side effects of each treatment? What can be done to improve the quality of your life whilst living with mesothelioma? How you might best prepare for your treatments and those lifestyle steps you might take to ensure living the highest quality life possible?
- Improve your health – Wherever possible you should consider improving your health including diet which can help to maintain your immune system during the stressful and often debilitating period of your treatment. Smoking can exacerbate your condition and should be avoided as too are high stress levels which can be reduced by certain enjoyable activities such as reading, aromatherapy, yoga or indeed any other activity which uplifts you mentally, spiritually or physically.
- Contact us immediately – Mesothelioma is a serious terminal condition which in almost all cases has been brought about through workplace exposure to asbestos dust and fibres and as such is a condition brought about through no fault of your own. We provide fast access to leading specialist Industrial Disease solicitors provider of mesothelioma and other asbestos-related legal services and will do all that is necessary to ensure that you and your family receive the maximum compensation available. We will also help you with appropriate benefit entitlement with The Department for Work and Pensions (DWP).
Treatments available for peritoneal mesothelioma
Peritoneal mesothelioma can be a difficult cancer to diagnose with treatment options determined by several factors;
- The stage of the cancer
- Existence of any other medical or health conditions
- General fitness of sufferer
Major surgery known as ‘peritonectomy’ involves removing part of the lining of the abdomen in order to remove as much of the cancer as possible and reduce symptoms. Another surgical procedure known as cytoreductive surgery is used to perform ‘total peritonectomy’ which involves the removal of as much of the tumour and affected tissue as possible followed by a heated chemotherapy treatment (hyperthermic intraoperative intraperitoneal chemotherapy – HIIC) which is directed into the peritoneal cavity.
In cases of advanced mesothelioma radical surgery is required to remove the tumour which is referred to as debulking.
Chemotherapy treatment as an out-patient might also be offered with the aim of shrinking the cancer and involves drugs administered by injection into a vein or when complimentary to surgery by means of a catheter which is fed into the abdomen through an incision on the stomach. Chemotherapy can be offered on its own or complimentary to surgery.
Supportive care (Palliative care) will be offered by a palliative care team in those instances where coping with intensive chemotherapy treatment is not possible due to illness. Treatments are still available for the management of pain relief and for symptoms of weight loss and build-up of abdominal fluid. Abdominal fluid can be drained from the abdomen using an ascetic tap.
Improving your peritoneal mesothelioma prognosis
- A prognosis is a doctor’s prediction on the outcome of a disease based upon a set of average national statistics and are therefore presented to a sufferer as a ‘guide only’. Many sufferers are taking on the challenge of their condition and living longer due to improved treatments, care and an improved lifestyle and diet.
- Life expectancy is assessed according to various factors which include, the type and stage of the mesothelioma, age, gender and general fitness of sufferer and the type of treatments suitable to a particular individual.
- Many sufferers who take advantage of available treatments and clinical trials will outlive their initial prognosis. Sadly, the nature and often late onset of symptoms means that mesothelioma is normally diagnosed during the latter stages of the disease after it has spread into the lymph nodes or other parts of the body. If diagnosed early, treatment is likely to be more successful offering a better prognosis.
- Treatment options for peritoneal mesothelioma offer a more favourable outcome in terms of overall survival rates compared with pleural mesothelioma and it is estimated over half of sufferers treated with ‘hyperthermic intraoperative intraperitoneal chemotherapy’ (HIIC) will live longer than five years
- In all cases, regardless as to how advanced your mesothelioma might be, palliative treatment is always available to ensure you maintain a longer and quality life.
- Whilst it is recognised you cannot change certain prognostic factors you can be proactive in terms of improving your overall health and well-being by undergoing recommended treatments and dealing positively with any side effects that might occur. If you are a smoker you might consider stopping on account this can cause further lung complications and jeopardise any potential surgery.
- A healthy immune system will help to manage treatments like chemotherapy and fight off diseases which could complicate recovery. Consider improving your diet and wherever possible take exercise which can have a significant impact on your life expectancy. Mesothelioma can significantly impact a person mentally and emotionally and it is important people do not become isolated and reach out for support and help whenever required. Complementary and alternative therapies like meditation, yoga and counselling can improve you well-being.
- Mesothelioma sufferers face tough decisions and challenges throughout their treatment process and hopefully many will have family and friends to support them. We understand many of the difficulties you are facing right now and would be pleased to speak with you regarding immediate access to specialist legal help for you, your family, friends and carers. We can also arrange contact with another organisation or charity on your behalf to see what other help might be available. Call us today on FREEPHONE 0808 164 6018
Compensation & government benefits for peritoneal mesothelioma
- Compensation is available to sufferers of peritoneal mesothelioma and is set at a level to reflect the nature of this terrible disease and give regard to those life changing costs and financial losses which inevitably follow and impact upon many families. Whilst compensation cannot bring back a loved one, reverse a diagnosis or restore former good health it can help to provide some financial peace of mind to sufferers and their families at a very difficult time in their lives.
- Experienced specialist industrial disease solicitors are waiting to speak to you to discuss all aspects of your case and provide reassurance as to how they would seek to progress your claim. Compensation settlements for mesothelioma involve high value awards, typically averaging in excess of £140K. Court provisions exist to enable your solicitor to obtain an early interim payment of £50K. Compensation is obtained from those former employers and/or their relevant insurance companies who negligently exposed you to asbestos fibres in the workplace.
- Sufferers of mesothelioma are also eligible to seek the non-means tested benefit, Industrial Injuries Disablement Benefit (IIDB) which is automatically assessed at 100% disability and a weekly payment of £168. We can help you with your benefit application which might include a claim under the 2008 Diffuse Mesothelioma Scheme which provides a one-off payment to sufferers where it has not been possible to recover compensation in instances of self-employment or where exposure was caused by washing clothes of a relative or from other environmental factors perhaps living near a factory where asbestos was produced.