Peritoneal Mesothelioma

Peritoneal mesothelioma cancer develops in the lining of the abdomen decades after asbestos exposure. This cancer can quickly reach major internal organs if it’s not diagnosed early on. Thankfully, treatment options are available for peritoneal mesothelioma and some patients live for many years. Get help if you or a loved one has peritoneal mesothelioma.

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What Is Peritoneal Mesothelioma?

Malignant peritoneal mesothelioma is a cancer that develops in the peritoneum (the lining of the abdominal cavity). It is the second most common type of mesothelioma, accounting for 10-15% of cases.

Mesothelioma of the peritoneum typically develops decades after exposure to asbestos, a very durable yet dangerous mineral. Many symptoms of peritoneal mesothelioma – including abdominal pain, swelling, and weight loss – don’t appear until the cancer has already spread, by which point it’s harder to treat.

Peritoneal mesothelioma is very aggressive and can be deadly. However, peritoneal mesothelioma patients may be able to get treatments like abdominal surgery and chemotherapy to live longer.

Peritoneal mesothelioma responds better to treatments than most other types of this cancer, so many patients can live for years after a diagnosis. A handful of peritoneal mesothelioma patients have even lived for 15-20 years or more because of treatments.

Mesothelioma Resource Group has a nursing support team that can help you find abdominal mesothelioma treatments in less time. We can also pursue financial aid for you so you can afford the treatments you need to help you live longer.

Find out if you’re eligible with a free mesothelioma guide.

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Peritoneal Mesothelioma Causes

The only known cause of peritoneal mesothelioma is asbestos exposure.

Asbestos was used between the 1930s and 1980s in dozens of industries, like construction work and shipbuilding. Asbestos is fireproof and very durable – but it also gives off tiny fibers if disturbed. If you breathe in or swallow the fibers, you could develop mesothelioma or other illnesses later in life.

The American Cancer Society (ACS) notes that asbestos fibers can reach the abdominal lining if swallowed. Once there, the fibers will remain trapped and irritate healthy mesothelial cells.

After 10-50 years of irritation from the fibers, cellular mutations can be triggered and mesothelioma tumors may start to form.

Manufacturers of asbestos-based products knew their goods led to life-threatening illnesses but said nothing as they wanted to keep making money. They could be responsible for causing your peritoneal mesothelioma – and you may be able to hold them financially accountable. Some past mesothelioma patients have received $1 million or more from these companies with our help.

Who Is at Risk of Peritoneal Mesothelioma?

Anyone exposed to asbestos fibers could develop mesothelioma 10-50 years after the fact, as the cancer has a long latency period (time between exposure and symptoms).

Men at Risk of Peritoneal Mesothelioma

Men are at the greatest risk of developing peritoneal mesothelioma. In 2017 a study published in the medical journal Lung Cancer International found that 56% of peritoneal mesothelioma patients were men. In the 20th century, asbestos-containing products were commonly used in jobs that usually employed men (like construction work).

Women are also at risk of developing peritoneal mesothelioma. It’s not known exactly why many women who do not work around asbestos develop mesothelioma, but secondhand asbestos exposure could be to blame.

For example, asbestos fibers could stick to male workers’ hair, skin, and clothing. The fibers could then travel home with them, putting their wives and children at risk of mesothelioma.

Peritoneal Mesothelioma Symptoms

The symptoms of peritoneal mesothelioma typically affect the abdomen. Patients usually won’t have any mesothelioma symptoms until the cancer has spread, though.

Common symptoms of peritoneal mesothelioma include:

  • Abdominal pain and swelling
  • Ascites (fluid buildup in the abdominal lining)
  • Changes to bowel movements
  • Constipation
  • Fever
  • Loss of appetite
  • Nausea and vomiting
  • Night sweats
  • Pain in the ribs and/or upper back
  • Weight loss

Some peritoneal mesothelioma symptoms are more commonly reported than others. For example, swelling of the abdomen is often the first reported symptom and is found in up to 80% of all patients. Pain in the abdomen and ascites are two other very common peritoneal mesothelioma symptoms.

How Is Peritoneal Mesothelioma Diagnosed?

The MD Anderson Cancer Center notes that between 300 and 500 peritoneal mesothelioma patients are diagnosed each year.

There are three common steps to getting a peritoneal mesothelioma diagnosis:

Initial Doctor’s Visit

If you’re concerned that you might have peritoneal mesothelioma, schedule a visit with your doctor.

Make sure to tell doctors:

  1. Your symptoms, when they started, and if they’re getting worse
  2. If you or a loved one was ever exposed to asbestos
  3. If other family members have had cancer
  4. If you’re worried that you could have cancer

Your doctor may recommend getting tested for peritoneal mesothelioma after this initial visit.

Imaging Scans and Other Tests

Doctors can use a couple of different tests to look inside your body to determine whether you might have peritoneal mesothelioma.

The first test is often a computed tomography (CT) scan. If doctors see solid masses in the abdominal cavity on a CT scan, they may think you have peritoneal mesothelioma. Doctors may use other tests like a magnetic resonance imaging (MRI) scan to see how far the cancer has spread.

Doctors may also check for thickening or growths on the omentum (part of the peritoneum that folds over the stomach) or scalloping (indenting) of abdominal organs like the spleen or liver.


If doctors think you have mesothelioma after taking imaging scans, they will recommend getting a biopsy to confirm the diagnosis. A biopsy is a procedure where doctors remove a tiny sample of fluid or tissue from an area that could be cancerous.

The biopsy sample is then delivered to a lab for review under a microscope to see whether peritoneal mesothelioma cells are present.

Did You Know?

A biopsy is the only way to confirm that you have peritoneal mesothelioma. Once you’ve been diagnosed, doctors can recommend treatments to help you live longer.

Have you or a loved one recently been diagnosed with peritoneal mesothelioma? Mesothelioma Resource Group may be able to help you find treatments and financial aid. Call (888) 360-2406 now.

Issues With Diagnosing Peritoneal Mesothelioma & Misdiagnosis

Peritoneal mesothelioma is very rare and shares symptoms with many other health issues, most of which are not life-threatening cancers. Because of these factors, it takes an average of 122 days (about 4 months) to diagnose peritoneal mesothelioma after the symptoms first appear.

Further, some peritoneal mesothelioma patients could be diagnosed with the wrong health condition. This is dangerous, as a misdiagnosis may allow the cancer more time to spread and worsen – giving patients less time to live.

Peritoneal mesothelioma can be misdiagnosed as:

  • Intestinal problems
  • Lymphoma that spread to the abdomen lining
  • Other peritoneal cancers
  • Ovarian cancer
  • Tuberculosis affecting the gastrointestinal tract

Some patients can even have both colorectal cancer and peritoneal mesothelioma at the same time, which can be confusing to properly diagnose.

Diagnosing Peritoneal Mesothelioma Cell Types

Doctors can see which mesothelioma cell type is present as part of a diagnosis. Peritoneal mesothelioma tumors can be made up of two different types of cancer cells. Some tumors contain both mesothelioma cell types.

Peritoneal mesothelioma cell types include:

  • Epithelioid mesothelioma: Also known as epithelial mesothelioma, this cell type accounts for 75-90% of peritoneal mesothelioma cases. Epithelioid mesothelioma is the easiest type to treat since the cells stick together and spread less quickly than the other types.
  • Sarcomatoid mesothelioma: This is the most aggressive and least common mesothelioma cell type. Only a small percentage of peritoneal mesothelioma tumors are made up of just sarcomatoid cells. Sarcomatoid mesothelioma cells spread rapidly and are very hard to treat.
  • Biphasic mesothelioma: A biphasic mesothelioma tumor is made up of both epithelial and sarcomatoid cells. Roughly 1 in 4 peritoneal mesothelioma patients will have biphasic mesothelioma. If there are more epithelioid cells present, the tumor will be easier to treat.

Peritoneal Mesothelioma Prognosis

A prognosis is the projected outcome after someone is diagnosed with a health condition. While a peritoneal mesothelioma prognosis is often poor, some patients may be able to achieve long-term survival.

Prognostic factors like a patient’s age and overall health, cancer spread, and cell type all play a role in what happens after a peritoneal mesothelioma diagnosis.

Doctors use two main statistics to measure prognosis: life expectancy and survival rate. View survival statistics for peritoneal mesothelioma below.

Peritoneal Mesothelioma Life Expectancy

Patients with peritoneal mesothelioma have an average life expectancy of 53 months, provided they’re treated with life-extending surgery and heated chemotherapy.

Median survival times are much worse if peritoneal mesothelioma patients don’t get treated. Life expectancies range from just 6 months to 1 year without treatment.

Peritoneal Mesothelioma Survival Rates

Survival rates are based on the number of patients that are alive after a certain amount of time has passed. Peritoneal mesothelioma survival rates are often measured in years.

Peritoneal mesothelioma survival rates include:

  • 1-year survival rate: 81%
  • 3-year survival rate: 60%
  • 5-year survival rate: 47%

In the survival rates listed above, all the patients were treated with chemotherapy and surgery.

Our team can help you find treatments that may improve your peritoneal mesothelioma prognosis. Get started with a free mesothelioma guide.

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Peritoneal Mesothelioma Stages

Most cases of peritoneal mesothelioma are not classified into official stages. Pleural mesothelioma is the only type of this cancer that has its own staging system.

“Staging has not historically been applied to MPM [malignant peritoneal mesothelioma] as the disease usually presents diffusely throughout the abdominal cavity and nodal or extraperitoneal spread is rare.”

– Translational Lung Cancer Research

However, doctors can note if the cancer is localized (contained) or advanced at the time of diagnosis.

  • Localized peritoneal mesothelioma hasn’t spread very far and is easier to treat. The tumors sometimes look like growths on the liver.
  • Advanced peritoneal mesothelioma is quite hard to treat. By this point, metastasis (cancer spread) has occurred so the cancer might be found in the omentum, ovaries, uterus, and/or lymph nodes.

The Cleveland Clinic also notes that the Peritoneal Cancer Index (PCI) could be used to classify peritoneal mesothelioma into four stages. This staging system divides the abdomen into different sections and allows doctors to “grade” the cancer based on how far it has spread.

However, most cases of peritoneal mesothelioma are not staged using the PCI.

Treatments for Peritoneal Mesothelioma

Peritoneal mesothelioma treatments offer patients the best chance at living longer with this cancer. Health care providers have a couple of different treatment options they can use to help peritoneal mesothelioma patients.

Arguably the most effective peritoneal mesothelioma treatment is a combination of abdominal surgery and chemotherapy. Other cancer treatments are being studied in clinical trials to see how effective or helpful they would be for peritoneal mesothelioma patients.

Cytoreductive Surgery With HIPEC

Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) remains the most effective peritoneal mesothelioma treatment. It’s also sometimes called a debulking surgery.

Doctors first use cytoreduction to remove all cancer tumors they can see from the peritoneal cavity. They will then apply chemotherapy that’s heated up to 103 degrees Fahrenheit into the abdomen.

“HIPEC is administered in the operating room right after the CRS (cytoreductive surgery) is completed. It usually takes about 90 minutes and may be an optimal way of ensuring that the chemotherapy is distributed to all the tissues in the abdomen.”

– Dr. H. Richard Alexander, Peritoneal Mesothelioma Specialist

With this mesothelioma surgery, patients can live for 53 months on average. The average 5-year survival rate after cytoreduction with HIPEC is 47%.


If a peritoneal mesothelioma patient can’t safely undergo cytoreduction with HIPEC, doctors may recommend systemic chemotherapy. Unlike HIPEC – which stays in the abdomen – systemic chemotherapy will go through the whole body to destroy cancer cells.

Systemic chemotherapy medications are given either through the veins or the mouth. Common chemotherapy medications used include pemetrexed and cisplatin.

Chemotherapy may also be recommended if a peritoneal patient has biphasic or sarcomatoid mesothelioma, according to Translational Lung Cancer Research.

Radiation Therapy

Through radiation therapy, doctors use X-rays or other energy beams to disrupt the growth of mesothelioma cells.

Radiation therapy is rarely used to treat peritoneal mesothelioma, as surgery and chemotherapy are usually more effective. It may still be used as a palliative (pain-relieving) treatment.

Palliative Treatments

Doctors may use palliative treatments to help ease painful symptoms of peritoneal mesothelioma.

Commonly used palliative treatments include:

  • Debulking surgery: Scaled-back debulking or cytoreductive surgeries may be performed to help peritoneal mesothelioma patients live with less pain.
  • Paracentesis: Doctors can use a paracentesis (needle inserted into the abdominal lining) to drain ascites, which in turn eases pain and swelling. Up to 90% of patients will feel relief after this treatment.
  • Peritoneal catheter: If you experience ascites that keep coming back despite getting them drained, your doctors might recommend a catheter. Catheters will allow you to drain ascites at home, so you can get relief whenever you start to feel unwell.

Doctors may use palliative care as your main course of treatment if the cancer is widespread. You can also get palliative care alongside first-line treatments cytoreduction with HIPEC or chemotherapy if doctors are trying to help you live longer.

Clinical Trials for Peritoneal Mesothelioma

Medical researchers continue to study new ways to treat peritoneal mesothelioma. Many new treatments are being studied in clinical trials taking place across the country.

Clinical trials are currently studying:

  • Enzyme therapy: Researchers are investigating how an enzyme called ADI-PEG 20 can be used alongside chemotherapy to help peritoneal mesothelioma patients. ADI-PEG 20 may stop cancer cells from making an amino acid that they need to grow.
  • Immunotherapy: This treatment boosts the body’s immune response, which is helpful as mesothelioma cells can sometimes escape the immune system otherwise. Immunotherapy is currently approved as a pleural mesothelioma treatment, so doctors are seeing if it can help peritoneal mesothelioma patients too.
  • Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC): With this procedure, doctors administer chemotherapy directly into the abdomen in the form of a spray using a pump. This may allow doctors to kill even more of the cancer than other forms of chemotherapy. Current trials are studying if PIPAC is more effective than other forms of chemotherapy when treating peritoneal mesothelioma.

Medical specialists can help you find peritoneal mesothelioma clinical trials that you might qualify for.

Mesothelioma Resource Group can also help you find top peritoneal mesothelioma treatments and pursue financial aid. Learn more by calling (888) 360-2406 now.

Top Peritoneal Mesothelioma Doctors

There are oncologists (cancer doctors) that work at hospitals across the country to treat peritoneal mesothelioma. Learn about some of the best peritoneal mesothelioma doctors below.

Dr. H. Richard Alexander

Dr. H. Richard Alexander treats peritoneal mesothelioma patients at the Rutgers Cancer Institute in New Jersey. Dr. Alexander’s specialty is surgical oncology. This means he’s very skilled at performing cytoreductive surgery with HIPEC and other treatments to help peritoneal mesothelioma patients.

Did You Know?

As a veteran of the U.S. Navy, Dr. Alexander also understands the issues that U.S. service members face, which is important as 33% of mesothelioma patients are veterans. Ships that Dr. Alexander served on during his Navy service – including the USS Mount Whitney and the USS Midway – were built with asbestos.

Dr. Alexander has also served as chairman of the board of the Mesothelioma Applied Research Foundation (a renowned mesothelioma patient advocacy group) and won many awards for his work.

Dr. Hedy Lee Kindler

Dr. Hedy Lee Kindler treats peritoneal mesothelioma patients at University of Chicago Medicine’s Comprehensive Cancer Center.

Dr. Kindler is at the forefront of peritoneal mesothelioma treatments, helping patients using cytoreductive surgery with HIPEC and studying new therapies too. As a nationally renowned physician, she is consistently recognized as a top doctor by leading publications like Castle Connolly.

Dr. Kindler’s father passed away from mesothelioma, so she can truly empathize with her patients and is dedicated to doing all she can to help.

Dr. James Pingpank

Dr. James Pingpank serves as the associate professor of surgery at UPMC Hillman Cancer Center in Pittsburgh, PA, where he treats peritoneal mesothelioma and other cancers.

Dr. Pingpank has been listed as a Castle Connolly top doctor. He is also a member of leading medical organizations such as the Association for Academic Surgery and the American Society of Clinical Oncology.

Dr. Paul Sugarbaker

Dr. Paul Sugarbaker was one of the most notable doctors treating peritoneal mesothelioma until his retirement in 2021. Dr. Sugarbaker spearheaded the use of cytoreductive surgery with HIPEC and treated more than 1,500 cancer patients using it.

“We are able to cure a lot of patients who previously had no treatments at all.”

– Dr. Paul Sugarbaker, Retired Peritoneal Mesothelioma Specialist

Since his retirement from active surgical treatment, Dr. Sugarbaker has shifted his focus to cancer research. As of 2021, he is analyzing data about cancer patients he helped throughout his career.

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Peritoneal Mesothelioma Survivors

Some peritoneal mesothelioma patients who receive aggressive treatments can outlive their initial prognosis and become long-term survivors.

For example, a woman in her mid-30s was diagnosed with peritoneal mesothelioma in 2006. Though her doctors said she would most likely die, this woman is still alive today – nearly 20 years after her diagnosis – as a result of the treatments she received.

Another woman was diagnosed with peritoneal mesothelioma in her mid-50s after complaining of abdominal bloating. She traveled from Ohio to New York 43 times for treatments. The treatments worked and she was able to live for 15 years after her diagnosis. She passed away without the cancer returning.

These mesothelioma survivors inspire others facing a grim diagnosis. There’s hope to become a long-term survivor, even if you’ve been diagnosed with this life-threatening cancer.

Help for Peritoneal Mesothelioma Patients

Peritoneal mesothelioma can be life-threatening, but the good news is that many patients can live for years after being diagnosed if they have the right medical care. And while treatments could be expensive, you and your family may qualify for financial aid.

Remember: Peritoneal mesothelioma is only caused by asbestos exposure, and manufacturers concealed the dangerous truth for decades. Mesothelioma Resource Group may be able to file claims against these manufacturers and get compensation for you.

Further, our nursing support staff has relationships with top mesothelioma doctors. This means we can help you access top medical treatments in less time.

Learn about the ways we can help you: Get a free mesothelioma guide now.

FAQs About Peritoneal Mesothelioma

What are the symptoms of peritoneal mesothelioma?

Common peritoneal mesothelioma symptoms include ascites (fluid buildup in the abdomen) as well as abdominal pain and swelling.

Most patients will experience swelling of the abdomen before any other symptom, according to a report from the Annals of Translational Medicine.

Peritoneal mesothelioma has a better long-term survival rate than many other types of this cancer, provided that the patients get treated.

The average 5-year survival rate of peritoneal patients who receive cytoreduction with HIPEC is 47%. This means that nearly half of all patients are still alive 5 years after receiving this treatment.

By contrast, only 12% of pleural mesothelioma patients are alive 5 years after diagnosis, according to the ACS.

There’s no cure for peritoneal mesothelioma at this time. However, doctors can perform cytoreductive surgery with HIPEC as a curative treatment. With a curative treatment, some patients may be informally considered cured if there’s no sign of the cancer afterward.

Some peritoneal mesothelioma patients that get cytoreduction with HIPEC can live for long spans of time in remission (where there are no signs or symptoms of the cancer).

Peritoneal mesothelioma patients can live for 53 months (more than 4 years) on average if they undergo cytoreduction surgery with HIPEC. A handful of peritoneal mesothelioma patients have lived for 15-20 years or more following their diagnosis.

However, peritoneal mesothelioma patients may only live for a year or less if they don’t receive any treatments since the cancer is very aggressive.

Peritoneal mesothelioma rarely spreads outside of the abdominal cavity. Instead, it typically invades organs within the abdomen.

Common places peritoneal mesothelioma tumors spread to include lymph nodes, ovaries, uterus, and tissue near the liver.

Doctors can recommend a peritoneal mesothelioma treatment plan based on how far the cancer has spread.

Mesothelioma Symptoms was founded by a team of advocates to educate people about this aggressive form of cancer. Mesothelioma affects thousands of people each year. We help give hope to those impacted by mesothelioma.

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