Peritoneal Mesothelioma

Peritoneal mesothelioma forms in the lining of the abdomen, called the peritoneum. It makes up around 10% of mesothelioma diagnoses and has the best prognosis of all types. Symptoms include abdominal pain, bloating, and fluid buildup in the abdomen. Surgery with heated chemotherapy has helped some peritoneal mesothelioma patients survive for 5+ years.

Learn About Your Diagnosis

What Is Peritoneal Mesothelioma?

Peritoneal mesothelioma is an asbestos-caused cancer that develops in the peritoneum. The peritoneum is a thin membrane that covers the abdominal cavity and the organs inside it, such as the stomach, liver, spleen, and intestines.

Peritoneal Mesothelioma infographic
Peritoneal mesothelioma is usually caused by ingesting asbestos fibers that travel from the digestive or lymphatic systems to the peritoneum. The fibers can mutate into cancerous cells after many years.

More rare than its counterpart that develops in the lungs, peritoneal mesothelioma affects about 600 Americans each year.

Despite being the second most common type of mesothelioma, peritoneal mesothelioma has the most favorable prognosis. Patients who undergo cytoreductive surgery with HIPEC live for 5 years or more, in many cases.

How Peritoneal Mesothelioma Develops

  1. Exposure: Asbestos fibers are swallowed or inhaled and become trapped in the stomach lining.
  2. Buildup: Over time, the fibers irritate healthy cells and damage cell DNA, causing cancer cells to grow and the peritoneum to thicken.
  3. Damage: Mesothelioma cells continue growing and spreading, eventually forming tumors.
  4. Cancer: The invasive peritoneal tumors progress rapidly until treatments help to slow their growth.

Who Is at Risk for Peritoneal Mesothelioma?

People at high risk of asbestos exposure are generally more likely to develop peritoneal mesothelioma. High-risk groups include blue-collar workers, veterans, and those who live near asbestos mines or natural deposits.

Loved ones of individuals exposed to asbestos may also be at higher risk through secondhand exposure.

“I got peritoneal mesothelioma from working with my dad. He was a subcontractor, and he used to take us with him on his job sites.”

– Brenda W., Peritoneal Mesothelioma Victim

Peritoneal Mesothelioma Symptoms

Common symptoms of peritoneal mesothelioma include:

  • Abdominal fluid buildup (ascites)
  • Abdominal pain
  • Bloating (abdominal distention)
  • Fever and night sweats
  • Fatigue
  • Nausea and vomiting
  • Loss of appetite
  • Unexplained weight loss

The symptoms of malignant peritoneal mesothelioma may not appear until 20-50 years after the initial exposure to asbestos. These symptoms tend to be mild and vague, so many patients aren’t diagnosed until after their cancer has spread.

Peritoneal Mesothelioma Diagnosis

In order to confirm a peritoneal mesothelioma cancer diagnosis, your doctor must perform a biopsy. They may also use imaging tests to look for signs of cancer and rule out other diseases.

Imaging Tests

Imaging tests are the first step in the diagnostic process for peritoneal mesothelioma. Patients who report abdominal pain and swelling may receive X-rays, a computed tomography scan (CT scan), or magnetic resonance imaging (MRI).


Next, if your doctor suspects cancer, they will perform a biopsy. During this procedure, your doctor will collect a fluid or tissue sample and examine it under a microscope to see if cancer cells are present.

Types of biopsies for peritoneal mesothelioma include fine-needle aspiration, core needle biopsy, or diagnostic laparoscopy. Although biopsies are more invasive than imaging tests, doctors rely on them to make a confident diagnosis.

Diagnosing Peritoneal Mesothelioma Stage

Peritoneal mesothelioma is not staged using the typical Tumor Node Metastasis (TNM) cancer staging system because it advances in an unusual way, often remaining in the abdomen instead of spreading to other parts of the body.

Peritoneal mesothelioma is instead classified as early or advanced.

Getting a Second Opinion

Because peritoneal mesothelioma is a rare cancer, even an experienced oncologist can misdiagnose it — which could delay or eliminate the possibility of curative treatment.

If you have any questions about your diagnosis, it’s critical to get a second opinion from a specialized mesothelioma doctor.

We can help you find a specialist near you — call us today at (888) 360-4215 for assistance.

Peritoneal Mesothelioma Prognosis

A mesothelioma prognosis describes the way the cancer is likely to progress and is dependent on factors such as age, mesothelioma cell type, cancer stage, and available treatment options.

Peritoneal mesothelioma has the best survival rate of all mesothelioma types. Patients who are treated with chemotherapy alone have an average life expectancy of 12 months. However, patients who receive surgery plus heated chemotherapy may live for 5 years or more.

In most cases, the most effective way to improve your prognosis is through early detection and prompt treatment. If you are experiencing symptoms of peritoneal mesothelioma, consult your doctor and talk to them about your history of asbestos exposure.

Peritoneal Mesothelioma Treatment

Mesothelioma treatment may be used to increase survival time (curative treatment) or to decrease symptoms (palliative treatment). The standard treatment options for peritoneal mesothelioma are surgery, chemotherapy, and radiation.


Mesothelioma surgery is generally the most effective form of treatment for increasing life expectancy. For patients who are eligible, the most common surgery for peritoneal mesothelioma is cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC).

Cytoreductive surgery with HIPEC has 2 parts:

  1. Cytoreduction: Doctors open a patient’s peritoneal cavity and surgically remove as much visible cancer as possible. This procedure is also called debulking.
  2. HIPEC: Before closing the abdomen, doctors apply heated chemotherapy directly to the area.

When surgeons are able to remove nearly all visible peritoneal mesothelioma tumors through cytoreduction, patients have a median survival of 56.7 months. Those who received a partial resection (removal) of tumors lived for an average of 7.4 months after surgery.

Additionally, cytoreduction with HIPEC is typically most effective for patients with the epithelioid cell type. Their median survival after surgery is roughly 5 times longer than that of patients with sarcomatoid or biphasic cell type.

Chemotherapy and Radiation

Peritoneal mesothelioma patients who cannot undergo cytoreductive surgery with HIPEC may turn to traditional chemotherapy both to extend their lives and reduce their symptoms.

Radiation therapy is generally not used to treat peritoneal mesothelioma because of the many abdominal organs that could be damaged by the high-energy treatment beams.

Palliative Treatment

Palliative treatment helps decrease pain and discomfort and increase quality of life. Palliative treatment options for peritoneal mesothelioma include standard chemotherapy, alternative therapies, and paracentesis, which involves draining excess fluid from the abdomen.

Clinical Trials

Through clinical trials, patients with peritoneal mesothelioma can access emerging treatments that may help them if traditional treatment options are not effective or available.

Emerging treatments for peritoneal mesothelioma include:

  • Anti-angiogenesis
  • Chemotherapy drug advancements
  • Gene therapy
  • Immunotherapy

Talk to your mesothelioma doctor to determine your eligibility for participating in a clinical trial.

Find Support After a Peritoneal Mesothelioma Diagnosis

The total estimated cost for mesothelioma treatment is around $400,000-$600,000. That said, victims and their families have many financial support options for their treatment expenses.

Learn more about compensation options that may be available to patients with peritoneal mesothelioma by clicking the icons below.

Following a cancer diagnosis, the high costs of care shouldn’t be an additional burden. The Mesothelioma Cancer Network team is available 24/7 to answer your questions and provide support and resources, contact us today.

Mesothelioma Support Team
Reviewed by:Dr. Mark Levin

Certified Oncologist and Hematologist

  • Fact-Checked
  • Editor

Mark Levin, MD has nearly 30 years of experience in academic and community hematology and oncology. In addition to serving as Chief or Director at four different teaching institutions throughout his life, he is also still a practicing clinician, has taught and designed formal education programs, and has authored numerous publications in various fields related to hematology and oncology.

Dr. Mark Levin is an independently paid medical reviewer.

Stephanie KiddWritten by:


Stephanie Kidd grew up in a family of civil servants, blue-collar workers, and medical caregivers. Upon graduating Summa Cum Laude from Stetson University, she began her career specializing in worker safety regulations and communications. Now, a proud member of the American Medical Writers Association (AMWA) and Editor-in-Chief of the Mesothelioma Cancer Network, Stephanie serves as a voice for mesothelioma victims and their families.

View 14 Sources
  1. Kim, J., Bhagwandin, S., & Labow, D. M. (2017). Malignant peritoneal mesothelioma: a review. Annals of translational medicine, 5(11), 236. Retrieved August 26, 2020, from doi:10.21037/atm.2017.03.96
  2. The American Cancer Society medical and editorial content team. (2017). Core Needle Biopsy of the Breast. Retrieved January 16, 2020, from
  3. U.S. National Library of Medicine. (2018). Diagnostic laparoscopy. Retrieved January 16, 2020, from
  4. Sugarbaker, P. H. (2019). Laparoscopy in the diagnosis and treatment of peritoneal metastases. Annals of Laparoscopic and Endoscopic Surgery, 4(42). Retrieved January 16, 2020, from doi: 10.21037/ales.2019.04.04
  5. Schaub, N. P., Alimchandani, M., Quezado, M., Kalina, P., Eberhardt, J. S., Hughes, M. S., … Avital, I. (2013). A novel nomogram for peritoneal mesothelioma predicts survival. Annals of surgical oncology, 20(2), 555–561. Retrieved January 16, 2020, from doi:10.1245/s10434-012-2651-5
  6. Lederman, G. S., Recht, A., Herman, T., Osteen, R., Corson, J., Antman, K. H. (1987). Long-term survival in peritoneal mesothelioma. The role of radiotherapy and combined modality treatment. Cancer(28). Retrieved January 16, 2020, from doi: 10.1002/1097-0142(19870601)59:11<1882::aid-cncr2820591107>;2-0
  7. Kaya, H., Sezgı, C., Tanrıkulu, A. C., Taylan, M., Abakay, O., Sen, H. S., Abakay, A., Kucukoner, M., & Kapan, M. (2014). Prognostic factors influencing survival in 35 patients with malignant peritoneal mesothelioma. Neoplasma,61(4), 433-438. Retrieved January 16, 2020, from doi:10.4149/neo_2014_053
  8. Magge, D., Zenati, M.S., Austin, F., Mavanur, A., Sathaiah, M., Ramalingam, L… & Choudry, H.A. (2014). Malignant Peritoneal Mesothelioma: Prognostic Factors and Oncologic Outcome Analysis. Annals of Surgical Oncology, 21(4), 1159-1165. Retrieved January 16, 2020, from
  9. Moffitt Cancer Center. (n.d.). Debulking Cytoreductive Surgery for Ovarian Cancer. Retrieved January 16, 2020, from
  10. Mesothelioma Applied Research Foundation. (n.d.). Treatment for Peritoneal Mesothelioma. Retrieved January 16, 2020, from
  11. Munkholm-Larsen, S., Cao, C. Q., & Yan, T. D. (2009). Malignant peritoneal mesothelioma. World journal of gastrointestinal surgery, 1(1), 38–48. Retrieved January 16, 2020, from doi:10.4240/wjgs.v1.i1.38
  12. Bagnyukova, T. V., Serebriiskii, I. G., Zhou, Y., Hopper-Borge, E. A., Golemis, E. A., & Astsaturov, I. (2010). Chemotherapy and signaling: How can targeted therapies supercharge cytotoxic agents?. Cancer biology & therapy, 10(9), 839–853. Retrieved January 16, 2020, from doi:10.4161/cbt.10.9.13738
  13. Marinaccio, A., Corfiati, M., Binazzi, A., Di Marzio, D., Scarselli, A., Ferrante, P., … ReNaM Working Group (2018). The epidemiology of malignant mesothelioma in women: gender differences and modalities of asbestos exposure. Occupational and environmental medicine, 75(4), 254–262. Retrieved January 16, 2020, from doi:10.1136/oemed-2016-104119
  14. Mazurek, J.M., Syamlal, G., Wood, J.M., Hendricks, S.A., & Weston, A. (2017). Malignant Mesothelioma Mortality — United States, 1999–2015. MMWR and Morbidity and Mortality Weekly Report, 66(8), 214-218. Retrieved January 16, 2020, from icon
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