Combination Therapy Most Effective Treatment for Peritoneal Mesothelioma

A new study, detailed in the September 2009 issue of the European Journal of Surgical Oncology, suggests that the optimal treatment for peritoneal mesothelioma may consist of a combination of cytoreductive surgery and intraperitoneal chemotherapy.
The rarest of all forms of the asbestos cancer mesothelioma, accounting for 20 percent or fewer of all diagnosed, cases, peritoneal mesothelioma affects the membranous lining of the abdominal cavity. Its only established cause is exposure to, and ingestion or inhalation of, asbestos fibers and is generally considered an industrial or occupational disease, as the majority of people are exposed to asbestos while on a job site. The disease can take as long as half a century to develop and be diagnosed, however, and its symptoms are often initially mistaken for the symptoms of other respiratory diseases and conditions. The prognosis for most mesothelioma patients is grim, with an average survival time of less than twenty four months.

Symptoms of peritoneal mesothelioma include abdominal swelling or pain, subcutaneous lumps, change in bowel activity, fatigue and nausea.

The study followed the research of British surgical oncologists as they performed laparotomies (incisions through the abdominal wall) and cytoreductive surgery on 17 peritoneal mesothelioma patients. Cytoreductive surgery, also known as debulking, removes a malignant tumor, or a portion of a malignant tumor, in order to enhance the effectiveness of subsequent radiation treatment or chemotherapy. Of the 17 patients studied, complete cytoreduction was achieved in eight and major debulking in eight. The last patient had only an exploratory laparotomy.

The median survival rate for the patients who experienced total cytoreduction was 3.7 years, whereas those with partial debulking (which was generally done for palliative purposes) survived a median 1.0 years after surgery.

It’s important to remember that each case of peritoneal mesothelioma, and each patient’s prognosis, is different. No single treatment can be considered the most successful without individual analysis of the patient’s overall health, the stage of their mesothelioma, and the location of their tumor. Nevertheless, the study confirms previous researchers’ conclusions that combination therapy is the most effective route to eradicating the symptoms and pain associated with this devastating, and fatal, disease.