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What To Know About Peritoneal Mesothelioma
Peritoneal mesothelioma is a cancer that develops in the membrane that lines the abdomen and its organs, known as the peritoneum. Asbestos exposure is its most common risk factor.
Peritoneal mesothelioma is a type of cancer that currently has no cure. Still, a combination of treatments, including surgery and palliative care, can help manage the condition, improve a person's outlook, and enhance a person's quality of life.
This article will discuss peritoneal mesothelioma, including its symptoms, risk factors, causes, diagnosis, and treatment.
Peritoneal mesothelioma is the second most common type of mesothelioma, and it involves the peritoneum. The peritoneum is a membrane that surrounds the organs in the abdomen, such as the intestines and the liver.
Generally, though, it is a rare type of cancer.
Getting an early diagnosis of peritoneal mesothelioma can be difficult. This is because it is an aggressive type of cancer that spreads to surrounding organs quickly.
According to a 2023 review, the incidence of peritoneal mesothelioma in the United States is 19.4 million cases among males and 4.1 million cases among females. The same review also estimates about 15,000 new confirmed cases of peritoneal mesothelioma each year.
Asbestos exposure is one of the most common causes of peritoneal mesothelioma and is responsible for about a third of cases. However, people can develop this cancer even without being exposed to asbestos.
Individuals who have occupational exposure to asbestos are at a higher risk of peritoneal mesothelioma. These may include those who work in construction, electrical work, roofing, plumbing, or the automotive industry.
Exposure to radiation or certain minerals may cause peritoneal mesothelioma. A person may be exposed to radiation due to undergoing radiation treatment.
A 2022 study also reports that people with certain gene variations, especially those associated with the BAP1 gene, may have a higher risk of developing mesothelioma, including peritoneal mesothelioma. The BAP1 gene plays an important role in preventing tumor growth.
While anyone can develop peritoneal mesothelioma, it is more common in advanced adulthood.
Doctors often find it challenging to diagnose peritoneal mesothelioma, especially in its early stages, since it does not usually produce any symptoms. They may sometimes misdiagnose peritoneal mesothelioma since its symptoms are similar to many other types of cancer.
The median age at the time of diagnosis is 63.3 years of age. Generally, though, it usually occurs in people around the ages of 40 to 50 years who have had exposure to asbestos.
Staging
Doctors use a cancer staging system called the peritoneal cancer index (PCI) to determine how advanced peritoneal mesothelioma is.
The PCI divides the belly into 13 sections and assigns each area a score from 0 to 3. Zero means no cancer, and 3 means the cancer is prevalent in that area. The doctor adds up all the scores to determine the cancer stage.
Stage 1 is the least advanced stage of cancer, while stage 4 is the most advanced.
Currently, there is no cure for peritoneal mesothelioma. Treatment depends on the stage of the cancer and the symptoms a person experiences. It aims to improve a person's outlook and quality of life.
Cytoreduction with hyperthermic intraperitoneal chemotherapy (HIPEC)
The first-line treatment for peritoneal mesothelioma is cytoreduction with HIPEC. This consists of undergoing surgery, where a doctor removes all tumors from the abdomen and the organs where cancer has spread, and then receiving HIPEC.
HIPEC is a type of chemotherapy that uses a safe temperature of 43°C and is applied directly to the abdomen. The heat makes chemotherapy stronger than a regular dose of the same drug, and it helps kill any remaining cancer cells that the doctor may have missed during cytoreduction surgery.
Surgery
Doctors may perform a peritonectomy (removal of the peritoneum) to treat peritoneal mesothelioma. If cancer has spread to other organs, such as the spleen, the gallbladder, or sections of the bowel, doctors may also remove them during the same procedure.
Immunotherapy
This approach uses drugs to activate the immune system to find and kill cancerous cells. However, this is not a first-line treatment for peritoneal mesothelioma. Still, doctors may sometimes recommend it depending on a person's cancer stage and symptoms.
Chemotherapy
Doctors may prescribe systemic chemotherapy if a person with peritoneal mesothelioma cannot undergo cytoreduction with HIPEC. The medication travels around the body through the bloodstream.
Chemotherapy may consist of a combination of drugs that can help kill cancer cells and slow down their growth. It aims to improve symptoms and a person's life expectancy.
Targeted therapy
Targeted therapy may help people who develop peritoneal mesothelioma due to a genetic mutation.
This therapy type targets genetic changes that cause the growth of healthy cells into cancer cells.
Radiation therapy
Radiation therapy may help kill cancer cells in small areas of the body following surgery. Radiation therapy may also be given as part of palliative care to ease symptoms linked to peritoneal mesothelioma, such as abdominal pain.
However, it is not a first-line treatment, since peritoneal mesothelioma does not usually grow as a single distinct tumor.
There is no cure for peritoneal mesothelioma, but receiving appropriate treatment can improve life expectancy. This, however, also depends on the stage of cancer at diagnosis.
Generally, the 5-year survival rate for people with peritoneal mesothelioma after receiving the diagnosis is about 30%. This statistic does not take into account the following factors:
People who receive a diagnosis today may be more likely to have a better outlook than the people considered for this statistic.
Peritoneal mesothelioma is a type of cancer that develops in the peritoneum, the membrane that lines the abdomen and its organs. The most common cause of peritoneal mesothelioma is asbestos exposure, causing about one-third of cases.
There is no cure for peritoneal mesothelioma, and doctors find it difficult to diagnose since it displays symptoms that are similar to many other types of cancer. However, several treatment options are available to manage peritoneal mesothelioma symptoms and improve life expectancy.
Your Guide To Stage 3 Breast Cancer Treatment
Stage 3 breast cancer treatment typically includes surgery and often involves several other therapies.
If you've received a stage 3 breast cancer diagnosis, the cancer has one or many of the following features:
Treating stage 3 breast cancer involves surgical removal of the tumor and surrounding tissue. Typically, it also includes systemic therapy to remove cancer cells from the body. Radiation and chemotherapy are also common treatment approaches.
Some people, depending on their subtype of breast cancer, may also receive targeted therapy for 1 year or more after active treatment to prevent the cancer coming back.
If treatment stops working, you can discuss your options with your doctor.
Stage 3 breast cancer treatment can involve a few different therapies. Your doctor will recommend a therapeutic combination based on:
Surgery
Surgery is usually a part of stage 3 breast cancer treatment. Some people have surgery first, while others have other treatments to try to shrink the tumor before getting surgery.
Types of surgery for stage 3 breast cancer include:
Radiation therapy
Radiation is typically done after surgery for stage 3 breast cancer. Radiation is high energy rays or particles that destroy cancer cells. There are two main types of radiation for breast cancer treatment:
Doctors choose where to aim radiation based on the type of surgery and the risk of the cancer coming back.
For example, if you have breast-conserving surgery, you might receive whole breast radiation. After those radiation treatments end and there's a high risk of recurrence, you might get extra radiation where the cancer was removed.
Chemotherapy
Chemotherapy is a type of drug therapy in which medications are given through a vein or by mouth. The drugs move through the bloodstream to target cancer cells.
For stage 3 breast cancer, chemotherapy is often neoadjuvant (before surgery) treatment, although not always. The goal is to shrink the tumor so less tissue has to be removed.
In some people, this might mean having the option of breast-conserving surgery if they prefer not to get a mastectomy.
Targeted therapy
Targeted therapy is a special kind of drug therapy. It works on specific proteins in cancer cells. Because not every type of breast cancer cell has these proteins, you can only benefit from targeted therapy if you have certain types of breast cancer.
Hormone therapy
Hormone therapy is a type of therapy that stops the growth of hormone receptor-positive tumors by stopping the effects of hormones on cancer cells or by changing how the body makes hormones.
People with hormone receptor-positive cancers get hormone therapy at the same time as trastuzumab (Herceptin). In cases when people are taking abemaciclib, doctors typically combine it with a hormonal therapy, such as with:
Immunotherapy
The timeline of breast cancer treatment is different for every person. For most people with stage 3 breast cancer, active treatment lasts about 1 year, including presurgery (neoadjuvant) treatment. In addition, you might have targeted treatments for 1 to 2 years, depending on the type of therapy.
Each type of treatment has its own side effects. Many of these, such as fatigue or nausea, might end once treatment is over.
Sometimes, there are long-term side effects of breast cancer treatment, such as osteoporosis, lymphedema, and longer-term fatigue.
Survival rates for breast cancer use data from large numbers of people to estimate a person's chance of surviving cancer at a given stage. Because survival rates are only estimates, they don't predict your individual outlook after a diagnosis.
Later stage breast cancers are either regional or distant. Regional cancer is when the cancer has spread to nearby lymph nodes. Distant cancer is when the cancer has spread to distant sites in the body.
Five-year relative survival rates compare people with a certain condition 5 years after diagnosis with those who do not have that condition.
After you have finished breast cancer treatment, your care team will schedule follow-up appointments. These visits can help you manage any symptoms. They also allow your doctors to monitor for any recurrence of the cancer.
If you have symptoms or a finding on a physical exam that suggests breast cancer has come back, your doctor might order blood tests or imaging tests, like a CT or PET scan, to check for recurrence.
Signs it's time to try a new treatment method
If your treatment ends and your cancer comes back, it might be time to try a different method for treating the cancer.
Similarly, if treatment has not stopped the cancer from growing, your doctor might suggest looking at different treatment strategies.
If you're experiencing any side effects, discuss them with a doctor. They can prescribe additional medications to help ease those effects while you still continue with your breast cancer treatment.
Bristol Immunotherapy Improves Responses In Lung Cancer, Setting Up Phase 3 Study
BARCELONA, Spain — Adding a second immunotherapy from Bristol Myers Squibb to an existing checkpoint inhibitor and chemotherapy improved responses for certain patients with a type of lung cancer, steering the approach into a Phase 3 study.
The Phase 2 RELATIVITY-104 trial was another hurdle for Bristol's Opdualag, which is essentially a combination of the company's powerhouse PD-1 inhibitor Opdivo and relatlimab, which targets another checkpoint called LAG-3. Opdualag is approved in advanced melanoma, but the drug has failed in some colorectal and liver cancer indications. The dose tested in the lung cancer study was higher than the one approved in melanoma.
The new study tested relatlimab with Opdivo and chemotherapy versus Opdivo and chemotherapy alone as a first-line treatment in advanced non-small cell lung cancer, with the aim to find which patients benefited from adding the anti-LAG-3 drug to the backbone of chemotherapy and immunotherapy, Samit Hirawat, Bristol's chief medical officer, told STAT.
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