Peritoneal mesothelioma is the second most common type of this cancer, accounting for 10%-30% of all cases. Irritation from asbestos exposure can cause mesothelioma tumors to grow in the abdominal lining. Surgery and heated chemotherapy can improve outcomes and relieve symptoms.
Written by: Karen Selby, RN | Medically Reviewed By Dr. Jacques Fontaine | Edited By Walter Pacheco | Last Update: February 25, 2025
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Peritoneal mesothelioma is a rare type of malignant cancer. It affects the peritoneum, which is the tissue that lines your abdominal cavity. This cancer is also known as abdominal mesothelioma and can cause stomach pain, swelling and digestive issues.
Asbestos exposure is the main cause of peritoneal mesothelioma. Inhaled asbestos fibers can get stuck in tissue and cause irritation. Over time, this irritation can change cells and make them cancerous.
Key Facts About Peritoneal Mesothelioma
Early detection is crucial for better treatment options and patient outcomes. However it can be challenging. Most people don’t develop symptoms until many decades after their asbestos exposure. Signs of peritoneal mesothelioma can also look like other diseases.
The most common symptoms of mesothelioma are ascites or fluid buildup, abdominal pain and bloating. Fluid in the abdomen puts pressure on internal organs causing pain and discomfort.
Epifanio Figueroa tells us his first sign of peritoneal mesothelioma was abdominal swelling. He shares, “It started with my stomach growing and it didn’t stop getting bigger. It was liquid that was being accumulated. It was from mesothelioma, but we didn’t know that at the time.”
Peritoneal Mesothelioma Symptoms
Other signs are changes in bowel movements, weight loss or fever. A 2023 report in Radiology Case Reports reported the risk of bowel obstruction with peritoneal mesothelioma. Early stage mesothelioma typically usually exhibits mild abdominal discomfort affecting the digestive system or changes in bowel habits.
Late stage mesothelioma will include significant abdominal pain, fluid buildup, weight loss, fatigue, nausea, vomiting and bowel obstruction. Rare and severe symptoms include, blood clots and fluid buildup in other places such as around the lungs (pleural effusion) or sac around the heart (pericardial effusion).
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Connect NowLong-term asbestos exposure is the primary cause of peritoneal mesothelioma. Regular asbestos exposure at work or in the military can be a major risk factor for malignant mesothelioma. Once inhaled or ingested, asbestos fibers can become trapped in the body.
If you have a history of asbestos exposure, let your doctor know. You could be at a higher risk of developing peritoneal or pleural mesothelioma, which develops in the lining of the lungs and is the most common type of mesothelioma. Your doctor may recommend regular mesothelioma screenings for you.
Exposure to asbestos is the largest risk factor for peritoneal mesothelioma. Most people are exposed at work.
Duration of the exposure plays a key role in the likelihood of the disease developing. There is no safe level of asbestos exposure. Even short-term exposure isn’t safe.
Common Risk Factors for Peritoneal Mesothelioma
Family members of asbestos workers are also at a higher risk of exposure. Occupational exposure can lead to secondary exposure. Workers can take asbestos fibers home on their clothes, hair or skin. Doing laundry, hugging a loved one in their work clothes and touching contaminated gear can lead to secondary exposure.
We spoke to mesothelioma survivor James D. about his peritoneal mesothelioma. He told us the exposure happened while working as a mechanic in Chicago. Many survivors also tell us they were exposed to asbestos while serving in the U.S. Armed Forces.
“I spend most of my time now helping others,” Tammy Frank said from her home in Cartersville, Georgia. “I never, ever thought I’d still be here 20 year later. I’ve been blessed. So I must be here for a reason.”
Diagnosing peritoneal mesothelioma is tough. Most people don’t show symptoms in the early stages. A biopsy or tissue sample is the only way to diagnose peritoneal mesothelioma, but other tests are also used in the diagnostic process.
Trina Reif, a 20-year survivor of peritoneal mesothelioma, for example had an exploratory laparotomy and peritoneal biopsies before her diagnosis. She first experienced fluid in her abdomen. Her doctor, Dr. Anton Strocel, tells us, “She presented to me with unexplained ascites (excess abdominal fluid).”
Diagnostic Tests
Your mesothelioma diagnostic process will likely first involve X-rays or CT scans. Your doctor may also order blood tests and MRIs.
A pathologist will examine a tissue sample from your biopsy. They’ll look for epithelioid, sarcomatoid or biphasic mesothelioma cell types. Your doctor will use this information to develop a treatment plan that’s best for your specific mesothelioma cell type.
Peritoneal mesothelioma staging shows how far the disease has spread. The Peritoneal Cancer Index is the system most used to stage peritoneal mesothelioma. PCI measures the size and spread of tumors in the abdomen. This information can help determine treatment options.
In stage 1, or early-stage peritoneal mesothelioma, the cancerous tissue is small. Tumors are only within the abdominal lining and lymph nodes are free of cancer. In stage 2, or mid-stage peritoneal mesothelioma, cancerous tissue is moderate. Tumors haven’t spread outside the lining or into lymph nodes. During stage 3 and stage 4, or late-stage mesothelioma, the cancerous tissue spreads more widely.
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The treatments your doctor will recommend for you will vary depending on your disease stage, health and treatment goals. A combination therapy plan, or multimodal approach, using HIPEC may be the best treatment option. But not all patients qualify for surgery. You may also be able to enroll in a clinical trial to access new and experimental therapies.
Most Common Treatment Options
Dr. Joseph Skitzki, a surgical oncologist at Roswell Park Comprehensive Cancer Center, regularly performs HIPEC for his peritoneal mesothelioma patients. He explains, “The results are quite impressive. About 80% of patients who are eligible for the treatment will be alive at 5 years, and about half of that number without any further evidence of disease.”
Finding the right specialist is key for treating peritoneal mesothelioma. Experts in this field know the unique challenges of this rare disease. Your doctor can refer you to a specialist and Patient Advocates can help you find the right doctor and cancer center for you.
Finding a top mesothelioma treatment center can help ensure the best outcome for you. Top mesothelioma treatment centers offer clinical trials and support services for patients and their families. Experience matters when treating rare cancers like peritoneal mesothelioma.
The average life expectancy for peritoneal mesothelioma is about 31 months after diagnosis. Treatment options and prompt treatment can affect your prognosis. Early detection and HIPEC surgery boost survival rates.
Aggressive treatments such as surgery help about 50% of patients live 5 years or more. Patients without treatment have a life expectancy of 6 to 8 months. Adopting healthy habits and new treatments may extend life expectancy.
Peritoneal Survival Rates
Age, gender, genetics, the stage of mesothelioma, cell type and tumor location can affect your prognosis. Women usually have a better outlook than men for peritoneal mesothelioma. People with the epithelioid cell type also typically have a better prognosis as it responds better to treatment. Your prognosis also improves if all tumors are able to be completely removed.
Get help paying for mesothelioma treatment by accessing trust funds, grants and other options.
Get Help NowLiving with peritoneal mesothelioma can be tough. However, a solid support system of family, friends and health care providers makes a big difference. Both patients and caregivers may face physical and emotional issues. Rest, proper nutrition and gentle movement can help you feel your best.
Collaborating with your medical team helps you get the right care. This support is key for managing symptoms and enjoying a better quality of life. Meeting and talking to others who are on a similar journey as yourself can also help. Joining a support group is a great way to find relief when dealing with hurdles of your diagnosis.
There is no cure for peritoneal mesothelioma. However, with treatment, outcomes can improve. For example, HIPEC with cytoreductive surgery and long-term chemo boosts survival more than 5 years. About 75% of people who undergo HIPEC live longer than 5 years.
Unlike malignant mesothelioma, benign mesothelioma is noncancerous and isn’t life threatening. Another rare subtype is papillary mesothelioma. Its most common type is benign.
Yes, it can go into remission. About 12% of peritoneal mesothelioma patients who get aggressive treatment have complete remission. Partial remission is also possible. Remission isn’t the same as a cure. Doctors watch patients closely. Cancer can return after remission.
Managing a cancer diagnosis is challenging for patients and their loved ones. There is no one right way to cope with mesothelioma. Knowing the details of your diagnosis can help you decide. Talking to a counselor, joining a support group, and eating well are all helpful. So are relaxing and exercising to manage your mental health.
Compensation for peritoneal mesothelioma can help pay for treatment. Legal options include lawsuits, settlements and trust funds.
Effective communication with your doctor is key. Here’s a short list of questions to ask.
Prepare questions before medical appointments. It’ll help you communicate with care providers. You will also have more control over your diagnosis and treatment.
Peritoneal mesothelioma is often misdiagnosed. It happens because of its non-specific symptoms. Many patients are first
Peritoneal mesothelioma is often misdiagnosed. It happens because of its non-specific symptoms. Many patients are first diagnosed with IBS, ovarian cancer or other gut issues. Later, they receive an accurate mesothelioma diagnosis.
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My family has only the highest compliment for the assistance and support that we received from The Mesothelioma Center. This is a staff of compassionate and knowledgeable individuals who respect what your family is experiencing and who go the extra mile to make an unfortunate diagnosis less stressful. Information and assistance were provided by The Mesothelioma Center at no cost to our family.LashawnMesothelioma patient’s daughter
Asbestos.com. (2025, March 17). Peritoneal Mesothelioma. Retrieved March 20, 2025, from https://www.asbestos.com/mesothelioma/peritoneal/
"Peritoneal Mesothelioma." Asbestos.com, 17 Mar 2025, https://www.asbestos.com/mesothelioma/peritoneal/.
Asbestos.com. "Peritoneal Mesothelioma." Last modified March 17, 2025. https://www.asbestos.com/mesothelioma/peritoneal/.
Dr. Jacques Fontaine is a thoracic surgeon at Moffitt Cancer Center in Tampa, Florida, where he heads up the Mesothelioma Research and Treatment Center. He specializes in minimally invasive robotic surgery and aggressive surgeries for mesothelioma.
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