Mesothelioma is a rare but aggressive type of cancer related to exposure to asbestos, a natural mineral that can be woven and mixed with cement. Before being proven toxic during the 20th century, it was widely used for about 100 years in industries such as construction, shipbuilding and manufacturing. If undisturbed, asbestos can be harmless, but when it comes in contact with other materials, asbestos fibers can be released into the air. The asbestos fibers can be inhaled or swallowed and cannot be fully expelled by the body. As the fibers become trapped in the mesothelial cells, they irritate the cells, causing the formation of tumors. This process takes decades and it affects different organs.
Mesothelial cells protect and moisten the organs through a lining known as the mesothelium. There are four different types of mesothelioma: pleural, peritoneal, pericardial and testicular mesothelioma, defined according to the location of the tumors, including the lungs, abdomen, heart and testicles, respectively. About 20% of the patients suffer from peritoneal mesothelioma, which occurs when mesothelioma develops in the lining of the abdomen, the peritoneum. There is currently no cure for the disease, but there are treatments that improve the symptoms. Peritonectomy is an option for patients with peritoneal mesothelioma.
Peritonectomy Surgical Procedure
Peritonectomy is the most common surgical procedure used with patients with this form of the disease. The purpose of the surgery is to resect the cancerous cells in the lining of the abdominal cavity. Peritonectomy is often referred as peritonectomy and cytoredutive. During the surgery, the surgeon makes an incision in the abdomen to gain access to the cavity and observe the cancerous growth. It is a complex procedure that can last 10 to 12 hours and parts of the bowels, gall bladder, liver, pancreas, spleen and stomach may be removed.
Benefits and Risks of Peritonectomy
Peritonectomy and cytoreductive surgery are aggressive and invasive treatment options, but the procedures are known to have encouraging results. The decrease of cancerous cells in the abdomen enables chemotherapy to penetrate the tissue. The greatest the amount of tumors removed, the better chemotherapy will work. Peritonectomy and cytoreductive surgery combined with chemotherapy can improve patients’ life span and increase survival in about three years, while patients with peritoneal mesothelioma usually face a prognosis of about a year.
However, it is a difficult surgery and includes numerous risks. The main possible side effects include pain, fatigue, poor appetite due to the general anesthesia, weight loss, swelling around the surgical site related to the normal response of the body to the incision, fluid drainage from the site of surgery that can be accompanied by a bad smell, fever and redness, bruising around the surgery site due to the leakage of blood from the small blood vessels under the skin, bleeding, infection at the incision site, as well as temporary organ dysfunction, according to the American Cancer Society.
Recovery and Life After Peritonectomy
The majority of patients need to stay at the hospital for about two weeks, which are used to recovery from the major surgery and in some cases to continue with chemotherapy. Heated chemotherapy is administered into the abdominal cavity during the surgery and the treatment is continued for two weeks. It helps kill any cancer cells left behind during the cytoreduction. During this time, patients’ health is monitored by physicians and nurses, with particular emphasis on the recovery of the digestive system, which is particularly affected by the surgery.
After being discharged, the recovery continues at home and patients are likely to need more two or three weeks before being ready to go back to work. Following the peritonectomy and cytoreduction surgery, patients receive food, fluids, vitamins and medications intravenously with a nasogastric tube placed from the nose into the stomach. The tube drains the content of the stomach until the recovery of the bowels. Due to the surgery, patients are expected to improve symptoms of peritoneal mesothelioma, which include weight loss, abdominal distention, hernias, loss of appetite, feeling of fullness, abdominal swelling or tenderness, fatigue, abdominal fluid buildup, bowel obstruction.