Peritoneal Mesothelioma

Malignant peritoneal mesothelioma is a cancer that starts in the lining of the abdomen and develops 20-50 years after inhaling asbestos fibers. This rare cancer makes up roughly 10-15% of all mesothelioma cases. Peritoneal mesothelioma patients have an average life expectancy of 63.2 months, but cytoreduction with HIPEC treatment can increase survival by up to 90 months.

What Is Peritoneal Mesothelioma?

Peritoneal mesothelioma is a type of malignant cancer that develops in the peritoneum, a protective lining covering the abdominal cavity and its organs, including the stomach, liver, and intestines. It is the second most common type of mesothelioma.
Peritoneal mesothelioma affects
300 American Flag
Americans yearly

Already Been Diagnosed?

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Peritoneal Mesothelioma Causes

Peritoneal mesothelioma cancer is almost always caused by exposure to asbestos.

Peritoneal mesothelioma develops decades after asbestos fibers are inhaled or swallowed and then become stuck in the lining of the abdomen. Once inside the body, the fibers can travel to the abdomen through the lymphatic system.

Asbestos fibers cannot be broken down by the body, which can cause severe and continuous irritation to healthy tissue. Over time, this irritation may cause scarring and cellular mutations, leading to the formation of mesothelioma tumors.

Who Is at Risk for Peritoneal Mesothelioma?

Those at highest risk of developing peritoneal mesothelioma are people routinely exposed to asbestos.

Groups facing frequent asbestos exposure include:

Women with mesothelioma are more likely than men to have peritoneal mesothelioma versus its pleural counterpart.

Women suffer from pleural mesothelioma roughly twice as frequently as they do peritoneal mesothelioma. For the male population, this statistic increases to 5, with men being 5 times more likely to receive a pleural mesothelioma diagnosis than peritoneal.

Peritoneal Mesothelioma Symptoms

Symptoms of peritoneal mesothelioma include:

  • Loss of appetite
  • Nausea
  • Abdominal pain
  • Swelling of the stomach
  • Unexplained weight loss
  • Fluid buildup in the abdomen (ascites)
  • Chills
  • Constipation
  • Diarrhea
  • Fatigue
  • Fever
  • Night sweats

The most common symptoms of peritoneal mesothelioma are related to the stomach and digestive system.

“Patients with peritoneal mesothelioma typically present to the doctor with abdominal pain, maybe swelling. All of a sudden they can’t button their pants or get their belts around them.”

Peritoneal Mesothelioma Diagnosis

Peritoneal mesothelioma is hard to diagnose because its symptoms are common to many other stomach and digestive issues, such as irritable bowel syndrome (IBS) and Crohn’s disease.

Mesothelioma specialists often rely on a patient’s asbestos exposure history, imaging tests, and a biopsy to make a peritoneal mesothelioma diagnosis.

Due to this lengthy diagnostic process, peritoneal mesothelioma takes roughly 4-6 months to diagnose after symptoms appear. A patient displaying symptoms should consult their doctor — and share with them their history of asbestos exposure — to help rule out other conditions.

Imaging Tests

Doctors may use CT scans or X-ray images of a patient’s abdomen to reveal signs of peritoneal mesothelioma. Tumor masses and fluid buildup, revealed by imaging scans, are common warning signs of this cancer.


A biopsy is the only way to confirm a peritoneal mesothelioma diagnosis. During a biopsy, doctors take a fluid or tissue sample from the patient to examine in a lab.

Getting a Second Opinion

Because peritoneal mesothelioma is so hard to diagnose, patients should seek a second opinion from an experienced mesothelioma specialist.

Getting a second opinion helps protect against misdiagnosis, which may cost patients the chance to receive critical life-extending treatment.

Peritoneal Mesothelioma Stages

There is no official staging system for peritoneal mesothelioma. Instead, some mesothelioma doctors diagnose peritoneal mesothelioma as either localized (early-stage) or advanced (late-stage).

Today, many doctors embrace an unofficial peritoneal mesothelioma staging system. This system has not yet been accepted by the American Joint Committee on Cancer (AJCC).

  • Stage 1: The cancer remains in the abdominal lining and has not spread to the lymph nodes.
  • Stage 2: The cancer has spread moderately without reaching the lymph nodes.
  • Stage 3: The lymph nodes are infected and/or the cancer has spread past the peritoneum.
  • Stage 4: Tumor growth is widespread.

Peritoneal Mesothelioma Prognosis

A peritoneal mesothelioma prognosis describes a patient’s expected disease outlook.

The prognosis for this cancer depends on various factors:

  • Stage at diagnosis: Peritoneal mesothelioma patients diagnosed early have better survival rates than patients with advanced cancer.
  • Cell type: Epithelioid peritoneal mesothelioma has a better prognosis than biphasic or sarcomatoid mesothelioma cell types.
  • Patient age and health: Younger, healthier patients live longer overall.
  • Eligibility for surgery: Patients who are able to receive curative surgery may increase their survival time by years.

Peritoneal mesothelioma has a more favorable prognosis than pleural mesothelioma and other, more rare mesothelioma types.

The average life expectancy for peritoneal mesothelioma patients who receive curative surgery is about 63.2 months, while those who do not receive treatment live for 6 months on average.

Peritoneal Mesothelioma Treatment

Treatments for peritoneal mesothelioma include surgery, chemotherapy, and radiation. The most effective treatment plans usually combine 2 or more treatment modalities (options).

Patients with advanced peritoneal mesothelioma may not qualify for curative treatment options, which typically require a long recovery period and have uncomfortable side effects. However, all patients can receive palliative care to help manage their symptoms.


The primary life-extending (curative) treatment for peritoneal mesothelioma is cytoreduction with HIPEC.

This procedure has two parts:

  • Cytoreductive surgery
  • Hyperthermic intraperitoneal chemotherapy (HIPEC)

During cytoreductive surgery, mesothelioma doctors physically remove all visible cancer from the abdominal cavity. The surgery is then supplemented by introducing a special form of heated chemotherapy called HIPEC to kill microscopic cancer cells that weren’t already removed.

This treatment takes 10-12 hours to complete, and patients usually need several months to recover from it.

Cytoreduction with HIPEC has the potential to extend the lifespan by several years, with some patients going on to achieve long-term survival.

“With [cytoreductive surgery with HIPEC], we can increase patient survival by up to 90 months [7.5 years].”

– Michael D. Kluger, Peritoneal Mesothelioma Specialist


HIPEC is the most common form of chemotherapy used to treat peritoneal mesothelioma. This technique involves directly applying heated chemotherapy drugs to the abdomen.

The direct application, and the heating of the drugs, makes this type of chemotherapy more effective than standard (systemic) chemotherapy.

Systemic chemotherapy can be administered orally or intravenously and is typically recommended to patients who don’t qualify for cytoreduction with HIPEC.


Radiation therapy may be used to shrink existing peritoneal mesothelioma tumors before cytoreductive surgery to help doctors surgically remove the cancer.

Radiation oncologists (cancer doctors) must be careful with the amount of radiation used, as it affects both cancer cells and nearby healthy cells.


Immunotherapy treatment, in which a patient’s immune system is stimulated to kill cancer cells, has proved effective in treating other types of cancers and is now the focus of several clinical trials that will gauge its potential for treating mesothelioma.

A phase II trial at The University of Texas MD Anderson Cancer Center found that a combination of the immunotherapy drug atezolizumab (brand name: Tecentriq®) and the chemotherapy drug bevacizumab (Avastin®) was effective at slowing the progression of advanced malignant peritoneal mesothelioma.

Clinical Trials

Clinical trials are available for patients who want to access emerging peritoneal mesothelioma treatment options, such as immunotherapy and gene therapy.

One currently-recruiting clinical trial is studying a peritoneal mesothelioma drug made out of a patient’s own white blood cells. This treatment, called MCY-M11, makes it easier for the body to target and kill cancerous mesothelioma cells.

To learn more about this clinical trial and other studies near you, visit the U.S. National Institutes of Health (NIH) website at

Palliative Treatment

Many late-stage or less healthy peritoneal mesothelioma patients cannot undergo aggressive treatment. Instead, doctors help relieve their symptoms and improve their overall quality of life through palliative care.

Palliative care for peritoneal mesothelioma includes:

  • Chemotherapy: Chemotherapy can relieve symptoms such as abdominal swelling and heaviness
  • Radiation therapy: Radiation has similar palliative effects to chemotherapy, but it typically causes fewer side effects
  • Cytoreduction: This procedure involves partially removing tumors in the abdomen, relieving symptoms like nausea and swelling of the abdomen
  • Paracentesis: Fluid between the linings of the abdominal cavity is drained, reducing shortness of breath, appetite loss, and other symptoms

Top Peritoneal Mesothelioma Specialists

Working with specialized mesothelioma doctors offers patients the best chance at long-term survival.

“Most doctors don’t see it and so they don’t know what to look for. I had every test that could be done, and they never found anything. So you have to have a specialist that deals with [mesothelioma].”

– Mary Jane W., Peritoneal Mesothelioma Victim

Below, learn more about peritoneal mesothelioma specialists across the United States — or contact us today for help connecting with a doctor near you.

Dr. Paul Sugarbaker

Dr. Paul Sugarbaker is one of the top peritoneal mesothelioma doctors in the country and the creator of the life-saving cytoreduction with HIPEC procedure. He treats patients at the Washington Cancer Institute in Washington, D.C.

Dr. Charles Conway

Dr. Charles Conway is known for his work in the diagnosis and treatment of peritoneal mesothelioma. He is the Director of Surgical Oncology at the Ridley-Tree Cancer Center in Santa Barbara, CA.

Dr. James Pingpank

Dr. James Pingpank is an experienced peritoneal mesothelioma doctor who specializes in treating less advanced cases. He practices at the University of Pittsburgh Medical Center in Pittsburgh, PA.

Common Questions About Peritoneal Mesothelioma

Can peritoneal mesothelioma be cured?

There is no cure for peritoneal mesothelioma, but treatments like cytoreduction with HIPEC may help eligible patients achieve long-term survival.

Is peritoneal mesothelioma always fatal?

Several peritoneal mesothelioma patients have lived for 5-7 years after their diagnosis, with some patients living 10 years or more.

What are the first signs of peritoneal mesothelioma?

Typical early symptoms of peritoneal mesothelioma include stomach pain, loss of appetite, nausea, and other stomach- and digestion-related issues.

Does everyone exposed to asbestos get mesothelioma?

No. Most people exposed to asbestos do not develop mesothelioma, although they may develop other asbestos-related diseases.

Getting Help for Peritoneal Mesothelioma

Getting specialized care from peritoneal mesothelioma doctors provides the best chance at long-term survival. However, treatment for this cancer costs hundreds of thousands of dollars — even with insurance.

Sokolove Law has helped victims of asbestos-related diseases pursue financial compensation for over 40 years. Compensation through a mesothelioma legal claim can help you afford treatment and provide financial security for your family members for years down the road.

To learn how Sokolove Law may be able to help you, get a free case review today.

Author:Sokolove Law Team
Sokolove Law Team

Contributing Authors

The Sokolove Law Content Team is made up of writers, editors, and journalists. We work with case managers and attorneys to keep site information up to date and accurate. Our site has a wealth of resources available for victims of wrongdoing and their families.

Last modified: September 2, 2021

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