Pleural and peritoneal mesothelioma rarely occur at the same time. But when they do, there is still hope for treatment.
That message comes from a new study conducted at Columbia University and published in the Annals of Surgical Oncology.
The researchers analyzed cases of patients diagnosed with both pleural and peritoneal mesothelioma at Columbia. They were looking for the factors that impacted their survival and the most effective ways to treat them.
Comparing Pleural and Peritoneal Mesothelioma
There are two primary types of malignant mesothelioma, the type of cancer most closely associated with asbestos exposure.
The most common type is pleural mesothelioma. With this type, the first tumors show up on the membrane that surrounds the lungs (pleura).
Chest pain, cough, and breathing difficulties are some of the most common symptoms of pleural mesothelioma. Both pleural and peritoneal mesothelioma can trigger fatigue and weight loss.
About one in five cases of mesothelioma are the peritoneal variety. This type of mesothelioma starts on the membrane around the abdominal organs. It often causes abdominal pain, bloating, and digestive issues.
An Unusual Combination
While it is uncommon for one person to get both pleural and peritoneal mesothelioma, it is not unheard of.
The Columbia team identified 50 patients who had both types of mesothelioma. More than half (52%) of these patients were diagnosed with a second type of mesothelioma with a year of their initial diagnosis.
For the rest of the patients, it was often two years or more before they got the news. The median time to second diagnosis for these patients was 30 months. The researchers concluded that the highest risk for being diagnosed with both pleural and peritoneal mesothelioma is in the first year.
Another revelation to come out of the study is that female patients and those who have chemotherapy directly in their abdomen (intraperitoneal chemotherapy) tend to live the longest.
But the best news is that having both pleural and peritoneal mesothelioma does not rule out multi-modal mesothelioma treatment and extended survival. The median overall survival for these patients from the time of their first surgery was 33.9 months.
In contrast, the typical life expectancy for someone diagnosed with pleural mesothelioma alone is about a year.
Lettica-Kriegel, AS, et al, “50 Patients with Malignant Mesothelioma of Both the Pleura and Peritoneum: A Single-Institution Experience”, May 7, 2019, Annals of Surgical Oncology, Epub ahead of print, https://link.springer.com/article/10.1245%2Fs10434-019-07409-5