Papillary mesothelioma, medically-known as well-differentiated papillary mesothelioma (WDPM), is a form of peritoneal mesothelioma marked by a slow growth pattern in which the cancer usually doesn’t spread past the affected areas. Since it’s one the least aggressive forms of mesothelioma, it’s often overlooked. Yet, WDPM can still cause detrimental damage if not diagnosed and treated.
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Although there still isn’t sufficient data to determine the long-term affects of WDPM, experts are constantly researching the disease to uncover more information. Some studies suggest that WDPM may not even be caused by asbestos exposure.
For instance, according to the Journal of Dental and Medical Services (IOSR), the majority of people who develop WDPM are women between 30 to 40 years of age who’ve never been exposed to asbestos.
Yet, studies also show a correlation between WDPM and asbestos exposure, typically while at work, through second-hand exposure, or through household products. Experts hope to understand the disease better as more information develops.
The tumors most often develop in the peritoneal area, but scientists have discovered that the tumors can also develop on the lung’s linings, the heart, and reproductive organs.
Symptoms will vary according to each person and where the papillary mesothelioma is located, but the majority of WDPM patients report there there aren’t any symptoms. The few symptoms reported include:
- Pain in the abdomen or pleura due to fluid build-up
- Pelvic pain
Since symptoms are so rare, WDPM is typically found during a surgery for other medical conditions that are unrelated to papillary mesothelioma.
Since symptoms are so rare, WDPM is typically found during a surgery or exam for other conditions unrelated to papillary mesothelioma, such as a pelvic exam or an unrelated CT scan. However, although the tumors can be detected via a pelvic exam or CT scan, the only true way to diagnose papillary mesothelioma is via a biopsy, which is typically scheduled if tumors are detected.
A biopsy entails a surgeon removing removing a piece of tissue from the area of the body where the tumor was detected. Once the tissue is removed, it’s sent to a lab where a pathologist views the cells in the tissue under a specialized microscope.
A variation and combination of treatments can be used when treating WDPM, just as any other form of mesothelioma. Yet, with such little current information on the disease, physicians are still unsure which form of treatment works best. For now, the common types of treatments include:
Exploratory laparotomy is sometimes performed prior to a patient undergoing cytoreductive surgery. Exploratory laparotomy a type of surgery in which the physician cuts an incision into the stomach in order to observe the abdominal organs. This allows physicians to determine the extent of the tumors and if necessary, schedule a cytoreductive surgery to remove the tumors.
It’s important to note however, that some physicians feel that an exploratory laparotomy is too risky to perform on a disease that’s still considered benign.
Cytoreductive surgery involves removing the major organs from the abdominal area in an attempt to remove the cancerous cells. Cytoreductive surgery typically takes anywhere from 10 to 12 hours, but most patients are admitted a day prior for testing, X-rays, and preparation. When cytoreductive surgery is the only type of treatment, patients have stated that abdominal pressure and pain is greatly relieved, but in combination with chemotherapy, patients have a better chance if eliminating more cancerous cells and prolonging their lifespan.
Surgery alone usually isn’t enough to effectively battle cancer cells, even with a disease that’s considered less-invasive than other forms of mesothelioma. However, in some cases of WDPM, chemotherapy alone has been successful.
Carboplatin is the most common medication used for chemotherapy for those with WDMP, and has proven to be effective in many instances. In fact, some studies show that after patients underwent chemotherapy with carboplatin, the disease never resurfaced.
Some patients receive a combination of surgery and chemotherapy, typically heated chemotherapy, which involves heating the medication so that its temperature a little higher than the patient’s body temperature. Known as the hot chemo approach (HIPEC), this form of chemotherapy works best for those with cancerous cells around the abdomen area.
Heated chemotherapy is normally only used when all other options have been exhausted.
People with WDPM generally have a better prognosis than those with any other type of mesothelioma. According to the Journal of Medical Case Reports, several patients who underwent chemotherapy, went on to survive ad have no trace of the cancer today. In rare cases, some patients passed away within a few years after treatment, but this is a striking difference between the survival rates of malignant mesothelioma rates, in which there is only a 5 to 50% chance that the patient will survive five years past diagnosis.
Since WDPM has a slow growth rate and typically doesn’t spread to other areas of the body, the outcome is favorable. Even if the cancer resurfaces, most people still have a strong chance of long-term survival as papillary mesothelioma’s subtype is epithelial mesothelioma, which is the easiest to treat.
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