Peritoneal carcinomatosis


Peritoneal carcinomatosis

Description, Causes and Risk Factors:

The peritoneum is a very thin coating of tissue. One of its layers surrounds individual abdominal organs and another layer forms a pouch around the entire abdominal cavity. Fluid fills the space between the layers to offer extra cushioning as the organs bump around in your body.

Peritoneal carcinomatosis is a rare type of carcinoma that affects the peritoneum, which is the thin layer of tissue that surrounds the organs in your abdominal cavity, as well as the abdominal cavity itself.

Peritoneal carcinomatosis develops when existing abdominal cancers, including appendix, colon, rectal, and pancreatic cancers, spread into the peritoneum. This causes tumors to grow throughout the peritoneum. The spread of an abdominal cancer to the peritoneum usually means that your abdominal cancer is in an advanced stage.

Another form of the disease, primary peritoneal carcinomatosis, begins in the peritoneum itself. This is also a rare condition, and tends to affect women who are also at risk for ovarian cancer. The most common cause of peritoneal carcinomatosis in women is ovarian cancer.

The Peritoneal Carcinomatosis Center at the UMass Memorial Medical Center is dedicated to improving the survival and alleviating suffering for people with peritoneal carcinomatosis through comprehensive, multidisciplinary, and compassionate patient care, basic, translational and clinical research and patient, family and community education.

Symptoms:

The most common symptoms of peritoneal carcinomatosis include acute or chronic aches, cramps, bloating, and full-body fatigue. Many symptoms are caused when excess fluid accumulates in the abdominal cavity, a direct consequence of nearby tumor activity. Other problems such as breathing difficulties, digestive problems, and chest pains may be present as well, depending on the extent and location of the original cancer.

Diagnosis:

If there is any suspicion that you may be developing either form of peritoneal carcinomatosis, your doctor will review your medical history and perform a variety of tests to confirm a diagnosis. These tests may include:

    Complete physical examination, family history, and past medical history.

  • Computed tomography (CT) scan - This procedure uses a computer to create a detailed picture of your peritoneum and then projects it using x-ray technology.

  • Tumor marker tests - These are blood tests indicating the presence of peritoneal cancer.

  • Ultrasound - This procedure uses sound waves to create a detailed picture of your peritoneum on a computer screen.

  • Biopsy - In this procedure, your doctor removes suspicious tissue from your peritoneum for examination under a microscope.

Treatment:

Surgery is the treatment of choice when tumors are small and isolated in the peritoneum. If an entire tumor can be removed and the primary cancer treated effectively, the patient has a good prognosis. Cancers in their later stages are typically treated with a combination of surgery, chemotherapy, and radiation. Even when it appears that treatment is successful, the condition can become a recurring problem. Regular checkups and exams are vital elements of follow-up care to make sure future problems are kept to a minimum.

Traditionally, the peritoneal carcinomatosis has been considered as a later incurable stage of the neoplastic injury, subsidiary of palliative systemic chemotherapy only, with or without reduction surgery of the tumoral mass (debulking). However, the studies carried out in the 1980s suggest that peritoneal carcinomatosis should be faced as a locoregional stage, and that a limited peritoneal seeding can be cured (40% in gastrointestinal origin cases) using a combination of debulking surgery and intraperitoneal perioperative chemotherapy.

The radical treatment for peritoneal carcinomatosis includes debulking and intraoperative hyperthermic intraperitoneal chemotherapy. Those patients that only have one controlled or controllable primary tumor located in the peritoneum can benefit from a treatment with a curative intention of the resection if it is complete or almost complete from a macroscopic perspective.

The invasive or non-invasive nature of the tumor on the surface of the peritoneum is also a defining feature when treating peritoneal carcinomatosis.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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