Peritoneal Cancer; the Silent & Unknown Killer
A Rare Disease, Cancer of the Peritoneum Can Be Deadly
Most people are unaware that inside the abdomen is a thin wall of cells that protects the organs inside by producing a fluid that lubricates them as they move about inside the body. This is called the peritoneum. Peritoneal cancer is a rare disease that sneaks up and hangs around unnoticed by most people until it is a well-developed cancer, when the symptoms begin to show up.
There is no known cause, although a history of breast cancer in the family may be a warning sign. It is rare in young people and even more rare in men.
Symptoms
Peritoneal cancer rarely shows any symptoms until the late stages, and even then they are rather ill-defined. They mimic ovarian cancer, although the ovaries are seldom overly affected by the cancer. They include:
- Frequent urination
- Nausea, diarrhea and constipation
- Weight loss or gain for no apparent reason
- Lack of appetite
- Unexplained vaginal bleeding
- Lower abdominal pain
If some or all of these symptoms are present a visit to the doctor's office is advised.
Diagnosis
There are many tests that are used to diagnose peritoneal cancer. The most common are these:
- Pelvic Exam
- Magnetic Resonance Imaging (MRI)
- Ultrasound
- Computed Tomography (CT) Scan
- Lower GI Series, usually using a Barium Enema
- Laparoscopy (a biopsy taken from the peritoneal tissue through an incision made by a surgeon)
- Abdominal Fluid Aspiration (Peritoneal Cancer often causes a fluid build-up in the abdominal cavity, and a sample of this fluid is taken and tested for cancer cells)
Treatment
An oncologist must determine the stage of the cancer - whether it is confined to the peritoneal layer or if it has metastasized. If it has spread, the extent of the cancer will be determined and appropriate treatments discussed.
Surgery must be performed to remove the tumor and any affected organs; these may include the liver, uterus, ovaries and/or the omentum (a layer of fatty tissue underneath the muscles of the stomach). The lungs and all lymph nodes should be tested, also.
Chemotherapy usually follows surgery to kill any remaining cancer cells, but in dealing with peritoneal cancer it is often used before the surgery, too. This is because the cancer can be so far-reaching that the surgeon sometimes will try to shrink the cancerous mass before removal.
Radiotherapy, the use of high-energy radiation, may be used to rid the body of cancer cells or reduce the tumor. This can be done from an external beam on the outside of the body, or internal radiation may be used.
If the cancer has spread to too many organs and there is no chance of recovery, or if the patient decides not to undergo further treatment, palliative care is used. In the case of peritoneal cancer, this means pain management and frequent drainage of fluid from the abdominal cavity. Weight and fluid management plays an important role in keeping the patient as healthy and comfortable as possible.
Remission
If the cancer has gone into remission, the patient should be tested approximately every three months for the first 2-3 years; after that the testing should be done at least twice a year. Peritoneal cancer has a high recurrence rate and the cancer patient may have to undergo repeated surgeries and bouts of chemotherapy.
