What You Need to Know About Peritoneal Cancer

Peritoneal cancer affects the peritoneum, a thin layer of tissue that lines the abdominal cavity and covers the organs within it, such as the stomach, liver, intestine, pelvis, bladder, and rectum. Peritoneum produces a lubricating fluid that helps the organs inside the abdomen to function smoothly. Abnormal cells can grow within the peritoneum, forming tumors. These tumors can eventually grow and affect nearby organs and tissues and, in some cases, can travel to other body parts through the bloodstream or lymphatic system. Like any other type of cancer, peritoneal cancer can be life-threatening if left untreated.   

Types of Peritoneal Cancer  

There are two types of peritoneal cancers – primary and secondary.  

Primary Peritoneal Cancer  

It is rare that cancer starts in the peritoneum rather than spreading from other body parts. Regarding symptoms, diagnosis, and treatment, primary peritoneal cancer is similar to ovarian cancer. It is often treated using the same method. 

Secondary Peritoneal Cancer  

It is a type of cancer that spreads to the peritoneum from another part of the body, such as the ovaries, colon, or pancreas. The treatment of secondary peritoneal cancer depends on the type and stage of primary cancer that has spread to the peritoneum.  

In both cases, early detection and treatment are crucial for better outcomes.  

Causes of Peritoneal Cancer  

The exact causes of peritoneal cancer are still unknown. Still, certain risk factors can increase a person's likelihood of developing the disease. These risk factors include:  

1. Age: Most cases occur in older adults, particularly those over the age of 60.

2. Gender: Women are at a higher risk of developing peritoneal cancer than men.  

3. Inherited genetic mutations: Having first-degree family members (parents, siblings, children) with peritoneal cancer, can increase the risk for the same. For example, mutations in BRCA1 and BRCA2 genes can increase the risk.

4. Obesity: People with more body fat have a higher risk.  

5. Gynecological factors: Women with a history of endometriosis, ovarian cancer, or other cancers in the reproductive system are at high risk.

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Symptoms  

The symptoms of peritoneal cancer vary depending on the stage and the location of the tumors. Many of these symptoms are due to fluid (ascites) buildup in the abdomen. It is important to note that many symptoms can also be caused by other conditions, such as irritable bowel syndrome (IBS), ovarian cysts, or inflammatory bowel disease (IBD). Peritoneal cancer symptoms are vague, but some symptoms may include the following: 

1. Abdominal or pelvic pain  
2. Bloating or swelling 
3. Changes in bowel habits such as diarrhea, constipation, or frequent urination 
4. Loss of appetite   
5. Unintended weight loss can be a sign of advanced disease 
6. Fatigue  
7. Nausea and vomiting  
8. Lack of energy  

If any of these symptoms persist or worsen over time seeing a healthcare provider for a proper evaluation and diagnosis is important.  

Diagnosis of Peritoneal Cancer  

Early detection of peritoneal cancer is crucial for better treatment outcomes. In the early stages, when the tumors are small and have not yet spread, treatment is generally more effective and has a higher chance of success. Regular screenings, especially for people with a personal or family history of cancer, can help with early detection.  

Healthcare providers may use a combination of tests and procedures to diagnose peritoneal cancer. These may include:  

1. Imaging tests: CT scans, MRI scans, or ultrasounds can help to visualize the abdomen and identify any tumors or abnormalities. But peritoneal cancer can be difficult to see using only these tests.  

2. Blood tests: The CA-125 test can measure the levels of certain blood proteins associated with ovarian and peritoneal cancers.   

3. Laparoscopy: Laparoscopy is a minimally invasive surgical procedure that involves inserting a thin, lighted tube with a camera into the abdomen to visualize the peritoneum and take tissue samples for biopsy.  

4. Biopsies: A surgeon takes a tissue sample from the affected area and examines it under a microscope to look for abnormal cells. A biopsy may be performed using a needle or during a surgical procedure.   

Management and Treatment   

The treatment choice for peritoneal cancer depends on the stage and type of cancer and the patient's overall health. For early-stage cancers, surgery may be sufficient to remove the affected tissue. A combination of surgery or therapy may be necessary for more advanced cases. The oncologist will work with the patient to determine the best treatment course based on their circumstances.

The most common treatment options for peritoneal cancer include the following:  

1. Surgery: It is often the first line of treatment for peritoneal cancer. Surgery aims to remove as much of the cancerous tissue as possible. Depending on the stage and extent of the tumor, the surgeon may remove the ovaries, fallopian tubes, uterus, and other affected organs and any tumors he peritoneum or other abdominal tissues.

2. Chemotherapy: Chemotherapy involves using drugs to kill cancer cells. These drugs are similar to treating ovarian cancer. Chemotherapy may be used before or after surgery to help shrink the tumors or to kill any remaining cancer cells. The therapy may be given orally or intravenously.  

3. Radiation therapy: It is rarely used as the first treatment for peritoneal cancer. Radiation therapy is mostly used with surgery or chemotherapy or as a stand-alone treatment to target small areas of cancer that have returned after the initial treatment.   

4. Targeted therapy: Targeted therapy involves using specific drugs that target cancer cells based on their unique characteristics. It may be combined with other treatments, such as chemotherapy or radiation therapy.  

5. Hyperthermic intraperitoneal chemotherapy (HIPEC): It is a two-step procedure. Cancerous tumors are surgically removed and then heated chemotherapy drugs are applied directly to kill any remaining cancer cells that may have been left behind during surgery.  

Read more: 6 Essential Dos and Don'ts for Post-Chemotherapy Recovery

Prognosis and Survival Rates  

Peritoneal cancer is generally considered a more aggressive type of cancer, with comparatively lower survival rates. However, advances in treatment have shown promise in improving outcomes for some patients diagnosed with this disease.

According to the statistics, the 5-year survival rate for people with peritoneal, ovarian, and fallopian tubes is 49%. However, survival rates can vary widely depending on the stage at which it was diagnosed and the type of treatment one has received.

Patients with peritoneal cancer who are generally in good health, and have a small tumor that hasn't spread, may have a better prognosis than those with more advanced cases or other underlying health conditions.

Patients with peritoneal cancer need ongoing monitoring and follow-up care after treatment. This may involve regular imaging tests and check-ups with healthcare providers to monitor for any signs of recurrence or complications. Patients should also be vigilant about reporting new or persistent symptoms to their healthcare provider as soon as possible.  

Conclusion  

Peritoneal cancer is rare and aggressive; if there are any symptoms or concerns about a certain health condition, seek medical attention immediately. The oncologist at ACTC can help diagnose and treat cancer with a comprehensive approach involving a team of specialists. Remember, early detection and treatment can significantly improve the chances of a positive outcome for patients with peritoneal cancer.