Peritoneum cancer: what it is, symptoms and treatment

Peritoneum cancer is a rare type of tumor that appears in the tissue that lines the entire inside of the abdomen and its organs, causing symptoms similar to cancer in the ovaries, such as abdominal pain, nausea, swollen belly and weight loss without apparent cause, for example.

The diagnosis of peritoneum cancer can be made by a general practitioner or oncologist through imaging tests, such as computed tomography and pet-scan, blood tests to check specific proteins, known as tumor markers, and mainly, by performing biopsy. Treatment is based on the stage of the tumor and the person's health conditions and consists of surgery, chemotherapy and radiation therapy.

This type of cancer is usually aggressive and the life span of a person who has a tumor in the peritoneum is not well defined, however, with surgery and chemotherapy it can reach up to 5 years. Also, if peritoneum cancer is discovered at an early stage, the person may live longer, but it will always be necessary to have tests annually.

Main signs and symptoms

Peritoneum cancer reaches the layer that lines the abdomen and can lead to the appearance of signs and symptoms such as:

• Bloating of the abdomen; Abdominal pain; Constipation or diarrhea; Tiredness and general malaise; Lack of appetite; Difficulty in digesting food; Weight loss without apparent cause.

In addition, if the disease is discovered at a more advanced stage, it is possible to identify ascites, which is when fluid accumulates within the abdominal cavity, and this can compress the lungs causing shortness of breath and difficulty breathing. Check how the treatment for ascites is done.

Possible causes

The causes of peritoneum cancer are not well defined, but it is known that, in some cases, this type of cancer develops because cancer cells from other organs reach the layer that lines the abdomen, through the bloodstream, and multiply giving origin of the tumor.

Some risk factors may also be related to the appearance of cancer in the peritoneum, such as women who use hormones after menopause, who have endometriosis and who are obese. However, women who use contraceptive pills, have had ovarian removal surgery or who breastfed are less likely to have peritoneum cancer.

What are the types

Peritoneum cancer begins to develop, mainly, from cells of organs of the abdomen or gynecological region, in the case of women, and is divided into two types, which are:

• Primary peritoneum cancer or mesothelioma: occurs when cellular changes occur primarily in this tissue that covers the abdomen; Secondary peritoneum cancer or carcinomatosis: it is identified when the cancer arises due to cancer metastases from other organs, such as stomach, intestine and ovaries.

Also, women diagnosed with ovarian cancer who have the BRCA 1 and BRCA 2 genes are at increased risk of developing secondary peritoneum cancer, which is why these women should be tested constantly. See more about ovarian cancer symptoms.

How the diagnosis is made

The diagnosis of peritoneum cancer can be made by the general practitioner through image exams such as ultrasound, magnetic resonance, computed tomography and pet-scan, however, to know the stage of the tumor it is necessary to perform a biopsy, which can be performed during an exploratory laparoscopy. Find out how laparoscopic surgery is done.

The biopsy is done by removing a small piece of tissue that is sent to the laboratory and then examined by a pathologist. The pathologist checks whether the tissue has cancer cells and determines the type of these cells, which is crucial for the oncologist to define the type of treatment. In addition, complementary blood tests may also be done to identify tumor markers, which are substances present in different types of cancers.

Treatment options

The treatment for peritoneum cancer is defined by the oncologist depending on the stage of the disease and the following options can be indicated:

1. Intraperitoneal chemotherapy

Intraperitoneal chemotherapy consists of applying medications inside the peritoneum and is the most suitable type of treatment for peritoneum cancer, as it allows the drugs to be absorbed quickly into the tissue. Generally, these drugs are heated to a temperature between 40 ° C to 42 ° C to prevent the body from cooling down and to facilitate the entry of drugs into cells.

This treatment is indicated for cases in which the peritoneum cancer has not spread to other organs, such as the brain and lung, being performed together with the surgery to remove the tumor and having the advantage of the person's rapid recovery, without presenting the effects side effects like hair loss and vomiting.

2. Chemotherapy in the vein

Chemotherapy in the vein is indicated for peritoneum cancer before surgery, so that the tumor reduces in size and is easier to be removed. This type of chemotherapy is not used as a conventional treatment for this type of cancer, as the diseased cells, present in the tumor, are resistant to several chemotherapy drugs used frequently.

3. Surgery

Surgery is done to remove the tumor in the peritoneum when the cancer has not reached other organs in the body and is indicated in people who are able to receive anesthesia. This type of operation must be performed by experienced cancer surgeons, as it is quite complicated and often involves the removal of parts of organs such as the liver, spleen and intestine.

Before performing the surgery, the doctor requests several blood tests as a coagulation test and blood typing test, in case the person needs to receive blood transfusion due to blood loss during the surgery. Learn more about blood types and compatibility.

4. Radiotherapy

Radiotherapy is the treatment in which radiation is used to destroy cells that cause peritoneum cancer and is applied through a machine that emits radiation directly where the tumor is located.

This treatment method is indicated by the doctor before the surgery, to reduce the size of the tumor in the peritoneum, however, it can also be recommended to eliminate cancer cells after the operation.

Can peritoneum cancer be cured?

This type of cancer is very difficult to cure and the goal of treatment is to increase the person's life span, providing a better quality of life and physical, mental and social well-being.

In the most severe cases, in which the peritoneum cancer is at an advanced stage and has spread to other organs, it is important to take palliative care measures, so that the person does not feel pain and great discomfort. See more what palliative care is and when it is indicated.

Treatment for peritoneum cancer can have undesirable effects, see the video for some tips on how to relieve these effects: