What is peritoneal carcinomatosis?

Peritoneal carcinomatosis (PC), also known as peritoneal cancer, is the spread of cancer that originates in the peritoneum, the thin membrane that covers the abdominal cavity, which includes the rectum, uterus and bladder. Peritoneal carcinomatosis generally occurs as a consequence of a tumour of the appendix, colon-rectum, or the ovaries, but it can also originate from other types of cancer (e.g. mesothelioma).

Symptoms of peritoneal carcinomatosis

The symptoms of peritoneal carcinomatosis can vary depending on the underlying cancer and the extent of the spread, but they often include:

Abdominal pain: Persistent and worsening abdominal pain or discomfort is a common symptom. It may be diffuse or localised and can be dull, aching, or sharp in nature.

Ascites: The buildup of fluid in the abdominal cavity, known as ascites, can cause abdominal distension (swelling) and discomfort. This fluid accumulation may lead to increased abdominal girth.

Changes in bowel habits: Altered bowel habits, such as diarrhoea or constipation, may occur due to the disruption of normal gastrointestinal function.

Nausea and vomiting: Nausea and vomiting can be associated with peritoneal carcinomatosis, especially if the cancer affects the digestive organs.

Loss of appetite: A decrease in appetite and unintentional weight loss can be observed in individuals with peritoneal carcinomatosis.

Fatigue: Persistent fatigue and weakness are common in people with advanced cancer, including peritoneal carcinomatosis.

Abdominal mass or fullness: Some individuals may feel a mass or fullness in their abdomen, especially if there is a significant tumour burden.

Changes in urinary habits: If the cancer affects the urinary system, it may lead to changes in urination patterns or urinary symptoms.

Difficulty breathing: In advanced cases, peritoneal carcinomatosis can cause pressure on the diaphragm, leading to difficulty breathing.

Gastrointestinal bleeding: In cases where the cancer has invaded the gastrointestinal tract, symptoms like blood in the stool or black, tarry stools (melena) may occur.

Malnutrition: As the disease progresses, it can interfere with the body's ability to absorb nutrients, leading to malnutrition and weakness.

How is peritoneal carcinomatosis treated?

Treatment of this cancer depends on the stage and size of your diagnosis, as well as your overall health. Usually, treatment involves radical removal, by debulking surgery, of all visible tumours and abnormal cells. In some cases, a resection of the abdominal and intestinal organs (spleen, ovaries, uterus, and liver) will also be necessary.

After completing the procedure, intraperitoneal chemotherapy will be performed directly in the operating room in order to remove debris and clean the abdominal cavity. This type of chemotherapy is performed in hyperthermia (increasing the patient's body temperature) to improve the effectiveness of the medications. After the intervention, the patient will remain in intensive care for 24 hours. The hospitalisation period can vary between 10 and 30 days.

In some cases where it is diagnosed at advanced stages, treatment will only be palliative care to relieve symptoms such as pain and weight loss.