General Practice 2022

Câncer of peritônio: what é, symptoms, causes and treatment

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Câncer of peritônio: what é, symptoms, causes and treatment
Câncer of peritônio: what é, symptoms, causes and treatment

Peritoneum cancer is a rare type of tumor that arises in the tissue that lines the entire inner part of the abdomen and its organs, causing symptoms similar to those of cancer in the ovaries, such as abdominal pain, nausea, swollen belly and loss of weight with no apparent cause, for example.

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

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

Main signs and symptoms

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

  • Swelling of the abdomen;
  • Abdominal pain;
  • Constipation or diarrhea;
  • Fatigue and general malaise;
  • Lack of appetite;
  • Difficulty digesting food;
  • Weight loss with no 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 out how the treatment for ascites is done.

Possible causes

The causes of peritoneal 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 rise to the tumor.

Some risk factors may also be related to the emergence of cancer in the peritoneum, such as women who use hormones after menopause, who have endometriosis and obesity. However, women who use birth control pills, have had ovarian removal surgery or who breastfeed are less likely to have peritoneal 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:

  • Cancer of the primary peritoneum or mesothelioma: occurs when cellular changes first occur in this tissue that covers the abdomen;
  • Secondary peritoneal cancer or carcinomatosis: is identified when 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 peritoneal cancer, so these women should be regularly screened. See more about ovarian cancer symptoms.

How the diagnosis is made

The diagnosis of peritoneal cancer can be made by the general practitioner through imaging tests such as ultrasound, magnetic resonance imaging, computed tomography and pet-scan, however, to know the stage of the tumor it is necessary to perform a biopsy, that can be performed during an exploratory laparoscopy.Learn how laparoscopic surgery is performed.

A 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 if the tissue has cancer cells and determines what type of these cells are, and this is crucial for the oncologist to define the type of treatment. In addition, complementary blood tests may also be performed to identify tumor markers, which are substances present in different types of cancers.

Treatment options

Treatment for peritoneal cancer is defined by the oncologist depending on the stage of the disease and the following options may be indicated:

1. Intraperitoneal chemotherapy

Intraperitoneal chemotherapy consists of the application of drugs into the peritoneum and is the most suitable type of treatment for peritoneal cancer, as it allows the drugs to be rapidly absorbed into the tissue.These drugs are usually heated to a temperature between 40°C to 42°C to prevent the body from getting cold and to facilitate the drugs' entry into the cells.

This treatment is indicated for cases in which the peritoneal 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 rapid recovery of the person, not showing side effects such as hair loss and vomiting.

2. Chemotherapy in the vein

Chemotherapy in the vein is indicated for peritoneal cancer before surgery, so that the tumor reduces in size and is easier to remove. 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 performed to remove the tumor in the peritoneum when the cancer has not reached other organs of 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 the performance of several blood tests such as a clotting test and a blood typing test, in case the person needs to receive a blood transfusion due to blood loss during the surgery. Learn more about blood types and compatibility.

4. Radiotherapy

Radiotherapy is a treatment in which radiation is used to destroy cells that cause cancer of the peritoneum and is applied through a machine that emits radiation directly at the site 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.

Is peritoneal cancer curable?

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

In the most serious cases, in which the peritoneal 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 about what palliative care is and when it is indicated.

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