Diagnosing the cancer of peritoneum

Diagnosis and cures of peritoneal cancer

What is cancer of the peritoneum? How is it diagnosed? How is it cured?

Only a few people are aware of the existence of the peritoneum. Now is the time for you to be acquainted with the ever helpful yet unpopular peritoneum. It is a large thin membrane in the abdominal cavity that connects and supports the internal organs such as stomach, liver, pancreas, large intestines, small intestines, etc. It is composed of folds that pass around and between the various organs. The peritoneum secretes serum that acts as a lubricant thus preventing friction between closely packed organs and helping the organs to move smoothly. This membrane also holds the abdominal organs in their proper position and serves as a barrier against infection.

A rare disease that can be deadly is hiding in the lining of the abdomen; a type of cancer that develops in the peritoneum called peritoneal cancer or primary peritoneal cancer (PPC). The cause of primary peritoneal cancer is unknown. However, there are different theories of its origin. Some say it is associated with an inherited faulty gene linked to breast cancer thus if there is a history of breast cancer in the family then it may be a warning sign. Cancer of peritoneum is common in older people, rare in younger people, rarest in men and mainly affects women.

During the disease’ early stage the symptoms rarely show. It is only at the late stage when symptoms show yet even then symptoms are somewhat vague. When symptoms show, they would be very similar to the symptoms shown by ovarian cancer as peritoneal cancer and ovarian cancer are very similar in view of the fact that both the peritoneum and ovaries are made of epithelial cells. Thus, both types of cancer are mostly treated the same way. When symptoms show, a patient will most likely experience frequent urination, lack of appetite, lower abdominal pain, diarrhea, nausea, constipation, and unexplained vaginal bleeding. The patient may also experience weight loss or weight gain for no apparent reason. One should pay a visit to the doctor if some or all of these symptoms are present.

Mostly, patients visit their GP who will examine them and then arrange to have necessary tests. The GP may refer the patients to a specialist: gynecologist. The doctor may conduct tests such as magnetic resonance imaging, ultrasound, computer tomography (CT) scan, pelvic exam, lower GI series, abdominal fluid aspiration and laparoscopy. But before doing any physical exam, the patient’s medical history will be checked first. Patients can choose whether to be checked by a female doctor or a male doctor. One should also be aware of the different tests commonly conducted in diagnosing peritoneal cancer. Let me give you basic yet useful information about the physical tests that I have mentioned in this article. Let me start with magnetic resonance imaging. This type of physical exam is a noninvasive diagnostic technique used in radiology and is used to visualize detailed structure inside the body.

Ultrasound is another non-invasive diagnostic procedure that uses ultrasonic waves to visualize the internal structure of the body. A picture called sonogram is produced showing any abnormality in the internal body structures. In addition to noninvasive diagnostic exams is computer tomography scan or CT scan. This technique is a special x-ray test that uses a computer connected to an x-ray machine and produces detailed images of the inside of the body. Pelvic examination is a complete physical examination of the female pelvic organs. This technique is also called manual uterine palpation and bimanual exam. Pelvic exam is done to evaluate the position and size of the vagina, uterus, cervix and ovaries as well as to help detect certain cancers in their early stage and infections or any problem in the reproductive system.  

Another medical procedure used to examine and diagnose problems with the large intestine is lower gastrointestinal series (lower GI series), also called as barium enema. In this diagnostic technique, patient’s colon must be filled with barium sulfate via rectum then an x-ray picture is taken. Peritoneal cancer often causes fluid build-up in the abdominal cavity. Through abdominal fluid aspiration, a sample of this fluid can be tested for cancel cells. Laparoscopy, also called as minimally invasive surgery, may be performed by a surgeon if the doctor suspects positive development of a disease. Through this technique, a sample is taken from the peritoneal tissue to be studied.

Cancer of peritoneum can be treated in various ways as it is diagnosed through different medical techniques. The stage of the cancer should first be identified by an oncologist before applying any treatment. It should be known whether the disease is confined to the peritoneum alone or has it spread from a part of the organ to other parts of it or from an organ to other organs. Treatment may include one or a combination of a number of different types of treatments used for primary peritoneal cancer. The treatment procedures may include surgery, chemotherapy and radiotherapy. Surgery is done to remove cancer in affected areas. This usually involves removing as much of the tumor elsewhere as possible. If there is any remaining cancer cells after the surgery chemotherapy may be given.

Chemotherapy is also given to patients if surgeons feel that it may be difficult to remove cancer cells through surgery. This is because chemotherapy uses anti-cancer drugs to destroy cancer cells or to make cancer cells smaller in turn making it easier for surgeons to remove cancer during the procedure. Radiotherapy uses high-energy rays to destroy cancer cells while doing as little harm as possible to normal cells in the body. This procedure is sometimes done to treat areas of primary peritoneal cancer if, in case, it comes back after surgery and chemotherapy. There are two ways in which radiotherapy may be done. The ways are either through external beam on the outside of the body or through internal radiation. In cases when patients refuse to undergo further treatment, or the disease had metastasized to too many organs and the chance of recovery has turned to almost zero, palliative care is used. This is done through frequent drainage of fluid from the abdominal cavity.

Cancer of peritoneum has high recurrence rate thus the patient may be required to undergo repeated surgeries and chemotherapy. If after the treatment cancer has gone into remission, the patient should be regularly checked more or less every three months for the first two to three years. Only after then that the patient should be checked or tested at least twice a month.