Learn how to diagnose peritoneal cancer

Cancer of peritoneum: The whats and whys

Cancer of the peritoneum – what is it? Who are at risk? How is it diagnosed? How can it be treated? These are the questions that will be answered in this article.

Peritoneum is a thin, delicate sheet that lines the inside wall of the abdomen, covers the uterus and extends over the bladder and rectum. It is made up of epithelial cells and helps the organs inside the abdomen to move smoothly by producing a lubricating fluid. It is in the peritoneum where peritoneal cancer develops and this type of cancer looks and behaves like ovarian cancer. The same with peritoneum, the surface of the ovaries is made from epithelial cells as well. For that reason, both epithelial cancer, the most common type of epithelial cancer, and peritoneal cancer produce some of the same symptoms and are both treated in the same way.

However, despite their similarities, ovaries are minimally involved when peritoneal cancer develops. Women who develop ovarian cancer after having had their ovaries previously removed likely have peritoneal cancer. In addition, women who are at an increased risk of developing ovarian cancer, particularly due to the BRCA1 and BRCA2 genetic mutations, also are at increased risk for peritoneum cancer.

It can be difficult to spot symptoms for peritoneal cancer during its earliest stage. Often, the symptoms are vague or it does not produce any symptom until in its development. Loss of appetite; general abdominal discomfort and pain such as gas, indigestion, pressure, swelling, bloating or cramps; nausea, diarrhea, constipation, frequent urination, weight gain or loss with no known reason, feeling full even after a light meal, and abnormal bleeding from the vagina are symptoms of peritoneal cancer which are similar to those of ovarian cancer.

The cancer of peritoneum can be diagnosed in many different ways such as pelvic exam, CA-125 Assay, CT scan, ultrasound, biopsy and barium enema. These tests and other physical exams are performed by doctors. But of course, doctors don’t directly go into performing tests. Upon consultation, your doctor will begin by asking you questions about any symptom that you may be experiencing. Review on your medical history will be conducted. A thorough physical examination will also be conducted.

As someone who is concerned of your health, you should be aware of the different tests mentioned above. Let us start with the pelvic exam.  This is a test conducted to find any abnormality in the size and shape of the fallopian tubes, vagina, ovaries, bladder, rectum and uterus. A test called CA-125 Assay is a blood test. This is conducted to measure CA-125 level. Now, what is CA-125? It is a tumor marker that is often found in higher-than-normal amounts in the blood of women with ovarian cancer or peritoneal cancer. Another type of exam is computed tomography, popularly known as CT scan. This type of exam provides a series of pictures of the different areas of the inside of the body.  With the use of a computer linked to an X-ray machine, the pictures produced are detailed and would show any abnormality.

Another procedure is lower GI series or barium enema. This type of test is conducted with the use of an X-ray machine. A series of X-rays of the colon and rectum is performed. Enema with a white chalky solution that contains barium is given to the patient. The barium in the solution outlines the colon and rectum on the X-ray. This makes tumors and other areas with abnormalities easier to see. A picture is then taken for further study to make diagnosis.  Ultrasound is a very popular type of physical examination. This is done with the use of high-frequency sound waves that produce pattern of echoes and this in turn creates sonogram. The sound waves are focused on the ovaries. A test that involves removing tissue from the suspected area of the body is called biopsy. The sample is then examined and studied by a pathologist under a microscope to make a diagnosis.

The surgeon performs laparotomy, an operation to open the abdomen, to obtain tissue samples. Oophorectomy, may be performed by the surgeon if cancer is suspected. In this procedure, the entire ovary is removed. Occasionally, when cancer is suspected, a needle biopsy is performed; however, in cases of ovarian tumors, this is not generally performed if surgery is planned.

If there are various forms of diagnosing peritoneal cancer, there are various ways of treating it as well. It should be noted that the type of treatment depends on different factors involved such as: the stage of your cancer, how extensive it has affected and spread to the other parts of the body, and of course, your general health. Since there are various treatment methods and factors to consider, you should work with your doctor in choosing and to develop the kind of treatment plan that is best for you and that would meet all your needs and the factors that you consider as well. If you have a pelvic mass or the place where the cancer first started to grow is unclear, the surgery may be used to diagnose and treat peritoneum cancer. The tumor is removed from the lining of the abdomen where the cancer started to grow. This procedure is called exploratory surgery.

Another approach in treating peritoneal cancer is chemotherapy in which most cases, received by patients on outpatient basis. This procedure involves injecting anti-cancer drugs into the veins. Since, peritoneum and the surface of the ovaries are made of epithelial cells, they show similar symptoms when they are affected by cancer. For this reason, the anti-cancer drug used for treating peritoneum cancer and ovarian cancer are similar as well. There is not only one chemotherapy drug, for this reason, treatment can be given weekly or every two weeks to three weeks depending on  the type of drug used. The cancer of peritoneum, in some cases, is not diagnosed until it has advanced. For patients whose disease has advanced, palliative care, commonly known as supportive care, is designed and aims to relieve symptoms such as pain, fluid in the abdomen and weight loss.