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Peritoneal Cancer

Clinical OncologyGeneral Surgery

Peritoneal cancer is a rare but severe form of cancer that involves malignant changes in the peritoneal tissues. The peritoneum is the thin membrane that surrounds the abdominal organs, and peritoneal cancer typically occurs due to metastasis from cancers originating in other organs within the abdominal cavity. In Hong Kong, peritoneal cancer is most commonly caused by the metastasis of ovarian cancer, making the incidence higher in female patients.

Symptoms

The symptoms of peritoneal cancer can vary depending on the severity of the condition. Still, some common signs include abdominal pain, bloating, loss of appetite, weight loss, abdominal swelling, and more. These symptoms may resemble those of other abdominal conditions, so further examination and assessment are necessary for an accurate diagnosis.

Cause & Factors

Cause

Peritoneal cancer is usually associated with cancers originating in other organs. For example, metastasis from cancers such as ovarian cancer, colorectal cancer, bladder cancer, and others can lead to peritoneal cancer.
Most cases of peritoneal cancer are caused by the spread of ovarian cancer cells to the peritoneal tissue. Ovarian cancer cells may spread through the lymphatic system or into the peritoneum.

Factors

Genetic Factors	Individuals with certain genetic variations may be more susceptible to peritoneal cancer. Those with a family history of ovarian cancer or other related cancers may face a higher risk.
Excessive Abdominal Surgeries	Having undergone multiple abdominal surgeries, especially those related to the ovaries or other abdominal organs, may increase the risk of peritoneal cancer.
Age	Peritoneal cancer is more commonly seen in middle-aged or older individuals.
Gender	Females are relatively more prone to peritoneal cancer, which is associated with a higher frequency of ovarian cancer metastasis.
Immune System Issues	Individuals with compromised or weakened immune systems may be more susceptible to peritoneal cancer.
History of Other Cancers	Having a history of other related cancers, such as stomach or colorectal cancer, may also increase the risk of developing peritoneal cancer.

Diagnosis

Diagnosing peritoneal cancer involves the following methods:

Clinical Examination	Physicians conduct abdominal palpation and physical examinations to perceive the presence of abnormal masses or other symptoms.
Imaging	Various imaging techniques such as abdominal ultrasound, CT Scan, and MRI may be employed to visualize the peritoneal region and identify tumours or other abnormalities.
Laparoscopy	Through laparoscopic surgery, doctors can directly examine the peritoneal region and obtain tissue samples for biopsy.
Biopsy	Tissue biopsies, typically performed through surgery or laparoscopic examination, are conducted to confirm whether the tumour is malignant.
Blood Tests	Specific blood markers may be tested, as elevated levels of specific markers can indicate peritoneal cancer.

The diagnostic process for peritoneal cancer often requires a combination of these methods to ensure a correct and comprehensive assessment.

Staging

Stage I: Cancer is localized to one area of the peritoneum.
Stage II: Cancer has spread to multiple areas within the abdominal cavity but remains within the peritoneum.
Stage III: Cancer has spread beyond the peritoneum to other areas, possibly involving the surfaces of organs or other structures.
Stage IV: Cancer has extended to distant organs, potentially including the liver, lungs, or other tissues far from the peritoneum.

Surgery	The removal of tumours on the peritoneum, sometimes involving the excision of affected organs. Surgery can be performed using either laparoscopic or open abdominal procedures.
Chemotherapy	Chemotherapy may be used before or after surgery to reduce tumour size or prevent recurrence.
Hyperthermic Intraperitoneal Chemotherapy (HIPEC)	During surgery, doctors may directly infuse chemotherapy drugs into the peritoneal area and circulate them to enhance the effectiveness of chemotherapy.
Radiation therapy	It may be used in specific cases of peritoneal cancer, typically following surgery or chemotherapy.
Immunotherapy	Some patients may undergo immunotherapy to boost the immune system's attack on cancer cells.