What Is Peritoneal Carcinomatosis? Everything to Know

Medically Reviewed By Faith Selchick, DNP, AOCNP
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Peritoneal carcinomatosis (PC) is a rare form of cancer in the peritoneum, which is the thin layer of tissue lining the inside of the abdomen. It is also known as peritoneal surface malignancy. Typically, this cancer forms when other tumors in the body spread to the peritoneum, and it is a sign that you have advanced stage abdominal cancer

PC can develop from many types of cancer. Most commonly, it arises in people with cancer of the colon, ovary, rectum, stomach, pancreas, or appendix. The treatment typically includes surgical removal of the tumor and chemotherapy. 

This article discusses the symptoms, causes, and treatment of PC. It also explains when you should contact a medical professional, the process of diagnosing cancer, and the steps you can take to help prevent it. 

What are the symptoms of peritoneal carcinomatosis?

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In the early stages, PC may not produce any symptoms. However, as the cancer progresses, you may experience symptoms such as:

  • nausea
  • diarrhea
  • abdominal pain
  • bloating
  • unexplained weight loss

Often the discovery of PC happens when there are more severe abdominal symptoms, such as ascites — a buildup of fluid in the abdomen — or intestinal obstruction

Learn more about the symptoms of cancer.

What are the causes of peritoneal carcinomatosis?

PC generally forms as the result of cancer already present in the body. It is most common in people with ovaries because the peritoneal tissue is very similar to ovarian tissue.

The cancers that are most likely to spread to the peritoneum include:

The cause of cancer is often unclear, but the disease is typically the result of a combination of factors. There are one or two ways in which PC may develop. 

The first way involves tumor cells separating from the original tumor and traveling through the abdominal cavity, eventually finding a place to anchor and grow in the peritoneum.

The second way involves tumor cells releasing and spreading in the body as the result of surgery or the manipulation of the primary tumor.  

Learn more about the causes of cancer.

What are the treatments for peritoneal carcinomatosis?

The goal of treatment for PC is to shrink the cancer and control it for as long as possible.

Treatment typically involves a surgical procedure to remove as much of the cancer as possible and then chemotherapy to destroy any remaining tumor cells. 

The type of treatment a doctor may recommend will depend on several factors, including:

  • the size of the cancer
  • the location of the cancer in the abdomen
  • your overall general health

If the cancer is advanced, the doctor may recommend palliative care to manage pain, improve quality of life, and address other symptoms that may arise. 

Cytoreductive surgery with HIPEC

Cytoreductive surgery involves removing all visible tumors. The surgeon may also remove organs from which they cannot detach the cancer. These may include the gallbladder, spleen, and part of the intestines. 

The second part of the procedure includes intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC), which is a method of delivering heated chemotherapy directly to the abdominal cavity through small tubes called catheters.

HIPEC typically lasts for about 30–90 minutes, depending on the type of chemotherapy. The purpose of this treatment is to destroy any remaining tumor cells. 

The advantage of this method is that cancers in the abdominal cavity are difficult to treat using chemotherapy via intravenous methods. Putting the chemotherapy directly into the abdominal cavity increases the chance of killing the tumor cells.

A surgical oncologist specializes in treating tumors. Learn more about the role of the surgical oncologist.

When should I speak with a doctor?

It is important to contact a doctor as soon as you have concerns about PC, as it is typically an advanced stage of cancer. Receiving an accurate diagnosis and beginning treatment as soon as possible increase the likelihood of a good outcome.

In particular, contact a doctor if you experience:

View our Cancer Appointment Guide for advice ahead of your appointment.

How do doctors diagnose peritoneal carcinomatosis?

Tests that a doctor may order if they suspect PC include:

It may not always be possible for doctors to determine the extent of the cancer using scans. Sometimes, exploratory surgery is the only way to get this information. 

Your doctor will be able to explain the tests to you and answer any questions you may have.

Can I prevent peritoneal carcinomatosis?

Cancer, including PC, can occur due to a combination of factors, including genetic, environmental, and lifestyle factors.

Although some of these are not preventable, you can still take steps to decrease your risk of developing cancer. 

These steps include:

  • maintaining a moderate weight through healthy eating and regular exercise
  • avoiding smoking
  • avoiding heavy alcohol consumption
  • avoiding radiation damage from the sun

If you think you have symptoms relating to cancer, contact a medical professional as soon as possible. They will be able to carry out tests to reach an accurate diagnosis.

What is the outlook for somebody with peritoneal carcinomatosis?

A person’s outlook can depend on the origin of the cancer, the extent of the growth, and how it responds to treatment.

For example, the survival rate for an individual with PC and colorectal cancer who does not receive treatment is about 4–7 months following diagnosis. This can increase to 12–23 months with palliative systemic therapy.

In cases where complete cytoreduction is possible, the survival rate can be as high as 63 months.

Researchers are also trialing new treatments that may, if the Food and Drug Administration (FDA) approves them, help increase survival rates.

Your doctor will discuss your outlook with you, taking into consideration your overall health and personal circumstances.

Summary

Peritoneal carcinomatosis is a form of cancer that affects the peritoneum. It is a rare form of cancer, occurring because of other tumors in the abdomen spreading to the peritoneum. It is usually a sign of advanced stage abdominal cancer.

In the early stages of PC, you may have no symptoms. However, over time, you may experience symptoms such as nausea, changes in bowel habits, unexplained weight loss, and abdominal pain.

Those who qualify for treatment may undergo cytoreductive surgery to remove the cancer. Doctors may then recommend HIPEC, which delivers heated chemotherapy directly to the abdomen to kill any remaining tumor cells. 

It is important to contact your doctor as soon as you have concerns about cancer. They will be able to carry out tests to reach an accurate diagnosis and advise you on which treatment options are available to you.

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Medical Reviewer: Faith Selchick, DNP, AOCNP
Last Review Date: 2022 Sep 15
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