Peritoneal carcinomatosis or peritoneal metastasis is a stage of advanced cancer that occurs when cancer cells spread throughout the peritoneum, the membrane that lines the abdominal cavity and internal abdominal organs. Recognizing the symptoms of peritoneal carcinomatosis is crucial for early diagnosis and treatment.
Common symptoms of peritoneal carcinomatosis
The origin of this tumor is usually associated with the spread of tumors of abdominal origin such as stomach, colon, ovary, pancreas or appendix through the peritoneum, although it can also come from extra-abdominal organs, such as breast cancer. Recognizing the symptoms of peritoneal carcinomatosis is crucial for early diagnosis and treatment.
Abdominal pain
One of the most common symptoms of peritoneal carcinomatosis is abdominal pain. This pain can vary in intensity and is often described as a constant dull ache that may worsen over time. The pain is due to irritation and thickening of the peritoneum due to the presence of cancer cells.
Abdominal distention
Abdominal distention is caused by the accumulation of fluid in the abdomen (ascites) or by high tumor burden. This accumulation can cause a feeling of heaviness and discomfort in the abdomen, and is often accompanied by shortness of breath.
Weight loss and lack of appetite
Peritoneal carcinomatosis can lead to significant weight loss and a marked decrease in appetite.
Digestive problems
Patients with peritoneal carcinomatosis often experience digestive problems such as nausea, vomiting or intestinal transit disorders such as diarrhea or episodes of intestinal obstruction.
Fatigue and weakness
Extreme fatigue and weakness are common symptoms in patients with peritoneal carcinomatosis.
Specific symptoms according to the primary tumor
Symptoms of peritoneal carcinomatosis can vary significantly depending on the origin of the primary tumor. The following are some of the most common symptoms associated with different types of cancer that may spread to the peritoneum:
- Colon: The patient may experience rectorrhagia or bleeding with stool.
- Stomach: Symptoms may include epigastric discomfort and pain, reflux, vomiting, and even vomiting blood.
- Ovaries: A sensation of abdominal mass and weight in the pelvis is common.
- Pancreas: Often manifest with obstructive jaundice, which causes the patient’s skin to turn yellow.
Early diagnosis of peritoneal carcinomatosis
Early diagnosis of peritoneal carcinomatosis is crucial to improve treatment options and the patient’s prognosis. According to Dr. Delia Cortés Guiral, director of the Viamed Institute of Advanced Surgical Oncology (IVOQA), this type of cancer is silent and is generally detected when it is already very advanced.
A subgroup of patients who have had a first cancer, especially ovarian, gastric, colon or appendiceal cancer are at high risk of developing peritoneal carcinomatosis. “In these cases we use nomograms and statistical calculators to assess this probability in their discharge reports and tumor committees. It is crucial that these high-risk patients follow a comprehensive follow-up protocol to detect and treat early any signs of peritoneal carcinomatosis, as a low PCI (Peritoneal Cancer Index) improves survival and prognosis,” explains Dr. Cortés.
Patients with synchronous debut of primary tumor and peritoneal carcinomatosis should be promptly referred to specialized centers for appropriate treatment.
Peritoneal carcinomatosis is a complex and serious condition that requires immediate specialized medical attention. Recognizing and understanding the symptoms can lead to early diagnosis and better outcomes with currently available treatment options and surgical techniques.
