Peritoneal cancer is a rare cancer with few warning signs that mainly affects women. It develops in a thin layer of tissue that lines the abdomen called the peritoneum. This tissue also covers the uterus, bladder and rectum. The usual role of the peritoneum is to produce a fluid to help organs move smoothly inside the abdomen and pelvis.
Peritoneal cancer can be hard to spot in the early stages because symptoms are vague.
When clear symptoms appear, the disease has often progressed and is at an advanced stage.
The symptoms of PPC (primary peritoneal cancer) include:
- A swollen abdomen caused by fluid build-up (ascites)
- Abdominal pain
- Bloated feeling
- Feeling of fullness, even after a light meal
- Constipation or diarrhea
- Frequent urination
- Feeling of being sick (nausea)
- Loss of appetite
- Unexplained weight gain
If any of the above symptoms persist for more then two weeks, particularly over the age of 40 or with a history of breast or ovarian cancer in you or your family members, an ultrasound of the pelvis and tumour markers (CA125, CEA, CA19.9) are recommended to further investigate the problem. A CT scan may also be utilised depending on the situation, as this has a more global look at the rest of the abdomen, which can often be involved, with cancer of the peritoneum. As much information as possible from imaging, blood tests, history and examination will allow Dr Farrell to give you the most accurate assessment preoperatively and ultimately the correct and complete treatment the first time.
All cancer results are reviewed weekly by expert gynaecological pathologists and by Dr Farrell in a multidisciplinary team (MDT) review meeting, to ensure that the highest possible standard of care is constantly attained.
Peritoneal cancer is usually at an advanced stage when it is diagnosed. The important aims of treatment are to remove as much of the cancer as possible with expert surgery to the pelvis and abdomen, with the use of chemotherapy before and/or after surgery to kill any remaining microscopic cells. All treatment decisions will be individualised to suite patient’s needs and requirements.
Because peritoneal cancer and advanced ovarian cancer are caused by similar cancer cells and have a similar pattern of disease spread, doctors treat them in much the same way depending on the size and location of the cancer, and your general health.
Dr Farrell is a Certified Gynaecological Oncologist (CGO) and has the special training and expertise required to enable the highest probability of achieving the goal of removing all of the cancer cells (no visible disease). Studies show that if all of the disease visible to the naked eye can be removed surgically, survival is improved. Dr Farrell also works with other specialised surgeons (peritonectomy surgeons, and trained upper GIT and colorectal surgeons, where needed), and they work together when required to ensure the best surgical result is achieved.
Choices for chemotherapy following surgery includes chemotherapy infused through the veins (intravenous), or heated chemotherapy given into the abdominal cavity immediately following the surgical procedure (heated intraperitoneal chemotherapy, or HIPEC, if performed at St George Hospital), or a combination of both types of treatment.
Dr Farrell keeps up to date constantly with the evidence for the best treatments available to ensure that you receive the highest standard of care for the best survival outcomes following a diagnosis of gynaecological cancer.
Dr Farrell will coordinate follow up after treatment is completed, with 3 monthly reviews for 2 years, then 6 monthly reviews for a further 3 years at minimum.
For more information follow the link to the Cancer Council Booklet for ovarian cancer information on this website.