Peritoneal Carsinomatosis Symptoms
The abdominal membrane (peritoneal) is covered with an epithelial-like abdominal membrane composed of a single cell layer, supported by the tissue connected to it; also called mesothelium.
The parietal peritoneum includes organs suspended in the abdominal wall and visceral peritoneal lines. In the abdominal space, the internal organs are covered with an abdominal membrane and hanging from the abdominal wall through the intestine gut (mesentery). Some organs are located in the retroperitoneum between the abdominal wall and the parietal peritoneum.
Tumor cells may spread to the peritoneal cavity prior to surgery by shedding from the predominant tumor or by surgical trauma, by manipulating the premature tumor and being released from the blood or lymph vessels.
All intraabdominal organs in the pelvic space can be targeted for tumor cells. Therefore, patients may develop intestinal obstruction, fistula formation, intestinal perforation and inadequate feeding.
In early stages, peritoneal cancer may not cause symptoms at all. Frequently, peritoneal cancer is even discovered by complete surprise during surgery for the primary tumor. Even during the asymptomatic stage, the disease may already be widespread and advanced, which supports the reputation of peritoneal cancer as a “silent killer”.
When the tumor nodules start to grow on the intestinal surface, they may cause progressive obstruction of the intestinal tract. This obstruction may result in an uncomfortable swelling of the abdomen, loss of appetite and weight, nausea and constipation. Additionally, non-specific symptoms, such as tiredness and pain, may occur.
Peritoneal carcinomatosis may also result in the accumulation of large amounts of watery fluid in the abdominal cavity. This phenomenon is called “malignant ascites” and eventually results in an enlarged abdominal cavity. For pseudomyxoma peritonei, the ascites typically consist of mucus; therefore, the name “jelly-belly” is sometimes used to describe this specific subtype. Ascites may cause symptoms similar to those of bowel obstruction, but ascites may also lead to shortness of breath due to pressure on the lungs.
Complete bowel obstruction, resulting in vomiting, abdominal pain and the inability to eat and drink, is often a late and severe symptom of peritoneal cancer and may result in rapid deterioration of the patient’s condition.