Peritoneal cancer

What is it?

Peritoneal Cancer starts in the lining of the abdominal cavity the ‘peritoneum’ which is like the plastic bag liner in which all your abdominal organs reside in. It should be regarded as a variety of ovarian cancer and is treated in an identical fashion and has identical outcomes. It is often only possible to finalise the diagnosis of peritoneal cancer versus ovarian cancer once all the surgical pathology specimens have been processed.

Presenting problem

Usually presents as vague abdominal symptoms such as bloating, fullness, indigestion, decreased appetite, weight gain or loss, change in bowel habits, fatigue, urinary frequency or incontinence, abdominal or pelvic pain, pressure in the abdomen.

Diagnosis

If any of the above symptoms persist for more then one month particularly over the age of 40 or with a history of breast or ovarian cancer an Ultrasound of the pelvis plus or minus tumour markers (CA125, CEA, CA19.9) are recommended to further investigate the problem. CT scanning 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 Land to give you the most accurate assessment preoperatively and ultimately the correct and complete treatment first time.

All cancer results are reviewed weekly by expert gynaecological pathologists and Dr Land in a multidisciplinary tumour board review meeting to ensure the highest possible standard of care is constantly attained.

Frozen Section – What is it?

If there is any concern regarding the nature (cancer or benign) of any abdominal lump, cyst or mass Dr Land will arrange a frozen section. This is a special assessment by a pathologist performed while you are asleep during the procedure on the abnormal tissue, cyst etc. to enable on the spot results which are telephoned through to Dr Land in the operating room. This enables a tailor made procedure to be performed immediately (all in the one procedure / anaesthetic) based on the intraoperative pathology result and what you and Dr Land have agreed upon that you wish to have done depending on the results: benign versus cancer.

ALL TREATMENT DESCISIONS WILL BE INDIVIDUALISED TO SUIT PATIENT NEEDS AND REQUIREMENTS

Treatment

In Disease that has spread throughout the peritoneal cavity the most important goal is to remove all visible disease, which may require quite an extensive procedure called a debulking operation.

Dr Land is a Certified Gynaecological Oncologist (CGO) and has the special training and expertise required to enable the highest probability of achieving this goal of optimal debulking (no visible disease).

Chemotherapy is frequently required as a powerful adjunct to surgery (either before and or after surgery) and Dr Land will arrange all necessary follow up including intraperitoneal chemotherapy where appropriate (chemotherapy into the abdominal cavity via a specially placed catheter).

Chemotherapy can usually be arranged closer to home for most patients who have come from outside Brisbane.

Follow Up

Dr Land will coordinate follow up after treatment is completed with 3 monthly reviews for 2 years then 6 monthly reviews for a further 3 years then usually annually thereafter. If you come from out of town alternate arrangements can be made in conjunction with your referring local team.