Peritoneal cancer is a rare cancer that affects women more than men. Peritoneal cancers are divided into primary cancers that originate in the peritoneum, and secondary cancers (or metastases), in which the main cancer is located outside the peritoneum but has spread to it. Both types are dangerous because they are difficult to diagnose and are not discovered until late. We will talk about them together. If you - or someone you know - have peritoneal cancer, there is no doubt that the question “How long does a patient with peritoneal cancer live?” has crossed your mind. Therefore, in this article, Dalili Medical will answer it and detail the factors that affect the length of time a patient with peritoneal cancer lives.

What is peritoneal cancer?

 

Peritoneal cancer, also known as primary peritoneal cancer or peritoneal cancer, is a rare type of cancer that occurs in only about six out of every million people. It develops in a thin layer of tissue that lines the abdomen, as well as the uterus, bladder, and rectum.

How long can you live with stage IV peritoneal cancer?

 

When peritoneal cancer is recognized or diagnosed in the early stages, the survival rate ranges from 11 to 18 months. But in the secondary stage of peritoneal cancer, the survival rate drops to 4-7 months.

Is peritoneal cancer curable?

 

This type of cancer, if diagnosed early in the early stages of infection, achieves a cure rate of up to 85%, which is an unprecedented rate in the treatment of tumors.

How often do you need peritoneal dialysis treatment?

 

Continuous peritoneal dialysis usually takes about 40 minutes. You need three to five sessions every day. Automated peritoneal dialysis usually takes eight to 12 hours. Most people choose to have automated peritoneal dialysis while they sleep.

What is the difference between hemodialysis and peritoneal dialysis?

 

Peritoneal dialysis aims to remove waste from the blood when the kidneys are unable to function properly. During peritoneal dialysis, the filtering fluid flows through a catheter (tube) into a part of the abdomen. The peritoneum in the abdomen acts as a filter, removing waste from the blood.

What is the peritoneum?

 

The peritoneum is a two-layer membrane made up of cells that lines the organs of the abdominal and pelvic cavity, covering the digestive system, liver, and reproductive organs. The peritoneal membranes and the fluid between the membranes protect the organs, allowing them to move freely against each other without sticking or rubbing.

Tumors that affect the peritoneum are divided into

1. Primary peritoneal tumors

2. Secondary metastatic peritoneal tumors

3. Colon and rectal tumors

4. Ovarian tumors

5. Stomach tumors

6. Appendix tumors

7. Pancreatic tumors

**Causes of peritoneal cancer and risk factors**

Age: As you get older, your chances of developing it increase.

Genetics: A family history of ovarian or peritoneal cancer increases your risk, as does carrying a BRCA1 or BRCA2 gene mutation or one of the Lynch syndrome genes.

Hormone therapy: Postmenopausal hormone therapy increases your risk.

Weight and height: Being overweight or obese increases your risk, as do tall people.

Endometriosis: Endometriosis increases your risk.

Factors associated with a lower risk of peritoneal or ovarian cancer include:

Taking birth control pills.

Breastfeeding.

Tubal ligation, removal of your fallopian tubes, or removal of your ovaries.

Note that removing your ovaries reduces your risk of peritoneal cancer, but it does not completely remove it.

**What is a peritoneal tumor scan**

 

1. CT scan

2. MRI

3. Ultrasound

4. Nuclear scan

What are the types of diseases?

 

Peritoneal cancer can have different pathological types. These types vary depending on the type of cell the cancer originates from. Some pathological types of peritoneal cancer are:

Epithelial peritoneal cancer: This is the most common type and originates from the epithelial cells on the surface of the peritoneum.

Peritoneal germ cell carcinoma: This type originates from germ cells and can spread to the peritoneum.

Mesenchymal peritoneal cancer: This is a rare type of peritoneal cancer that originates from mesenchymal cells. It often resembles soft tissue sarcoma.

Lymphoma: Although lymphomas that originate from the lymph nodes in the peritoneal area are rare, they can be considered peritoneal cancer.

**Diagnosis of peritoneal cancer**

Primary and secondary peritoneal cancers are difficult to diagnose in the early stages because the symptoms are vague and can easily be attributed to other causes.

Peritoneal cancer is often found only during surgery to remove a known tumor elsewhere in the abdomen.

First, your doctor will do a physical exam, take your medical history, and ask about your symptoms. He or she may order a series of tests to determine the diagnosis.

Tests used to diagnose peritoneal cancer include:

Imaging tests of the abdomen and pelvis: Ascites may be seen. Tests include CT scans, ultrasounds, and MRIs. However, peritoneal cancer is difficult to visualize with imaging tests.

A biopsy of an area that looks abnormal on examination, including removing fluid from ascites, to look for cancer cells. This may result in cancer cells implanting in the abdominal wall.

Diagnosis using a barium enema (lower gastrointestinal series): With this test, you will first receive an enema containing aChalky white solutions called barium, this shows the colon and rectum on X-rays and can detect some tumors and other problems.

Upper gastrointestinal series: Diagnosis is made by swallowing barium and X-rays show the esophagus, stomach, and duodenum (the first part of the small intestine).

Blood tests: To look for chemicals that may be elevated in peritoneal cancer, such as CA 125 and HE4, which are chemicals made by cancer cells. They are elevated in peritoneal cancer and also ovarian cancer, and may be elevated for other reasons, so this test cannot confirm the diagnosis of these cancers.

Laparoscopy: These are minimally invasive techniques to look directly at the peritoneum. They are considered the “gold standard” in diagnosis.

How is the tumor staged?

 

Staging peritoneal cancer is a process used to determine the extent and progression of the cancer. This staging process is important in determining a patient’s treatment options and predicting prognosis. Peritoneal cancer is staged as follows:

Stage I: At this stage, the cancer is confined to tissues on or near the surface of the peritoneum. It is usually found in one area.

Stage II: The cancer has spread to more areas of the peritoneal lining or organs, but is still confined to the abdomen.

Stage III: At this stage, the cancer has spread further within the abdomen and may have spread to surrounding organs or lymph nodes.

Stage IV: At this more advanced stage, the cancer has spread to organs outside the abdomen or to other parts of the body.

The stage of peritoneal cancer is usually determined by imaging tests (CT scans, MRIs, and ultrasounds) and biopsies taken during surgery. Staging results are used to determine a patient's treatment plan and prognosis. It is important to perform this stage to develop a personalized treatment approach for each patient.

**Symptoms of Peritoneal Cancer**

Symptoms of peritoneal cancer usually depend on the type of cancer, the stage of the cancer, and how far it has spread. Usually, symptoms do not appear in the early stages, making it difficult to diagnose and treat. However, some symptoms that some people experience include:

Indigestion

Nausea

Vomiting

Abdominal pain

Fatigue

Abdominal swelling

Bloating

Loss of appetite

Weight fluctuations (weight gain or weight loss)

Feeling of fullness in the stomach

Vaginal discharge

Back pain

Shortness of breath

Difficulty eating

Urinary blockage

Irregular bowel movements

**Factors that affect how long a person with peritoneal cancer lives**

- Cancer stage **Cancer stage is a medical term that doctors use to classify tumors according to their severity. The higher the stage, the more widespread and dangerous the cancer is. There are five stages numbered from 0 to 4. The stage increases with time and the diagnosis is delayed, so early diagnosis is important because it gives the patient a longer period to live. The stage of the tumor depends on its size, spread to the lymph nodes, and invasion of other organs when diagnosed. Thus, stage IV is the most dangerous and most fatal stage of cancer. Peritoneal cancers are usually diagnosed late because they do not cause many symptoms, and therefore the patient does not feel them until late. Therefore, this cancer is considered a dangerous cancer.

- Is this cancer primary or secondary?** Primary cancer is the cancer that first arose from the peritoneum itself. As for secondary cancer, it is the cancer that first arose outside the peritoneum and later spread to it. In general, secondary cancer indicates that the cancer has become late, and therefore the survival rates are low in it, and are less than primary peritoneal cancer.

- Type of cancer** Primary peritoneal cancer includes types including:

Similar to ovarian cancer, which is the most common.

Malignant mesothelium, the expected life expectancy of the patient ranges between 55 months in the best type and 13 months in the worst.

Small round cell tumor, which is the worst type, where the 5-year survival rate ranges between 15 and 30%.

Leiomyosarcoma, where the 5-year survival rate is 64%.

As for secondary peritoneal cancer, the survival rate depends on the location of the primary cancer.

If the primary cancer is in the pancreas, the patient lives for an average of 2.9 months, which is the worst type of secondary cancer.

If the primary cancer is in the stomach, the patient lives for an average of 6.5 months.

If it is in the colon, the patient lives for 6.9 months, which is the best type.

- **Patient age** Cancer becomes more dangerous with age. The survival rate for women over the age of 65 is 29%. In women under 65 years of age, it is approximately 60%.

- **Degree of malignancy of cancer cells**

- Presence of ascites (fluid in the abdomen), which is evidence that the cancer is dangerous

- Presence of metastases in the liver, which is evidence that the cancer is dangerous

- The patient's health and ability to perform daily activities

- The treatment applied and the body's response to it

- Cancer recurrence, which is indicated by some blood and laboratory tests

How is treatment performed according to the stages?

 

The treatment of peritoneal cancer may vary depending on the stage and type of cancer and the patient's general health condition. The following is a general treatment method according to the stages of peritoneal cancer:

Stage 0 and Stage I: Among the treatment options, surgical intervention plays a major role. This surgery involves removing the tumor and trying to control the cancer. Adjuvant treatments such as chemotherapy or radiotherapy may also be considered after surgery, but they are determined individually for each patient.

Stage II and Stage III: Treatment usually involves surgery, although surgery can be applied to a more widespread area. Adjuvant treatments such as:Chemotherapy or radiation therapy is most common after surgery. If the cancer has spread to lymph nodes or other organs, additional treatments that target these areas may be needed.

Stage IV: Treatment generally focuses on palliative treatments, with surgery playing a limited role. Palliative treatments are used to control symptoms and improve quality of life. Systemic treatments such as chemotherapy, targeted therapies, and immunotherapy are frequently used. Pain management, nutritional support, and psychosocial support are important to improve a patient’s quality of life.

Treatment for peritoneal cancer is individualized for each patient and is determined by taking into account the patient’s health status, age, the biological characteristics of the tumor, and other factors. The treatment plan is developed by the oncologist based on the patient’s individual needs.

**Treatment for peritoneal cancer**

The patient will likely have a treatment team that includes:

A surgeon.

An oncologist.

A radiologist.

A gastroenterologist.

A specialized nurse.

Treatment for primary peritoneal cancer is similar to treatment for ovarian cancer. For both primary and secondary peritoneal cancer, treatment depends on the location and size of the tumor and your general health. Treatment for secondary peritoneal cancer also depends on the condition of the primary cancer and its response to treatment.

**Surgery**

Surgery is usually the first step: Your surgeon will remove as much of the tumor as possible and may also have to remove your uterus (hysterectomy).

Or your ovaries and fallopian tubes (oophorectomy) or your fallopian tubes.

The layer of fatty tissue near your ovaries is called the omentum.

Your surgeon may remove any abnormal tissue in your abdominal area for further testing.

Surgical techniques known as cytoreductive surgery (CRS) have allowed surgeons to remove more cancerous tissue, which has improved the outlook for people with peritoneal cancer.

**Chemotherapy** Your doctor may use chemotherapy before surgery to shrink the tumor in preparation for surgery. It can also be used after surgery to kill any remaining cancer cells, making surgery more effective in many cases. This technique uses heat along with chemotherapy delivered directly to the site of the peritoneal cancer. It is known as hyperthermic intraperitoneal chemotherapy (HIPEC). This is a one-time treatment given immediately after surgery. The combination of CRS and HIPEC has “revolutionized” the treatment of peritoneal cancer, according to many researchers, but it has not yet been fully accepted as a standard treatment.

**Targeted therapy**

In some cases, a targeted therapy drug may be used. These drugs aim to stop cancer cells without harming normal cells. Targeted therapies include:

Monoclonal antibodies target immune cells on cells that promote the growth of cancer cells. These drugs can be combined with chemotherapy drugs.

PARP (poly-ADP ribose polymerase) inhibitors block DNA repair.

Angiogenesis inhibitors prevent the growth of blood vessels in tumors. Hormone therapy, radiation therapy, and immunotherapy may also be used in some cases of primary peritoneal cancer.