What are the Consequences of Cancer Spread to the Peritoneum?
Peritoneal cancer can lead to two main complaints:
Formation of ascites (accumulation of fluid in the abdominal cavity)
In every healthy person, a small amount of fluid is present in the abdominal cavity, to facilitate the smooth gliding of the small bowel. This fluid is being produced continuously, especially by the peritoneum of the small bowel, and is being absorbed continuously as well, especially by the peritoneum of the underside of the diaphragm and by the peritoneum of the omentum. In peritoneal cancer, there can be an imbalance between production and absorption of fluid, e.g. by blocking of the absorption by the tumor implants, resulting in ascites. The patient notices that he or she is rapidly gaining weight and that the abdomen is swelling.
Ascites caused pain, discomfort, difficulty in breathing, weakness, loss of appetite.
The tumor implants on the surface of the intestine can cause the intestine to stick to itself and to the abdominal wall, reducing mobility of the bowel and causing sharp angles. The tumor implants at the outside of the intestine can compress the intestine by their volume and block the passage of the intestinal contents. This results in abdominal cramps, vomiting, absent passage of gas and stools, and a swollen abdomen, a condition known as intestinal obstruction/malignant bowel obstruction (MBO). A solitary tumor in the large bowel (colon or rectum) could also block the lumen and cause obstruction. The treatment of this condition which is a different entity is usually surgery or stenting (refer to the section on colorectal cancer)