Until recently, the classical treatment of peritoneal cancer consisted of intravenous chemotherapy. In case of obstruction, a surgical intervention, such as a bypass between the bowel segment before and the segment behind the obstruction, was often carried out. In case of ascites (peritoneal fluid), medication to expulse fluid was prescribed and punctions were performed if necessary.
What has changed recently in Peritoneal Cancer Treatement?
Since the last 25 years, a new form of treatment has been introduced for the management of peritoneal carcinomatosis, which consists of removal of all the gross tumor (cytoreductive surgery) followed by Hyperthermic Intraperitoneal Chemotherapy (HIPEC).
Which patients are suitable for Cytoreductive Surgery and HIPEC?
There are too main concerns: the primary site of the tumor (read the section on ‘who can be treated’) and secondly the patient condition and disease spread. For evaluating a patient’s general well being and the extent of disease spread, the surgeon performs a thorough evaluation. It is important for the patient to be in a good general condition. The blood tests and lung function should be normal. A CT scan/PET CT scan is done to evaluate the exact extent of disease in the peritoneal cavity and to rule out involvement of other organs. Patient selection is of utmost importance for the success of this treatment.