Peritoneal Carcinomatosis (Peritoneal Surface Malignancy)

Why choose us for peritoneal carcinomatosis care?

Peritoneal carcinomatosis is cancer that spreads to the tissues that make up the abdominal cavity lining. It can be challenging to treat. At Mays Cancer Center, home to UT Health San Antonio MD Anderson Cancer Center, you can access leading treatment options, close to home.

A team of highly trained cancer doctors with different areas of expertise collaborates to determine the most appropriate treatment for you. 

Our experts deliver specialized treatment that combines surgery with chemotherapy. This procedure, called cytoreductive surgery with HIPEC (hyperthermic intraperitoneal chemotherapy), requires intensive training. We are one of the few centers in San Antonio to offer it. 

What you need to know about peritoneal carcinomatosis

• Peritoneal carcinomatosis is also called peritoneal surface malignancy. It refers to any cancer that spreads to the abdominal cavity (the space between internal organs in the abdomen) after developing elsewhere in the body (like the colon).
• Peritoneal carcinomatosis is different from primary peritoneal cancer, which is cancer that originates in the peritoneal tissue. Doctors treat these two conditions in different ways.
• Peritoneal carcinomatosis requires input from multiple specialists. Our doctors offer personalized evaluation and advanced treatments for peritoneal carcinomatosis. 

How to talk to your doctor about peritoneal carcinomatosis

A peritoneal carcinomatosis diagnosis may raise many questions. You’re in the right place. Our team is experienced in treating this complex condition. 

Your doctor will explain all your treatment options, including how cancer or treatment could impact your life. We care about you and consider what matters to you when making treatment recommendations. 

You might want to ask your doctor about:

• Additional testing you might need and how tests help guide your treatment plan
• Cancer stage, including any other areas the cancer affects and what that means for your health
• Treatment options, including whether you’re a candidate for cytoreductive surgery (surgery to remove cancer cells) with or without HIPEC 
• Clinical trials for which you may be eligible, at any phase of your care
• Support services to help you heal after surgery or manage treatment side effects 

We encourage you to include a supportive family member or friend in your care, should that be a comfort to you. We welcome your support person at your appointments.

Types

Many cancers can spread to the abdominal cavity, leading to peritoneal carcinomatosis. These include:

• Appendix cancer
• Colon cancer
• Pancreatic cancer
• Stomach cancer

Primary peritoneal cancer refers to cancer cells that start in peritoneal tissues (cells that line the abdominal wall and organs), such as mesothelioma.

You might want to ask your doctor about:

• Additional testing you might need and how tests help guide your treatment plan
• Cancer stage, including any other areas the cancer affects and what that means for your health
• Treatment options, including whether you’re a candidate for cytoreductive surgery (surgery to remove cancer cells) with or without HIPEC
• Clinical trials for which you may be eligible, at any phase of your care
• Support services to help you heal after surgery or manage treatment side effects

We encourage you to include a supportive family member or friend in your care, should that be a comfort to you. We welcome your support person at your appointments.

Symptoms

Peritoneal carcinomatosis symptoms are often vague. Some people experience no symptoms at all, especially in the early stages of the disease.

Symptoms may include:

• Bloating or swelling near the abdomen (belly)
• Discomfort or pain near the midsection
• A lump (or mass) you can feel when pressing on the abdomen
• Changes in bathroom habits, such as constipation or frequent bathroom trips
• Nausea or vomiting
• Extreme tiredness after even minimal exertion

Diagnosis

We use many different tests to diagnose peritoneal carcinomatosis. Your doctor will first thoroughly evaluate your symptoms, which includes reviewing your medical history.

If our specialists suspect peritoneal carcinomatosis, they may order one or more tests:

• Imaging tests like CT or MRI scans capture fine details of the abdominal cavity and help doctors pinpoint the location of cancer cells and potential cancer spread.
• Tissue or fluid analysis is a procedure where doctors remove a small piece of tumor tissue or abdominal fluid. Pathologists (doctors who specialize in diagnosis) then examine cells under a microscope for signs of cancer. These tests can confirm or rule out cancer.

Learn more about diagnosing cancer.

Treatment

Our team of doctors works closely to care for patients with peritoneal carcinomatosis. Surgical oncologists consult with radiologists (medical imaging experts) and other doctors to review your test results and decide the next steps in your care.  All patients are discussed at our multi-disciplinary tumor board. 

Depending on the details of your case, you may be a candidate for a specialized treatment called cytoreductive surgery, with or without HIPEC (hyperthermic intraperitoneal chemotherapy). 

During cytoreductive surgery with HIPEC, surgeons first remove all signs of cancerous tissue. They then apply a concentrated dose of heated chemotherapy medicine to the abdominal cavity to treat remaining cancer cells directly. 

Our experienced specialists include cancer surgeons and critical care doctors trained to perform this technical procedure with a high degree of safety. We are one of the few centers in San Antonio with the skills and capabilities to offer this advanced treatment option.

Currently, cytoreductive surgery and HIPEC are offered for peritoneal carcinomatosis secondary to:

• Appendix cancer that has spread to the peritoneum
• Colon cancer that has spread to the peritoneum
• Mesothelioma
• Certain gynecological cancers, such as fallopian tube cancer and ovarian cancer

Some patients may benefit from additional chemotherapy before or after surgery. Your care team will make treatment recommendations based on your situation and input.

Find out more about cancer treatments.

Research and clinical trials

As an academic medical center with far-reaching research resources, we participate in hundreds of clinical trials at any one time.

Our physician-scientists are currently exploring the potential benefits of cytoreductive surgery and HIPEC for other cancers, including certain gastrointestinal tumors. Your doctor will explain how any ongoing clinical trials for which you may be eligible may enhance your care.

Get more information about cancer clinical trials and research.