Omentum

LorettaMarshall said:

Gina~Something is amiss! B sure 2 have 2nd Opinion!

Dear Gina

Am wondering how long ago this mass in your mom’s omentum was discovered.  Normal CA-125 falls in the range of 35, so a high of 229 should be a cause for even more investigations.  You ask if there are other similar cases.  I’m thinking you’re asking if anyone else has had a mass in their omentum.  So I thought I would share a bit about my cancer. 

My own story is that I went to the ER here at home thinking I might have a hernia.  (November of 2012) Two hours later I was given the results of a CT scan, and it read:  PERITONEAL CARCINOMATOSIS!

I went to the University of Pittsburgh Medical Center for a SECOND opinion 3 weeks later.  There a laparoscopic exploratory surgery and a PET scan revealed Ovarian Cancer as well.  I was told that the tumors were too numerous and too large to perform a Cytoreductive Surgery (CRS) prior to having some pre-op chemotherapy.  So I came home and proceeded a regimen of Carboplatin and Paclitaxel (Taxol).  They were effective in reducing the number of tumors to a size more conducive to surgery.  So a Cytoreductive surgery (CRS) was performed by a Dr. David Bartlett on July 1, 2013. 

My CRS was never intended to be “curative” because this is a Stage IV diagnosis, but it was performed to remove all non-essential organs to which the cancer could spread.  I had already had my uterus removed at age 36, and an appendectomy at age 12, otherwise they would have been removed as well.  So my operation resulted in the removal of my “omentum—spleen—gallbladder—fallopian tubes—ovaries—and resectioning of my intestines”.  This is a major surgery.  And depending on where a patient is treated, a procedure called HIPEC is often performed.  This will be something you will want to consider.  You mentioned CT scan—how about a PET scan or a Transvaginal Ultrasound by chance? 

So I would ask if your mom has had a SECOND opinion preferably with a gynecologic oncologist who is especially trained in the female reproductive organs.  I would highly recommend a 2^nd opinion at UPMC or some hospital that also specializes in the HIPEC procedure.  This is (layman’s term) a hot chemo bath at the end of the surgery designed to treat the inside of the abdominal cavity only.  That way the chemo is more highly concentrated to the cancer in the area, and does an excellent job of killing microscopic tumor cells yet undetectable by an ordinary CT or PET scan. 

(I have compiled several informative YouTube videos) and posted them a special topic re HIPEC on the Peritoneal link.  HYPERTHERMIC INTRAPERITONEAL CHEMOPERFUSION (HIPEC) TREATMENT--You can read it here:  https://csn.cancer.org/node/309344

I will give you some other links that will give you further information below my name, but if I were you, I would by all means have a SECOND opinion at a reputable hospital as soon as possible.

Has your mother had a colonoscopy.  The peritoneum is where the colon is located as well.  Am wondering if your mom has had a colonoscopy as a tool that shed some light on the source of this mass on the omentum? 

Note that I am not saying that your mom’s diagnosis may turn out to be similar to mine, but both Peritoneal cancer and Ovarian cancer are treated in the same way.  The omentum is located in the abdomen which is situated in the Peritoneum.  The National Cancer Institute article cited below states that cancer can begin in the Peritoneum and spread to the Ovaries or Ovarian cancer can spread to the Peritoneum.  In my case, it was found in both my ovaries and my Peritoneum when I was diagnosed.

More than one cancer can find its way to the Peritoneum and spread to the omentum, so I would want to be certain that doctors have checked out her colon as well.  Don’t mean to scare you, but when there is a mass on the omentum, something is going on.  Here’s wishing you all the best in finding answers soon.

Loretta

(Peritoneal Carcinomatosis/Ovarian Cancer Stage IV) since November 2012

1.  http://news.cancerconnect.com/cancer/newly-diagnosed/

“Newly Diagnosed

A new diagnosis of cancer can be a shock, making you feel out of control and overwhelmed. Getting informed can help alleviate these feelings. Remember, very few cancers require emergency treatment; you have time to learn about your diagnosis and treatment options, ask questions, and get a second opinion. This section is designed to help you address your initial questions before you move forward with your treatment…”

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2.  http://news.cancerconnect.com/types-of-cancer/ovarian-cancer/

3.  http://news.cancerconnect.com/types-of-cancer/ovarian-cancer/ovarian-cancer-overview/

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4.  https://www.oncolink.org/cancers/gynecologic/ovarian-cancer/all-about-ovarian-cancer

“…A rare type of cancer, called primary peritoneal cancer, is a malignant tumor arising from the peritoneum, the lining of the abdominal cavity. It tends to behave in a fashion very similar to ovarian cancer, and they can look identical under the microscope. The treatments used are often the same as those used for ovarian cancer. This type of cancer can develop in women with intact ovaries or in those who have had their ovaries removed…”

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5.  https://www.cancer.gov/types/ovarian

“OVERVIEW…

The ovaries and fallopian tubes are part of the female reproductive system. There is one ovary and one fallopian tube on each side of the uterus (the hollow, pear-shaped organ where a fetus grows). The ovaries store eggs and make female hormones. Eggs pass from the ovaries, through the fallopian tubes, to the uterus. The peritoneum is the tissue that lines the abdomen wall and covers organs in the abdomen. Part of the peritoneum is close to the ovaries and fallopian tubes.

 The most common type of ovarian cancer is called ovarian epithelial cancer. It begins in the tissue that covers the ovaries. Cancer sometimes begins at the end of the fallopian tube near the ovary and spreads to the ovary. CANCER CAN ALSO BEGIN IN THE PERITONEUM AND SPREAD TO THE OVARY.

The stages and treatment are the same for ovarian epithelial, fallopian tube, and primary peritoneal cancers…”

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 6.  https://www.kenhub.com/en/videos/anatomy-of-greater-omentum

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7.  http://www.uchospitals.edu/news/2011/20111030-omentum.html

“Fat cells in abdomen fuel spread of ovarian cancer -Similar process may boost growth of other cancers

October 30, 2011

A large pad of fat cells that extends from the stomach and covers the intestines provides nutrients that promote the spread and growth of ovarian cancer, reports a research team based at the University of Chicago in the journal Nature Medicine, published online October 30th, 2011.

Ovarian cancer, the fifth leading cause of cancer deaths in women, tends to spread within the abdominal cavity as opposed to distant organs. In 80 percent of women, by the time ovarian cancer is diagnosed, it has spread to the pad of fat cells, called the omentum. Often, cancer growth in the omentum exceeds the growth of the original ovarian cancer. 

"This fatty tissue, which is extraordinarily rich in energy-dense lipids, acts as a launching pad and energy source for the likely lethal spread of ovarian cancer," said study author Ernst Lengyel, MD, PhD, professor of obstetrics and gynecology at the University of Chicago. "The cells that make up the omentum contain the biological equivalent of jet fuel. They feed the cancer cells, enabling them to multiply rapidly. Gaining a better understanding of this process could help us learn how to disrupt it."

The researchers performed a series of experiments to identify the role of these fat cells as major mediators of ovarian cancer metastasis. The first step was to understand the biological signals that attract ovarian cancer cells to the omentum and use it for rapid growth.

The spread of ovarian cancer cells to the omentum can happen quickly. Ovarian cancer cells injected into the abdomen of healthy mice find their way to the omentum within 20 minutes. The researchers found that protein signals emitted by the omentum can attract the tumor cells. Inhibitors which disturbed these signals reduced this attraction by at least 50 percent.

Once ovarian cancer cells reach the omentum, they quickly develop the tools to devour the sustenance provided by this fatty tissue, reprogramming their metabolism to thrive on lipids acquired from fat cells. Ovarian cancer can rapidly convert the entire omentum, a soft fat pad, into a solid mass of cancer cells…”

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8.  http://www.myhealthyfeeling.com/omentum-cancer-2/

“…Causes of omentum cancer

The exact reasons for the different types of ovarian cancers are not known. As a rule, cancer starts due to the mutation of normal, healthy cells into abnormal, altered cells. The healthy cells tend to grow and multiply at a uniform rate and die after a definitive time period.

On the other hand, cancer cells tend to grow and multiply at a rapid pace. They also do not die. An accumulation of such cancer cells results in the formation of a mass or tumor.

Cancer cells also tend to separate from their initial origins and spread to other tissues in the body. Such spread of the cancer cells is called metastasis, and metastasis of ovarian cancer cells is what results in omentum cancer.

There are several risk factor that increase the chances of ovarian cancer and thereby the vulnerability to omentum cancer. Some of them include:

• A family history of ovarian cancer or omentum cancer increases the risk to the condition.

• Women who have inherited gene mutations such as breast cancer gene 2 (BRCA2) and breast cancer gene 1 (BRCA1), as well as have a inherited syndrome  hereditary nonpolyposis colorectal cancer or HNPCC, are at greater risk to develop ovarian cancers and omentum cancer.

• A personal history of cancers of the colon, rectum, breast, or uterus increases the risk to developing omentum cancer

• Women who have never been pregnant have increased risk to ovarian cancer and omentum cancer

• Ovarian cancer or omentum cancer tends to develop after menopause and the risk increases with age

• Some studies indicate that hormone replacement therapy may increase the risk to ovarian and omentum cancer

  Omentum cancer treatment

• Omentum cancer can be treated by surgical removal of the omentum. The accompanying ovarian cancer would also involve treatment that uses surgery for removal of the ovaries and other affected tissues.

• Chemotherapy may be used to intravenously inject drugs that are specifically designed to find and kill the cancer cells. Such drugs may also be directly injected in the abdomen to kill the abnormal cells that cause omentum cancer…”

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Thank you so much Loretta.  Her diagnosis sounds very similar to yours.  We have now seen a Gyno Oncologist and surgery has been schedule to remove anything and everything in the area that needs to be removed and then given a treatment plan.  I appreciate all of the info. you shared !  It's so nice to hear from someone that has been through it.