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Hamzah_mohd~Here R web links 2 help U find answers 4 Mum's rare cancer~hope it helps!

LorettaMarshall's picture
LorettaMarshall
Posts: 682
Joined: Sep 2012

Have chosen to create a new forum topic since "hamzah_mohd" has entered into a discussion that took place in 2011.  More than likely many of those are no longer posting, but if they are, they can still answer but I doubt that many replies will come from people who posted in that particular time frame.  Nevertheless, I would prefer to put this posting on a forum topic all its own.  Loretta

The posting I am referring to is shown below:

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https://csn.cancer.org/comment/1580221#comment-1580221

hamzah_mohd

Peritoneal Cancer cure or new technology ?

Hi all,

I am from india, my mother is recently diagnosed with advanced pertioneal cancer, near abdomen. doctors here says it is a rare type of desease, which only occurs in women. i read all of your post, could anyone please suggest what treatment we should look forward to. my mums age is 50.”

Dear hamzah_mohd

Have read your letter and am sorry to hear about your mum.  I don’t know how many posts you have read on this site, but I will say one thing.  Men can also have Peritoneal Cancer.  For instance, I was in the hospital at the University of Pittsburgh Medical Center.  There I met a young gentleman, age 23, who was there and had the Cytoreductive Surgery, plus the heated intraperitoneal treatment.  His appendix had ruptured and caused cancers to form that resulted in him having the same kind of surgery as did I (Cytoreductive Surgery – CRS).  

Actually although this is a rare disease, the treatment usually follows the same regimen as Ovarian Cancer.  I happen to have first been diagnosed with Peritoneal Carcinomatosis, meaning multiple large tumors floating around in the peritoneal fluid in my abdomen.  A 2nd opinion at the University of Pittsburgh Med. Ctr. In Pittsburgh, PA did exploratory surgery and found it to be in my ovaries as well.  So I was instructed to first have chemotherapy and then come back for a re-evaluation.  The neo-adjuvant chemo prior to surgery did reduce the size of the tumors enough to make me a candidate for Cytoreductive surgery. 

So to answer your question “in a nutshell” an American expression meaning in a few words, Peritoneal Cancer is treated in much the same way as Ovarian Cancer.  However, the cancer may have spread to the Peritoneum from more than one place in one’s abdomen.  It can also be associated with Colon Cancer as well.  So below my name I will share with you a few links that will give you more info.  Now please understand that I am only a cancer patient myself, and am incapable of diagnosing a patient, but to be specific about treatment for your mum, one would have to know more than just “advanced Peritoneal Cancer”.  There are different types of cancer that can be classified as “Peritoneal Carcinomatosis”.   Cancer from other places in the abdomen can metastasize (spread) to the Peritoneum.  Lastly, these references will give you a general idea of what Ovarian cancer diagnoses and treatments are involved. 

However, I have found a site that speaks about a specific diagnosis called Extraovarian Primary Peritoneal Carcinoma.  Quite naturally it would be a type of Peritoneal Cancer that only women can have men don’t have ovaries.  So even though you say, “advanced peritoneal cancer”, it must be different from Peritoneal Carcinomatosis, which both men and women can be diagnosed with.  So when you look at your mum’s health reports and know exactly what diagnosis have they given her, then you can “comb” through these references and find specific info relative to her individual diagnosis.    

 In any event, I will give you some links for both Peritoneal Carcinomatosis as well as one for “ExtraOvarian Primary Peritoneal Cancer.  My diagnosis is definitely Peritoneal Carcinomatosis and is directly related to my ovaries.  Whereas, I have another friend who has been diagnosed with Peritoneal Carcinomatosis which has spread from her colon.  So there could be different drugs and treatments prescribed depending on the “primary cancer” and the secondary metastasis.  So you would need to provide the exact title of mum’s diagnosis to be absolutely about the treatment.  From all that I’ve read, it is still treated the same as Ovarian cancer.

I hope that you are at one of the top hospitals in India that is capable of giving your mum the utmost care and am wishing for your mom, the very best treatment that exists in India.

Loretta

Peritoneal Carcinomatosis/Ovarian Cancer Stage IV/ DX 11-2012/Pre-op chemo of Carboplatin/Taxol then Cytoreductive Surgery July 1, 2013 @ UPMC

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(My note:   This review was reported in 1998.  Surely some advancement has been made since then, but it does serve to differentiate one type of ovarian cancer from another.  Yet it is to be treated in a similar fashion as ovarian cancer.)

1.  http://www.cancernetwork.com/ovarian-cancer/extraovarian-primary-peritoneal-carcinoma

“Extraovarian primary peritoneal carcinoma (EOPPC), a relatively newly defined disease that develops only in women, accounts for approximately 10% of cases with a presumed diagnosis of ovarian cancer. Characterized by abdominal carcinomatosis, uninvolved or minimally involved ovaries, and no identifiable primary, EOPPC has been reported following bilateral oophorectomy performed for benign disease or prophylaxis. Most cases are of serous histology; however, nonserous tumors have been observed.

Although EOPPC is similar to serous ovarian carcinoma with respect to clinical presentation, histologic appearance, and response to chemotherapy, molecular and epidemiologic studies have indicated that it may be a separate entity. This review explores the clinical presentation, management, prognosis, and survival of EOPPC

Researchers at the Roswell Park Cancer Institute [17] reported an overall response rate of 65% in a group of 23 EOPPC patients treated primarily with cisplatin-based regimens following cytoreductive surgery. This response rate was comparable to that achieved by the authors with similar combinations in patients with ovarian carcinomas. Tumor grade did not influence response to chemotherapy. These authors [17] suggested that EOPPC patients should be treated in a similar fashion as those with ovarian adenocarcinoma…

Conclusions

Recognition of EOPPC seems to be increasing. Patients with EOPPC should be reported separately from those with ovarian carcinoma but should be treated in a similar fashion. Recent reports [30, 44] of the prognostic significance of residual tumor mandate that surgeons should make every effort to achieve maximal tumor debulking when faced with the occasional patient who has abdominal carcinomatosis, normal-sized ovaries, and no identifiable primary tumor. “

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2.  https://www.ncbi.nlm.nih.gov/pubmed/26181452

(My note:  This report is dated 2013)

Rare form of extraovarian primary peritoneal papillary serous carcinoma with solitary cystic lesion mimicking a liver tumor; report of a case.

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3.  http://www.patologia.es/volumen40/vol40-num1/40-1n07.htm

INTRODUCTION

“…Extraovarian primary peritoneal carcinoma (EOPPC) is a rare malignant epithelial tumor that develops from the peritoneum lining the pelvis and abdomen and is characterized by abdominal carcinomatosis, uninvolved or minimally involved ovaries, and no identifiable primary tumor (1). It is similar to serous ovarian carcinoma with respect to clinical presentation, histologic appearance, pattern of spread, treatment, and prognosis (2).

This entity has been reported under various names including

serous surface papillary carcinoma of the peritoneum,

extraovarian müllerian adenocarcinoma,

multiple focal extraovarian serous carcinoma,

and normal-sized ovary carcinoma syndrome (2,3).

This entity was first described by Swerdlow in 1959 as «mesothelioma of the pelvic peritoneum» (4). Although most cases of EOPPC are of serous histology, nonserous tumors have been reported. It accounts for between 7% and 15% of cases with a diagnosis of ovarian cancer (2)…”

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

“…Common Epithelial Tumors: Common epithelial cancers that start in the surface epithelium account for the majority of ovarian cancers and include the following types:

Serous: This is the most common type of ovarian cancer and accounts for about 40% of common epithelial cancers. It occurs most often in women between the ages of 40 and 60.

  • Endometrioid: This type of ovarian cancer accounts for about 20% of common epithelial cancers and is associated with endometriosis in 5% and endometrial carcinoma (cancer of the womb) in 20% of cases. It occurs most often in women between the ages of 50 and 70.

  • Mucinous: Mucinous cancers account for 6-10% of common epithelial ovarian cancer and most often affect women between 30 to 50 years of age.

  • Clear Cell Carcinoma: Clear cell carcinomas account for about 5% of common epithelial tumors and most often affect women between age 40 and 80.

  • Undifferentiated Cancers: The remaining 15% of common epithelial cancers are referred to as undifferentiated tumors because their exact cell of origin cannot be determined under a microscope.

  • Borderline Ovarian Tumors: These ovarian tumors of low malignant potential are a subgroup of common epithelial tumors that occur in 10-15% of cases. These tumors are between cancerous and non-cancerous in nature. They originate on the surface of the ovary, but do not invade deeper tissues of the ovary. They have a better prognosis (prediction about the possible outcome of a disease) and cure rate than invasive ovarian tumors…”

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    5.  http://news.cancerconnect.com/types-of-cancer/ovarian-cancer/surgery-for-ovarian-cancer/

    Surgery Overview

    The successful treatment of ovarian cancer requires the involvement and coordination of several different treatment approaches, including surgery, chemotherapy and, in rare cases, radiation therapy. Nearly all women with ovarian cancer will undergo surgery and chemotherapy. The role of surgery in the initial management of ovarian cancer is to obtain a specimen for determining an accurate diagnosis, provide local treatment of the cancer in the pelvis and abdomen, and obtain other prognostic information to determine the stage of cancer and what additional treatment may be necessary.

    Despite surgical removal of the tumor, many patients with ovarian cancer will already have microscopic cancer cells, called micrometastases that have spread away from the ovary to other locations in the abdomen and distant parts of the body. These micrometastases often cannot be detected by currently available tests. Surgery is a local therapy and cannot treat micrometastatic cancer. Therefore, additional systemic treatment using chemotherapy is required to treat micrometastatic cancer. Information obtained during surgery and from other tests determines whether additional treatment with chemotherapy is necessary. Because most patients with ovarian cancer have advanced disease at diagnosis, the majority of patients will receive chemotherapy as part of the overall treatment plan.

    Often, patients with ovarian cancer are initially treated with surgery aimed at debulking (decreasing the size of) the tumor. This type of surgery, in which the goal is to remove the greatest volume of cancer cells possible, is also called “cytoreductive” surgery. After completion of the surgery, most patients are placed on a chemotherapy regimen…”

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    6.  https://www.safesearch.ask.com/web?q=peritoneal%20cancer%20diagnosis&prt=NSBU&chn=1000820&geo=US&ver=22&locale=en_US&guid=333950C0-F332-49D9-8207-443FE0C2AF63&doi=2016-12-21&o=APN10162&ctype=&tpr=121

    Different diagrams showing the Peritoneal cavity and organs therein.

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    7.  https://www.ucsfhealth.org/conditions/peritoneal_cancer/

    “Peritoneal Cancer

    Peritoneal cancer is a rare cancer that develops in the peritoneum, a thin, delicate sheet that lines the inside wall of the abdomen and covers the uterus and extends over the bladder and rectum. The peritoneum is made of epithelial cells. By producing a lubricating fluid, the peritoneum helps the organs to move smoothly inside the abdomen.

    Peritoneal cancer looks and behaves like ovarian cancer, but the ovaries are minimally involved. Women who develop ovarian cancer after having had their ovaries previously removed likely have peritoneal cancer.

The surface of the ovaries also is made from epithelial cells. Therefore, peritoneal cancer and the most common type of ovarian cancer, called epithelial cancer, produce some of the same symptoms and are often treated in the same way. In addition, women who are at an increased risk of developing ovarian cancer, particularly due to the BRCA1 and BRCA2 genetic mutations, also are at increased risk for peritoneum cancer…”

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8.  https://www.ucsfhealth.org/conditions/peritoneal_cancer/diagnosis.html

“Peritoneal Cancer Diagnosis

In making a diagnosis of peritoneum cancer, your doctor will begin by asking about any symptoms you may be experiencing, as well as reviewing your medical history and conducting a thorough physical exam. The following tests also may be performed:

  • Pelvic Exam — This test involves feeling the uterus, vagina, ovaries, fallopian tubes, bladder and rectum to find any abnormality in their shape or size.
  • Ultrasound — This refers to the use of high-frequency sound waves that are aimed at the ovaries. The pattern of the echoes they produce creates a picture called a sonogram. Healthy tissues, fluid-filled cysts and tumors look different on this picture.
  • CA-125 Assay — This is a blood test used to measure the level of CA-125, a tumor marker that is often found in higher-than-normal amounts in the blood of women with ovarian cancer or peritoneal cancer.
  • Computed Tomography (CT) Scan — This is a series of detailed pictures of areas inside the body created by a computer linked to an X-ray machine.
  • Lower GI Series or Barium Enema — This is a series of X-rays of the colon and rectum. The pictures are taken after the patient is given an enema with a white, chalky solution containing barium, which outlines the colon and rectum on the X-ray, making tumors or other abnormal areas easier to see.
  • Biopsy — This test involves removing tissue from the suspected area for examination under a microscope. A pathologist studies the tissue to make a diagnosis.

    To obtain the tissue, the surgeon performs a laparotomy, an operation to open the abdomen. If cancer is suspected, the surgeon may perform an oophorectomy, where the entire ovary is removed. Occasionally a needle biopsy is performed, but this is not generally performed on ovarian tumors if surgery is planned.”

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9.  https://www.ucsfhealth.org/conditions/peritoneal_cancer/treatment.html

Peritoneal Cancer Treatment

Treatment for peritoneum cancer will depend on a number of factors, including:

  • The stage of your cancer, or how advanced it is
  • How extensively your cancer has metastasized, or spread to other parts of the body
  • Your general health

You and your doctor will work together to develop the most effective treatment plan that best meets your needs.

Treatment for peritoneum cancer may include combinations of the following approaches:

Surgery

Surgery may be used to diagnose and treat peritoneum cancer if the place where the cancer first started to grow is unclear, or if you have a pelvic mass. This procedure is called exploratory surgery, during which the tumor is removed from the lining of the abdomen where the cancer has started to grow.

Chemotherapy

Chemotherapy uses anti-cancer drugs, which are usually injected into a vein. The drugs used for peritoneum cancer are similar to those anti-cancer drugs used for treating ovarian cancer. Depending on the type of chemotherapy drugs used, this treatment can be given weekly or every two to three weeks. In most cases, patients receive the treatment on an outpatient basis.

Supportive care

Unfortunately, in some cases, peritoneum cancer is not diagnosed until it has advanced. Supportive care, also known as palliative care, is designed for patients whose disease has advanced to the point where they are too ill to cope with intensive chemotherapy.

Supportive care aims to relieve symptoms of peritoneum cancer, such as pain, weight loss and fluid in the abdomen, which can be drained during a procedure called abdominal paracentesis.”

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10.  https://www.ucsfhealth.org/conditions/ovarian_cancer/index.html

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11.  https://www.ucsfhealth.org/conditions/ovarian_cancer/treatment.html

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12.  https://csn.cancer.org/node/309344

“HYPERTHERMIC INTRAPERITONEAL CHEMOPERFUSION (HIPEC) TREATMENT. My post on the Peritoneal Cancer link – This consists mainly of videos by my surgeon, Dr. David Bartlett, UPMC relative to how and why HIPEC is used.  This procedure may not be available in India, but I would check all the hospitals and inquire as to the availability of this unique procedure prior to settling on any one medical facility.  There are multiple videos here that will explain fully the procedure and why it is done.  Many with Peritoneal Cancer may be candidates for Cytoreductive Surgery and/or HIPEC treatment here in the states.

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