Treating stage 3 peritoneal cancer
Treatment for Stage 3 peritoneal cancer usually involves an aggressive combination of surgery, chemotherapy and radiotherapy. All three techniques are used in an attempt to remove the cancer and prevent its recurrence. Surgery usually involves a total hysterectomy; the womb and both ovaries are removed. As much of the actual cancer is taken away as is physically possible and the fatty lining of the abdomen, the omentum, may also be removed.
Chemotherapy may be provided before surgery, to reduce the mass of the tumor, or following surgery, to destroy any cancerous cells left behind. Combinations of 5-fluorouracil, doxorubicin and cisplatin may be used. In some cases, chemotherapy may be offered both before and after surgery, or as an alternative to surgery where an operation is considered too radical for the health of the person involved. Chemotherapy is administered either weekly or fortnightly as an outpatient and can be highly effective in reducing tumour size. Unfortunately, however, these aggressive drugs do come with many unpleasant side effects, including nausea, lethargy and headaches and anti-nausea drugs are also usually necessary.
Radiotherapy is not generally used as a primary treatment for peritoneal cancer, although it is occasionally called upon to tackle stubborn areas of cancer that return following surgery and which do not respond to chemotherapy.
Treating stage 4 peritoneal cancer
In Stage 4 peritoneal cancer, the treatment is generally more palliative, with the focus on reducing the symptoms and making the patient comfortable, rather than fighting the disease. Pain relief is paramount in palliative care, often involving high strength morphine-based pain killers. Advanced peritoneal cancer produces large amounts of fluid, distending the abdomen and causing discomfort. This can be drained away using a technique known as abdominal paracentisis.
Clinical trials and peritoneal cancer
Peritoneal cancer is so rare that doctors are uncertain how it will respond to the new treatments that are being developed for other cancers. It is therefore likely that anyone with peritoneal cancer will approached to participate in a clinical trial. As well as looking at how the cancer responds to therapy, such trials may also help researchers to identify biomarkers so that they can develop a blood test to diagnose peritoneal cancer at a much earlier stage.