Madrid, 15 October 2024. - Peritoneal carcinomatosis involves the spread of digestive or gynecological tumors in the peritoneum and is a condition that urgently needs more specialized units to provide the best possible treatment of patients, according to several experts, who emphasize that this type of cancer should be talked about more widely. In Spain, there are currently around 40 specialist units for the treatment of these tumours, as the heads of the Peritoneal Oncology Unit at MD Anderson Cancer Center Hospiten Madrid - doctors Santiago González and Gloria Ortega - informed the EFE news agency.
This afternoon Doctors Ortega and González will be participating in the conference “Peritoneal Oncology. Celebrating 20 years”, together with a number of other professionals and patients to coincide with the 20th anniversary of this specialist unit at the hospital. Ortega, an oncological surgeon, explains that peritoneal carcinomatosis is the metastasis in the peritoneum of tumors of the abdominal cavity: of the digestive organs such the colon, stomach, small intestine and appendix; and the gynecological organs, principally the ovary and fallopian tubes.
These are secondary tumors, but the tumor can also originate in the peritoneum - the tissue lining the abdominal cavity - although this is less frequent, according to Dr. González, medical director and head of the Surgical Oncology department at MD Anderson Hospiten Madrid - joint organizers of the event together with EFE.
Prevalence and incidence vary according to the primary tumor from which the condition originates
The symptoms are non-specific – including abdominal discomfort, bloating, and difficulty with digestion – meaning that by the time this type of metastasis is detected, it is often already in an advanced stage.
Diagnosis of peritoneal carcinomatosis is usually obtained through imaging - ultrasound, CT or magnetic resonance imaging; but if this is not possible, and there is a strong suspicion of tumor spread, laparoscopy is used, involving the introduction of a camera near the navel after incision.
If we go back 30 years “there was no remedy” for these types of tumor, but over the last three decades treatment techniques have been developed in “selected patients” - who will initially respond better - through cytoreductive surgery combined with intraperitoneal chemotherapy (within the abdomen), explains Dr. González.
“We surgically remove all the tumor implants that we can see,” says the doctor, adding that to achieve this it may be necessary to remove parts of the peritoneum or some organs.
“Once there is nothing left there, we apply chemotherapy directly inside the abdomen that we heat up to around 42.5 degrees. We usually maintain it for about 90 minutes”, continues Dr. González.
This combination of cytoreductive surgery and intraperitoneal chemotherapy with hyperthermia “is what has shown that the patients in selected cases can actually survive much longer.”
Not all patients are candidates for this surgery, and these are currently treated with intravenous palliative chemotherapy “which produces better results now than 30 years ago”. There is also the option of combining this with pressurized intraperitoneal aerosol chemotherapy, among other techniques.
These are treatments that will benefit patients in specialized units, such as the one led by Ortega and González, comprising a team of professionals specializing in a variety of disciplines including medical oncology, surgery, radiology, nursing, anesthesiology and pathology.
“There are still patients with peritoneal carcinomatosis in Spain and many parts of the world who do not have access to a specific unit of this type; this is happening less and less, but it still occurs,” underlines González.
The expert goes on to state that in cases of breast or colon cancer patients are referred to specific units, “they must be aware that peritoneal oncology units exist” and that “we still have to build more of them” so that every patient can be properly valued and offered what they may need.
Dr. Ortega is of the same opinion, and stresses that today we are aware that one single specialist cannot cover everything involved in the treatment of a patient, “and even less so in a situation as complicated as this”.
A specialized unit “is fundamental,” agrees Ortega, and argues that they are necessary so that patients do not miss “their best treatment opportunity.”
In fact, one of the main demands among patients is that they can be referred to specialized units, as explained to EFE by Sandra Lara de Liz, President of the Peritoneum Association, who a few years ago overcame a tumor of this type and is herself participating in the conference this afternoon.
When she received her diagnosis, a peritoneal pseudomyxoma, this type of tumor was even less known than today, which is why she decided to promote the association, she explains.
“Often when we hear from patients they ask us: how can it be that no one has told me about this? How can it be that at no time did anyone inform us that these units specializing in peritoneal oncology exist? Because often, even within the health sector itself, no one actually knows about them,” she says.
For the President of Peritoneum, it can make “a big difference” for the patient to receive treatment in a specialized unit, and she informs us that the centers that have them can be found on the association's website.
In addition, just like the experts, she highlights the importance of talking about these tumors because “lives could be saved.”
You can watch the video with the summary of the day here.