How is peritoneal carcinomatosis caused?

Peritoneal carcinomatosis represents an advanced developmental stage of various tumors that develop in various intraventricular organs, such as the intestine, the ovaries, the appendix, the stomach, the pancreas and the liver. Additionally there are tumors -thankfulyl more rarely- that develop directly from the peritoneum (mesothelioma, pseudomyxoma).

The peritoneal mesothelioma: It is a rare tumor, with a frequency of 2/1.000.000/per year and it represents approximately a 10-20% out of every 2.000 new mesothelioma incidents recorded annually in the United States. Its frequency is continuously rising and it is closely connected to exposure to asbestos.

All the intraventricular and intrapelvic organs may be affected by a tumor and more often than others the rectum, the stomach and the ovary.

The peritoneal pseudomyxoma: A protopathic tumor that usually begins from the appendix and has a median survival for patients of 6 to 10 years if treated conventionally. Its main characteristic is that the abdomen fills with infinite quantities of a colloidal fluid - mucus. The treatment of choice that can offer a 20-year-long survival up to full healing is debulking surgery and HIPEC application.

Colorectal cancer: It is the second most common malignancy in general population with a frequency of 47,7/100.000 in men and 36,2/100.000 in women. Colorectal cancer frequency has increased over the last years, especially because of bad eating habits.

Stomach cancer: It is closely connected to eating habits and it seems that the cancer risk is increased for persons that consume large quantities of canned food and fruits and only a small quantity of vegetables.

Ovarian cancer: The fundamental risk factor is heredity, with an appearance frequency in 5-10% of the population. Women that have a first degree relation (mother, sister, daughter) with a person that has been affected by ovary cancer have an increased risk of developing the same condition at some point.

While the disease spreads, the cancer cells arrive and disperse in the peritoneal membrane that covers the intraventricular and intrapelvic organs (visceral peritoneum). When this "barrier" is overcome, cancer cells can move on to the intraventicular cavity, with the help of the peritoneal fluid.

In the case of mesothelioma, where the peritoneum is directly affected, cancer cells rupture the peritoneal membrane and are diffused in the peritoneal fluid. The cancer cells that will get into the peritoneal fluid may survive or die depending on the nutrients contained in that fluid. These cells have the tendency of accumulating in those points where the peritoneal fluid is recycled due to backflow, this creating masses which continuously grow in size, are diffused in the entire abdomen and commence the carcinomatosis mechanism.