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Pseudomyxoma Peritonei is a very rare type of cancer that usually begins in your appendix as a small growth, called a polyp. Or, more rarely, it can start in the ovary or other parts of the bowel.
Pseudomyxoma Peritonei does not act like most cancers and does not spread through the bloodstream or the lymphatic system. It spreads inside the tummy (abdomen), rather than into nearby tissues of the bowel or liver. The mucus collects inside the abdomen and causes symptoms. It develops very slowly and it may be many years before you have any symptoms from this type of cancer.
Pseudomyxoma has no known cause. There are no known lifestyle changes that one can make to lower the risk of developing pseudomyxoma peritonei.
Some people will not have any of these symptoms, so Pseudomyxoma Peritonei can be difficult to diagnose. In women, this type of cancer can sometimes be confused with ovarian cancer, because ovarian cancer may also cause a swollen abdomen. Some types of ovarian cancer cells also produce mucin.
Often, it is only after an operation to look into the abdomen (a laparotomy) that pseudomyxoma peritonei is properly diagnosed. Once diagnosed, a CT scan can help the doctor find out how far the cancer has spread through the abdomen.
Symptoms may include persistent abdominal or pelvic pain, which can indicate the presence of Pseudomyxoma Peritonei and should be evaluated by a healthcare provider.
This symptoms resulting from the accumulation of mucinous fluid in the abdominal cavity. Treatment usually involves surgical removal of mucinous tumors and chemotherapy, aiming to alleviate symptoms and improve the patient’s well-being.
Changes in bowel habits, such as diarrhea or constipation, may occur due to the buildup of mucinous fluid in the abdomen, requiring medical assessment to determine the underlying cause.
This section lists common tests that may be performed and it is not necessary for all the tests to be performed for a patient. Your doctor will select the tests that will assist him /her to have the maximum information about the tumor/ disease.
Mucinous tumors are more common in the ovary, appendix and rarely the colon/ rectum. Hence doctors may advise you to do some blood tests like CEA and CA-125 (tumor markers) that may give an idea about the origin of Pseudomyxoma.
This section lists common tests that may be performed and it is not necessary for all the tests to be performed for a patient. Your doctor will select the tests that will assist him /her to have the maximum information about the tumor/ disease.
Mucinous tumors are more common in the ovary, appendix and rarely the colon/ rectum. Hence doctors may advise you to do some blood tests like CEA and CA-125 (tumor markers) that may give an idea about the origin of Pseudomyxoma.
This test may be done as one of the initial tests to find out and gives an idea about the extent of spread of mucinous substance in the tummy.
A biopsy means a diagnosis made under a microscope by a pathologist using a small bit of tissue removed from a suspicious areas or lumps that are found to be abnormal. These tests typically report the presence of abundant mucin (jelly like substance) in the biopsy.
A CT scan is a type of x-ray that gives a picture of organs and other structures (including any tumours) in your body. It is used to see more details of a cancer and its relation to the surrounding organs in your body. It also gives information related to cancer spread.
If possible, you will have surgery combined with chemotherapy into the abdomen. The procedure is called cytoreductive surgery. This removes most or all of the visible tumour in your abdomen. The surgeon strips out the lining of the abdomen, the peritoneum and removes any tissues inside the abdomen affected by pseudomyxoma. This will vary between people, but can include any of the small bowel, large bowel, spleen, liver, and in women the womb and ovaries.
If your tumour is small and slowly growing your doctor may just keep a close eye on it and may suggest chemotherapy or surgery in the future if it continues to grow.
This type of surgery removes as much of the tumour as possible. It will not cure the pseudomyxoma peritonei but reduces symptoms and can help people to feel comfortable for as long as possible. This might mean removing your womb and ovaries if you are a woman, and sometimes part of your bowel. Unless you have cytoreductive surgery, it is hard to remove all of the tumour. So the tumour will come back. Then you need to have more surgery, and sometimes may need several debulking operations.
If you can’t have cytoreductive surgery you may have chemotherapy. You may have either chemotherapy into a vein or as tablets. These chemotherapy drugs tend not to cause bad side effects and your doctors and nurses will monitor you with regular blood tests and CT scans.
Dr. Deepak Chhabra is a consultant Surgical Oncologist with an extensive experience in cancer surgeries. He is has specialized in Hepato (Liver) -Biliary (Gallbladder) and Pancreatic Cancer Surgeries.
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