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Pseudomyxoma Peritonei: Uniting For Strength, Inspiring Hope Together

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Insights Of Pseudomyxoma Peritonei

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Pseudomyxoma Peritonei : Essential Functions

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 Has Two Major Parts :
  • This polyp eventually spreads through the wall of your appendix and spreads cancerous cells to the lining of the abdominal cavity (the peritoneum).
  • These cancerous cells produce mucus, which collects in the abdomen as a jelly like fluid called mucin.
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How Does Pseudomyxoma Peritonei Spread?

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.

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The Causes Of Pseudomyxoma Peritonei

Pseudomyxoma has no known cause. There are no known lifestyle changes that one can make to lower the risk of developing pseudomyxoma peritonei.

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Explore Some Common Symptoms Of The 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.

Discover The Typical Symptoms Associated With Intestine Cancer

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Abdominal or pelvic pain

Symptoms may include persistent abdominal or pelvic pain, which can indicate the presence of Pseudomyxoma Peritonei and should be evaluated by a healthcare provider.

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Abdominal swelling & bloating

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.

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Changes in bowel habits

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.

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The Tests Carried Out To Diagnose Pseudomyxoma Peritonei

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.

The Tests Carried Out To Diagnose Pseudomyxoma Peritonei

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.

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Ultrasound Of The Abdomen

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.

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Tumor Biopsy

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.

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Computerised Tomography (CT) Scan

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.

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Surgery For Pseudomyxoma Peritonei

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.

Some Important Information On Surgery Of Pseudomyxoma Peritonei :

  • After the surgeon has removed all signs of tumour, you have chemotherapy directly into your abdomen (intraperitoneal chemotherapy). This means putting the chemotherapy drugs straight inside the abdominal cavity, where they can directly come into contact with the cancer cells.
  • You may have a heated solution of mitomycin C put into your abdomen during and after your operation.
  • After your surgery, you may have more intraperitoneal chemotherapy with another drug called fluorouracil put into your abdomen for 4 days. The idea of this treatment is that it will kill off any tumour cells that were left behind after the surgery. The aim is to cure the disease or reduce the risk of it coming back.
  • The operation itself is long and can sometimes take 10 hours or more. It can take quite a while to recover because of the length of surgery and the removal of any organs affected by the cancer. Sometimes people need more than one operation, several months apart.
  • This intensive surgery is not suitable for everyone. The surgery takes a very long time and you may be in intensive care or a high dependency unit for up to 5 days. You are fed by a tube into your stomach or a vein, and are likely to be in hospital for 2 to 3 weeks. About 3 out of every 10 people (30%) have serious complications after treatment. About 1 out of 5 patients (20%) need a stoma after surgery.
  • Many people with pseudomyxoma peritonei will have already had surgery at another hospital because this condition wasn’t suspected to begin with. Even if you have already had surgery, your specialist may recommend further surgery, followed by intraperitoneal chemotherapy.

Explore the different required stages of surgery

Wait And Watch:

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.

Debulking:

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.

Chemotherapy:

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.

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Pseudomyxoma Peritonei (PMP) is a rare condition where jelly-like mucinous tumors develop in the abdomen, typically originating from the appendix or ovaries. These tumors produce mucin that fills the abdominal cavity.

Symptoms include abdominal distension, pain or discomfort, changes in bowel habits, hernias, and sometimes, fluid buildup causing swelling in the legs or scrotum.

Here, individuals seek information about the underlying causes and factors that may increase the likelihood of developing PMP, which often involves discussing its association with appendiceal tumors.

Diagnosis involves imaging tests like CT scan or MRI to visualize mucinous tumors, along with analysis of ascetic fluid (abdominal fluid) and biopsy to confirm the presence of mucinous cells.

Treatment typically involves cytoreductive surgery (CRS) to remove visible tumors and heated intraperitoneal chemotherapy (HIPEC) to kill remaining cancer cells.

Looking For Another Perspective On Pseudomyxoma Peritonei Insights?

About doctor

Dr. Deepak Chhabra

MS. (Bom), DNB, M.R.C.S. (Edin. UK)
Fellow GI Surgical Oncology & Robotics (Seoul, Korea)
Specialist HPB Training (Nagoya Univ, Japan)

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.

  • Member at the Department of Surgical Oncology at Lilavati Hospital, Mumbai
  • First clinical Co-Ordinator of the Asia-Pacific Neuroendocrine tumor registry (AP-NET registry) in India.
  • One of few specialist in Hepatobiliary and Pancreatic Cancer Surgeries from Nagoya University in Japan.
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