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Male doctors said my ‘female’ cancer was incurable. Then a woman took command and gave me hope

When my silent assassin emerged last autumn, I pressed my surgeon about the prognosis for a form of peritoneal cancer that strikes women in stealthy fashion. “Do you really want to know?” he replied. “Your cancer is incurable.” As I gazed at him in disbelief, he coolly recommended palliative care at a nearby regional hospital with an easy commute. My memory of this moment has a Caravaggio-like quality, a camera obscura scene of shadows and shock. I did not weep. I rebelled. I raged at the notion of being ushered toward a comfortable death by male doctors from a community hospital who confidently assured me that this was the sole treatment for a female malady.

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Featured

 Peritoneal Cancer: Detection, Diagnosis & More

Peritoneal cancer can be very difficult to diagnose. Because early-stage peritoneal cancer typically causes no symptoms, it is usually not discovered until its advanced stages (stage III or IV). Unfortunately, this often means that the cancer has spread to other parts of the abdomen, making it much more difficult to treat. While ultrasound, CT, and MRI can all be used to detect abnormalities in the liver – to accurately confirm peritoneal cancer diagnosis, laparoscopy or exploratory surgery are often performed. Given its complexity, peritoneal cancer diagnosis relies heavily on ruling out other similar cancers that it could easily be mistaken for. This requires image interpretation from expert subspecialist radiologists. If your doctor suspects peritoneal cancer, a second opinion is recommended before treatment of surgery.

 Primary Peritoneal Carcinoma: A Rare Malignancy Presenting a Diagnostic Challenge

With the advancement in technologies and the development of a vast variety of tests, diagnosing diseases has become relatively easy. However, certain diseases are challenging to diagnose due to their similarities with other disease processes. Primary peritoneal carcinoma (PPC) is one of the infrequent tumors that has a resemblance to an ovarian tumor, often making it hard to diagnose. The symptoms are non-specific, and by the time primary peritoneal cancer is diagnosed, the patient is usually at an advanced stage. Although diagnosis might be suspected based on presenting symptoms, it is rarely confirmed with symptomatology alone, requiring additional tumor markers or radiological studies. Sometimes it is diagnosed after surgical removal of the lesion.

 State-of-the-Art Therapy in Peritoneal Carcinomatosis Management

Pressurized Intraperitoneal Aerosol Chemotherapy is a novel therapy used in those with peritoneal carcinomatosis from various cancers, such as gastric, pancreatic, ovarian, and colorectal. Cancer is considered advanced disease when it spreads to the peritoneum (the layer lining inside the abdomen) and can be challenging to treat. Invasive open abdominal surgery to remove all of the tumors and instill chemotherapy has been the standard of care when applicable; however, it exposes patients to prolonged hospital care, intensive care admission, and significant side effects.

Articles of Interest

Barbara’s Story: A Surprising Cancer Diagnosis in More Ways Than One

Peritoneal cancer is extremely rare but mimics the looks and behavior of ovarian cancer. However, unlike ovarian cancer, peritoneal cancer can occur in women whose ovaries have been removed, notes June Hou, MD, Barbara’s physician and a member of the Herbert Irving Comprehensive Cancer (HICCC) at NewYork-Presbyterian(link is external and opens in a new window)/Columbia University Irving Medical Center.

Peritoneal Cancer: A Rare Abdominal Cancer

Symptoms of peritoneal cancer are often vague, making it difficult to diagnose until the cancer is advanced. It is often fatal, though new treatments for peritoneal cancer are improving survival rates.

Peritoneal Metastasis: A Dilemma and Challenge in the Treatment of Metastatic Colorectal Cancer

The peritoneum, a common metastatic site of colorectal cancer (CRC), has a high incidence and poor prognosis that makes it difficult to diagnose early. Peritoneal metastasis (PM) depends on the synergistic action of multiple molecules and the regulation of various components of the tumor microenvironment.

Primary Peritoneal Cancer

Primary peritoneal cancer (PPC) grows out of the epithelial cells of the peritoneum. PPC is a rare type of cancer, usually associated with cancer of the ovary. They are both very similar, sometimes indistinguishable from one another, and treatment is the same for both types of cancer. There are few known risks for this disease, although age and certain genetic mutations associated with breast and ovarian cancer are among them. These cancers tend to occur in older women and are extremely rare in men.

Primary Peritoneal Cancer (PPC)

Primary peritoneal cancer (PPC) is a relatively rare cancer that develops most commonly in women. PPC is a close relative of epithelial ovarian cancer, which is the most common type of malignancy that affects the ovaries. The cause of primary peritoneal cancer is unknown, but it is important for women to know that it is possible to have primary peritoneal cancer even if their ovaries have been removed.

Resources

Peritoneal cancer: 8 questions, answered

Peritoneal cancer is not the same as ovarian cancer, but the two types of cancer share similar characteristics. The cells look the same under the microscope. Peritoneal cancer spreads and behaves the same way as ovarian cancer. We also treat it the same way.

StatPearls

Peritoneal cancer, both primary and secondary, presents as a rare and aggressive malignancy. Primary peritoneal cancer originates within the peritoneum itself, while secondary peritoneal cancer stems from metastasis of primary tumors located in adjacent organs such as the ovaries, gastrointestinal tract, or mesothelium. Symptoms may include abdominal pain, bloating, changes in bowel habits, and unexplained weight loss. Diagnosis typically involves a combination of imaging studies, cytology, and biopsy.