Friday, 2 August 2013

Pseudomyxoma Peritonei Awareness Month Part Two

Post number two for Pseudomyxoma Peritonei Awareness Month and today I will be focusing on the cancer itself. I hope you find this post interesting, remember to check Pseudomyxoma Survivor to find out more. I will be using the abbreviation PMP in this post.

PMP usually begins as a slow growing tumour in the appendix known as a low grade appendiceal neoplasm (LAMN). It can also begin in the bowel, bladder or ovary but this is very rare. The causes of PMP are currently unknown.

Most PMP sufferers don’t have symptoms but when they do, they can include:
*Slow Increase in Waist Size
*Loss of Appetite
*Unexplained Weight Gain
*Abdominal or Pelvic Pain
*Changes in Bowel Habits
As with most symptoms, the above do not mean you have PMP but they should be investigated by a doctor to rule anything out.

PMP can be difficult to diagnose and can sometimes be incorrectly diagnosed, as my friend Dawn Green discovered. It is sometimes discovered during an operation for another issue or during investigations into abdominal symptoms. A CT scan can be used to make a PMP diagnosis but biopsies and operations are also sometimes required.

As with most cancer types, PMP is treated depending on a number of factors including your general health, the size and position of the tumour and whether it has spread or not.

Radiotherapy isn’t suitable for PMP as the PMP cells aren’t sensitive to radiotherapy and they are usually spread over too large an area for this treatment type to be effective.

Surgery may be offered to treat this cancer type and is available in two forms:
Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)
This is also known as the Sugarbaker technique (as Sugarman is the name of the surgeon who developed it) and can also be known as The Mother of All Surgeries. It is an intensive treatment that is used to remove the tumour and hopefully cure PMP. It involves removing the lining of the abdomen or organs such as the bowel and gallbladder as well as the fatty tissue found in the stomach (omentum). Women may also have their uterus and ovaries removed. Around half of people undergoing HIPEC require a stoma (colostomy bag) but this is usually temporary and can be revered after around six months.
The second part of the surgery involves a heated chemotherapy drug being put in the tummy for around ninety minutes once the tumour has been removed. This is known as Hyperthermic Intraperitoneal Chemotherapy or a chemo bath. The combination of the heat and the chemo aims to kill any of the cancerous cells that may have been left behind.
This is a huge operation and can last around ten hours. It also involves a stay in the critical care unit whilst you recover and you may in hospital for around two weeks following the surgery. It has possible serious complications which should be discussed with you beforehand.
There are two specialist centres that offer this surgery: The Basingstoke and North Hampshire Hospital and The Christie Hospital

Debulking Surgery:
This is done with HIPEC is not possible. The aim of this surgery is to remove as much of the tumour as possible to reduce the symptoms. It can involve removing the omenum and bowel as well as the uterus and ovaries for females.
This surgery is unlikely to remove all traces of the cancer and it is likely to grow back afterwards which means further debulking surgeries may be needed. The downside of this is the procedure becomes more complicated and there are fewer benefits but more risks. A permanent stoma is sometimes needed after this kind of surgery to prevent bowel obstructions.

I hope this post has been informative for you. Please do check out Dawn’s fantastic charities website for more information


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