Peritoneal Surface Malignancies Treatment in Lucknow

Symptoms of Peritoneal Surface Malignancies

PSMs present a range of symptoms that can significantly impact quality of life. Common symptoms include:

• Abdominal Bloating and Distension: Caused by fluid accumulation (ascites) in the abdominal cavity.
• Abdominal Pain or Discomfort: Resulting from tumor pressure on organs or nerves.
• Changes in Bowel Habits: Including constipation, diarrhea, or bowel obstruction due to tumor growth.
• Nausea and Vomiting: Often associated with severe tumor burden or digestive interference.

Types of Cancers Leading to Peritoneal Surface Malignancies

Several cancers can spread to the peritoneum, causing peritoneal carcinomatosis or other PSM conditions. Dr. Harshit Srivastava specializes in treating the following:

• Pseudomyxoma Peritonei (PMP): A rare condition involving mucinous tumor deposits in the abdominal cavity, typically originating from a low-grade appendiceal mucinous neoplasm (LAMN) or high-grade appendiceal mucinous neoplasm (HAMN). PMP requires specialized treatment like CRS with HIPEC, as it does not respond to conventional chemotherapy.
• Appendix Cancer: Arises from abnormal cell growth in the appendix, with subtypes like mucinous tumors, carcinoid (neuroendocrine) tumors, adenocarcinoma, and goblet cell carcinomas. It frequently leads to peritoneal carcinomatosis.
• Ovarian Cancer: Originates in the ovaries or fallopian tubes, with over 50% of cases spreading to the peritoneum, causing significant abdominal symptoms.
• Colorectal Cancer: Begins as benign polyps in the colon or rectum, with advanced cases leading to peritoneal metastasis requiring aggressive intervention.
• Malignant Peritoneal Mesothelioma: A rare cancer linked to asbestos exposure, causing extensive peritoneal spread and ascites.
• Gastric Cancer: Stomach cancer spreads to the peritoneum in up to 14% of new cases and is a common site of recurrence (~50%) post-surgery.
• Other Cancers: Endometrial, small bowel, hepatobiliary, pancreatic, and neuroendocrine tumors may also cause peritoneal carcinomatosis, treated with CRS, HIPEC, or PIPAC in select cases.

Diagnosis of Peritoneal Surface Malignancies

Accurate diagnosis is essential for tailoring effective treatment plans for PSMs. Dr. Harshit Srivastava employs state-of-the-art diagnostic methods at Apollomedics Hospital:

• Contrast-Enhanced CT Scan: Identifies peritoneal tumor deposits and ascites, guiding treatment decisions.
• MRI with Diffusion-Weighted Imaging: Detects small peritoneal lesions with high sensitivity.
• PET-CT Scan: Assesses metabolic activity and systemic cancer spread.
• Tumor Markers: Blood tests for CEA, CA-125, and CA 19-9 help determine cancer type and progression.
• Diagnostic Laparoscopy and Biopsy: Offers direct visualization of the peritoneum and histopathological confirmation, assessing eligibility for CRS with HIPEC.

Advanced Treatments for Peritoneal Surface Malignancies

Dr. Harshit Srivastava offers a comprehensive range of treatments for PSMs, combining surgical expertise with innovative therapies to achieve optimal outcomes:

Cytoreductive Surgery (CRS) with HIPEC

What is CRS with HIPEC?

Developed by Dr. Paul Sugarbaker, Cytoreductive Surgery (CRS) aims to remove all visible tumor deposits in the peritoneal cavity. The procedure’s complexity depends on the Peritoneal Carcinomatosis Index (PCI), which quantifies tumor spread.

Following tumor removal, Hyperthermic Intraperitoneal Chemotherapy (HIPEC) delivers heated chemotherapy directly into the abdomen for 60–90 minutes. The heat enhances drug penetration, targeting microscopic cancer cells to reduce recurrence.

Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC)

What is PIPAC?

PIPAC is a minimally invasive treatment delivering chemotherapy as an aerosol (gas) into the abdominal cavity via laparoscopy. It is repeated every 6–8 weeks to control tumor growth and symptoms in patients unsuitable for CRS with HIPEC.