Peritoneal cancer

Peritoneal Cancer

Our surgical oncologists have specialized training and expertise in treating patients with cancers of the peritoneum (the lining of the abdomen).

Some of these cancers arise from the peritoneum itself (eg., mesothelioma) but most occur when cancer spreads out from the area of original tumor (eg., appendix, colon). Advanced surgery, called “cytoreduction” or “peritoneal stripping” can be combined with heated chemotherapy given in the belly (called “HIPEC”), to treat these cancers in some patients.

The BC Peritoneal Malignancy Program was launched by our group, in collaboration with the BC Cancer Agency and Vancouver General Hospital, in October 2013. We provide a centralized assessment and treatment program for all BC and Yukon residents with peritoneal cancer who meet eligibility criteria.

Click on the sections below to learn more about peritoneal cancer and its treatment.

CRS is a major surgery that removes most or all of the visible tumours inside the abdomen, the lining inside the abdomen, and any organs where the cancer may be growing. Organs that may need to be removed during surgery include: Spleen, Gallbladder, Female reproductive organs (ovaries, fallopian tubes and uterus), Appendix, Omentum (a layer of fat inside the abdomen), Parts of the small and large intestine.

The extent of the surgery depends on how much the cancer has spread. The surgeon begins by making an incision down the centre of the abdomen to see if the surgery can proceed. Often, more cancer is seen during the surgery than the scans show. A small percentage of the time, the surgeon is unable to continue with the surgery. If the abdominal tumours are on vital blood vessels or on organs that cannot safely be removed, then the surgery is not possible.

If the surgeon proceeds with the surgery, the surgical team removes all of the visible cancer tumours and then treats the patient with heated chemotherapy (HIPEC).

The HIPEC procedure is designed to kill any remaining cancer cells after all the visible cancer is removed. The surgeon selects the chemotherapy drug based on the patient’s cancer type. The treatment team infuses a heated chemotherapy solution (40° to 42° Celsius) directly into the abdomen. This is sometimes called a heated chemotherapy bath. Heated chemotherapy is continuously circulated throughout the abdomen for 30 to 90 minutes. The solution is then removed, the abdomen rinsed out, and the incision is closed. Some patients receive additional intravenous chemotherapy treatments before and/or after your surgery.