Dr. Pandalai on the Development of Peritoneal Carcinomatosis in CRC

Prakash Pandalai, MD, ​assistant professor of surgery, surgical oncologist, University of Kentucky, Markey Cancer Center, discusses the development of peritoneal carcinomatosis in colorectal cancer (CRC).

Peritoneal carcinomatosis is a disease that affects many patients with CRC. Notably, this occurs when the primary tumor ​perforates or spreads outside of the colon and sheds tumor cells into the abdominal cavity​. These cells often stick to the peritoneum or other organs​, such as the small intestine or omentum, Pandalai says. 

Peritoneal carcinomatosis is a complicated condition. As such, it’s critical for patients to understand the natural history ​of the disease. Different analogies could be used, such as the grilled cheese analogy. In this example, the melted cheese could represent the cancer cells and the toasted bread could represented the peritoneum. When the 2 pieces of bread are stuck together with melted cheese, they become difficult to separate. In this analogy, cancer cells ​that stick to the peritoneum could cause ​highly morbid complications, such as abdominal pain and bowel blockages.

Systemic chemotherapy is rarely effective in terms of penetrating the peritoneal cavity. Therefore, surgery with heated intraperitoneal chemotherapy is often implemented, Pandalai concludes.