Carcinomatosis is a medical condition in which multiple carcinomas will develop from a primary source, often simultaneously. They are forms of metastasis and whether they spread in a general manner or in a defined pattern, they will still be a form of disseminated cancer. In medical circles, the term Carcinomatosis refers a situation in which multiple sites will have multiple secondaries. It was, strictly speaking, used to refer to carcinomas which are a type of epithelial cancers and not lymphomas, cancer of the lymphatic system or sarcomas either. The term has been diluted to mean all those cancers that have a characteristic spread.
There are various types of Carcinomatosis: Types of Carcinomatosis
It is important to note that Carcinomatosis by far and large refer to cancer tumors that originate from epithelial surfaces called adenocarcinomas while if the cancer cells are of mesenchymal origin or sarcomas then their dissemination is called sarcomatosis. The classification of Carcinomatosis is based on whether they affect the lungs or the other body cavities.
1. Lung Carcinomatosis There are two kinds of Carcinomatosis for the lungs;
Lymphangitic carcinomatosis This Carcinomatosis is formed when a cancerous tumor metastasizes into the lung. In the lungs, the tumors will form nodules that are not only distinct but will be spread by the lymph vessels that are found in the lungs. Up to seven percent of these cells will be spread. The effect is impairment of breathing mechanism which in addition will make the lungs to become stiffer and compression of the blood vessels that are located alongside the lymph vessels that have been distended.
Miliary carcinosis. Miliary carcinosis is similar to military tuberculosis in terms of their radiographic appearance. They are characterized by a pattern of metastases which are not only modular but also small in sizes.
2. The other types of Carcinomatosis are found in the body cavities and which manifest by the growth of tumor cells along the surfaces of the organs lining the body cavities include:
Peritoneal Carcinomatosis. This Carcinomatosis affect the lining of the abdominal cavity with the most common being ovarian carcinomas. The cells produce fluids which can generate ascites. This process is very typical in carcinomatosis but is a rare occurrence in peritoneal sarcomatosis. The fluid produced can take two form, mucinous as is the case in pseudomyxoma peritonei or just plain serous as is the case in peritoneal carcinoma.
Pleural carcinosis. This is a type of Carcinomatosis that though it grows in body cavities, it is associated with poor prognosis in addition to the obvious malignant pleural effusion.
Leptomeningeal Carcinomatosis. This is a form of Carcinomatosis in which tumor grows central nervous system especially its meningeal covering. Carcinomatosis manifests itself differently according to the part of the body which it affects. The shortening of breath and haemoptysis, for, example is a symptom if it occur in the lungs.
Carcinomatosis is a type of cancer which leads to development of carcinomas in multiple forms and simultaneously from the primary source of the cancerous cells. Though similar to the other metastatic diseases, it is different in that it does not only involve the spread of the carcinomas from their sources to regional nodes because multiple sites will have multiple secondaries. There are many types of cancers whose carcinomas spread from source. Though some medical experts refer to all these forms as types of Carcinomatosis, the term should not include sarcomas or lymphomas and strictly speaking should only include carcinomas or epithelial cancers. Carcinomatosis is not easy to identify from the myriad of cancers and worse, treatment options are not completely curative but a control mechanism.
How Carcinomatosis is diagnosed
The biggest challenge in the diagnosis of Carcinomatosis is that it presents itself with symptoms or diseases that are associated with other medical conditions. For example Carcinomatosis of the liver manifests as jaundice which can also result from other causes such as liver cirrhosis or gallstones. The latter diseases have to be tested for and ruled out before the jaundice is ruled out to be specifically as a result of Carcinomatosis. Of course there are other properties of cancerous cells that will be used to tell if the disease is as a result of Carcinomatosis or not.
When the presence of carcinomas or cancerous cells can be identified with in a n organ to gether with the following diseases, then it is a strong indication of Carcinomatosis:
· Haemoptysis in the lungs
· Neurological diseases of the brain
· Pathological fracture of bones
When Carcinomatosis is the biggest suspect, the doctors will seek to find a primary tumor which, to complicate the diagnosis process, may lack in up to six percent of the patients. Recent improvement in investigative technology is providing the much needed breakthrough for the process with histology being the leading breakthrough so far though it can be anaplastic and result in no convincing diagnosis at all.
How Carcinomatosis is managed
Aforementioned, there is no realistic means of curing Carcinomatosis. Available common treatments for several types of cancers, like chemotherapy and radiotherapy produce a minimal effect, often palliative. Surgery is often performed on the carcinomas. Such surgery debaulks the tumour so that chemotherapy thoroughly destroys the infected epithelial tissues. For the liver cases, the metastases that are secondary to colorectal cancer may be resectioned leading to limited number of successes in different patients.
On the flip side there are patients who have had considerable success with the mainstream chemotherapy and radiotherapy in combination to other treatment forms. For example, patients who have leptomeningeal metastases that are a secondary of cancer of the breast have been to improve to the point of recovery with a combination of intravenous chemotherapy, intrathecal chemotherapy, radiotherapy applied to spinal leptomeninges and radiotherapy for the whole brain. For the patients who have no hope of imptovement pain control and dyspnoea in palliative care or dying at home management techniques can still be used.