Carcinomatosis

What is carcinomatosis?

Carcinomatosis (carcinosis) is a condition that happens when cancer in one part of your body spreads, blanketing another part of your body with several new tumors. Carcinomatosis may be the first sign of cancer. More often, it occurs after you’ve already been living with cancer for a while.

A type of metastatic cancer, carcinomatosis is a sign that cancer is in the advanced stages and likely can’t be cured. Your healthcare providers may recommend treatment that eases your symptoms and gives you as much time as possible to be with your loved ones.

Types of carcinomatosis

There are three common forms of carcinomatosis. Each is associated with different types of cancer:

• Leptomeningeal carcinomatosis. Cancer has spread to the membranes on your brain and spinal cord. Cancers commonly associated with this type are breast cancer, lung cancer and melanoma.
• Pulmonary lymphangitic carcinomatosis. Cancer that started in your breast, lungs, stomach, kidneys, liver or colon has spread to the lymphatic system in your lungs.
• Peritoneal carcinomatosis. Cancer has spread to the lining of your abdomen (peritoneum). Most start in your ovaries, stomach, colon or rectum.

What are the symptoms of carcinomatosis?

Carcinomatosis symptoms vary based on where the cancer has spread. For example, carcinomatosis in your brain causes different symptoms from carcinosis in your lungs or abdomen. Possible symptoms based on tumor location include:

• Headache (brain).
• Confusion and memory problems (brain).
• Trouble breathing (lungs).
• Chest pain (lungs).
• Cough (lungs).
• Coughing up blood (lungs).
• Diarrhea (abdomen).
• Nausea and vomiting (abdomen).
• Abdominal pain (abdomen).
• Unintended weight loss (abdomen).

What causes carcinomatosis?

Carcinomatosis happens when a malignant tumor that started in one part of your body spreads to another part. Often, several tumors appear in more than one site. Medical experts don’t know why the cancer spreads, but carcinosis creates new challenges when it comes to living with cancer.

How is carcinomatosis diagnosed?

If you have carcinosis, you’ve likely already been coping with cancer. That’s why healthcare providers may weigh the benefit of doing tests to confirm you have carcinomatosis against the physical discomfort you might have during them.

Tests that check for the various types of carcinomatosis include:

• Bronchoscopy. For this test, a provider uses a scope to look inside your lungs. They may also remove a tissue sample to check for cancer cells (biopsy).
• Chest X-ray. This test can show signs of swelling in your lungs.
• Computed tomography (CT) scan of your chest. This is the most common test used to show tumors in your abdomen. It can also show signs of tumors in your lungs.
• Electrocardiography and echocardiography. These tests check how your heart is working. They can show if problems with your lungs are harming your heart.
• Lung V/Q scan. This scan looks for blood clots in your lungs.
• Magnetic resonance imaging (MRI). An MRI can show detailed images of tumors in your brain or abdomen.
• Positron emission tomography (PET) scan. Healthcare providers inject a radioactive tracer into your body to detect signs of cancer spread to your lungs or abdomen.
• Spinal tap. Your healthcare provider may collect a sample of your cerebrospinal fluid (the liquid that surrounds your brain and spinal cord) to check for cancer cells.
• Ultrasound of your abdomen or pelvis. This test can show whether you have fluid build-up in your abdomen (ascites). Most people with peritoneal carcinomatosis have ascites.

How is carcinomatosis treated?

In most cases, carcinomatosis is a sign that cancer has advanced beyond the point of being curable. Your healthcare provider will keep that in mind when recommending treatments. In some cases, your provider might recommend palliative care to help ease symptoms. They may talk to you about hospice care.

Treatments that may ease carcinosis symptoms or help you live longer include:

• Surgery. Your surgeon may remove tumors in your abdominal lining (cytoreductive surgery) or lungs. If you have fluid build-up in your brain, you may need an implant called a shunt to drain the fluid and relieve pressure.
• Radiation therapy. This treatment uses strong beams of energy to kill cancer cells. Your provider may use radiation to treat tumors causing symptoms in your lungs or brain.
• Chemotherapy. Chemo kills cancer cells throughout your body. Providers use specialized forms of chemotherapy to treat cancer in your abdomen (HIPEC) and brain (intrathecal chemo).
• Targeted therapy and immunotherapy. Your provider may recommend these treatments if a primary tumor that responds well to them has spread to your brain or spinal cord.

How can I prevent carcinomatosis?

You can’t prevent carcinomatosis. But you can take steps to catch it early so your healthcare provider can treat it. If you have advanced-stage cancer, talk to your healthcare provider about carcinosis symptoms so you’ll know what to look for.

What can I expect if I have carcinomatosis?

Unfortunately, there isn’t a cure for carcinomatosis. But your outlook depends on many factors, including the primary tumor type (where the cancer started) and your age. There may be treatments available that can help you live longer and with a better quality of life.

It’s important to discuss your prognosis with your healthcare provider so you know what your best options are.

How do I take care of myself?

There are things you can do to maintain your quality of life if you’re living with carcinomatosis:

• Ask about treatment options. While you and your healthcare provider may decide against aggressive treatment, there may be treatments to ease your symptoms and manage the cancer.
• Tell your provider about changes in your symptoms. Your provider can recommend ways to help manage your symptoms if they’re changing or getting worse.
• Let your loved ones know what you need. Many times, family and friends want to help but don’t know what you need. You might appreciate having someone run errands, make meals or simply spend time with you.
• Get help with planning for the future. Ask your healthcare provider about programs that will help you with the final steps in your cancer journey.