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What is the prognosis for peritoneal disease?

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Patient's Query

Hello doctor,

Could you please review this letter and report as they seem to differ? We have been informed that the following are metastases, which we agree with one liver metastasis, one aortocaval node, and one subpleural nodule.

However, the oncologist's letter mentions possible peritoneal disease. Why did the CT (computed tomography) report not mention peritoneal disease, and why has the oncologist rated it? The metastases are under 0.787 inches. Would ablation be a better option? Irinotecan has not been effective so far—what are the next steps? What is the prognosis?

Please advise.

Thank you.

Answered by Dr. Amol Kumar Wasudeorao Diwan

Education:

MBBS

Professional Bio:

Dr. Amol Kumar Wasudeorao Diwan is a qualified Specialist in Pulmonary Medicine, Tuberculosis, and Respiratory Diseases with extensive years of clinical experience. He has a vast network of professional contacts in the medical field, an outstanding ability to provide healthcare with an emphasis on holistic approach, treating the patients as a physical, emotional, and social being, has an excellent bedside manner, and an admirable ability to establish rapport with the patient. He also has exceptional skills in imparting health related teachings for a complete and speedy recovery of his patients and has an incomparable critical thinking and analytical skills.

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome to icliniq.com.

I understand the situation you are facing, but it is important to accept the facts about your patient. Firstly, the patient has an incurable disease and has already undergone major surgery. Despite treatment, the underlying disease is progressive, and most importantly, it is widespread in distant organs. Consequently, the treatment options are very limited. The treatments that have been tried have not been effective, and the disease is not responding to the current therapies.

Addressing your questions:

  1. The aortocaval node has increased in size, which suggests peritoneal progression. The oncologist can observe this in the CT (computed tomography) images. It is important to note that radiologist findings are not always final. Additionally, there are adrenal metastases present.
  2. Ablation of liver metastases alone will not cure the disease, as it is at stage 4 and has already spread to other organs. Therefore, treating metastatic lesions will not address the primary disease.
  3. The fact that Irinotecan has not worked indicates that the malignancy is chemoresistant. As a result, any future palliative treatments may not be effective.
  4. Regarding prognosis—your primary oncologist has already provided information on this. The disease is now at stage 4 with no response to palliative chemotherapy, which means the prognosis is very grave. Despite the progressive nature of the disease, the patient is currently asymptomatic, which is fortunate. However, it is difficult to predict when the condition will worsen or how long the patient will remain stable. It is advisable to focus on symptomatic palliative care.

I hope this information helps you.

Thanks for using icliniq, and have a nice day.

Medically reviewed by Dr. Divya Banu M
Published At January 18, 2020
Reviewed At August 14, 2024

Education:

MBBS

Professional Bio:

Dr. Amol Kumar Wasudeorao Diwan is a qualified Specialist in Pulmonary Medicine, Tuberculosis, and Respiratory Diseases with extensive years of clinical experience. He has a vast network of professional contacts in the medical field, an outstanding ability to provide healthcare with an emphasis on holistic approach, treating the patients as a physical, emotional, and social being, has an excellent bedside manner, and an admirable ability to establish rapport with the patient. He also has exceptional skills in imparting health related teachings for a complete and speedy recovery of his patients and has an incomparable critical thinking and analytical skills.

This doctor is not available for online consultations on the platform anymore.

Education:

BDS

Professional Bio:

Dr. Divya Banu M is a dedicated Dental Surgeon with valuable clinical experience. She specializes in the diagnosis, prevention, and treatment of various diseases and conditions affecting the oral cavity. With a gentle and patient-centered approach, she is committed to promoting oral health and enhancing smiles through quality dental care. Her areas of expertise include restorative dentistry, preventive dental care, and cosmetic dental procedures.

This doctor is not available for online consultations on the platform anymore.

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Companion

Peritoneal Cancer Metastasis Prognosis Companion

How it works

Peritoneal disease, especially when metastatic, can be complex. This section helps you understand key aspects of its progression, treatment challenges, and prognosis.

1

Disease
Progression

2

Metastasis
Implications

3

Chemoresistance
Challenges

4

Ablation
Limitations

5

Prognosis
Navigating

6

Palliative
Care

This information is based on general medical guidance. It is not a substitute for professional medical advice; consult a qualified clinician.

Always consult a doctor before taking medication; self-medication carries serious health risks. Take exact prescribed doses, and never start, change, or stop treatment without medical supervision.

Education:

MBBS

Professional Bio:

Dr. Amol Kumar Wasudeorao Diwan is a qualified Specialist in Pulmonary Medicine, Tuberculosis, and Respiratory Diseases with extensive years of clinical experience. He has a vast network of professional contacts in the medical field, an outstanding ability to provide healthcare with an emphasis on holistic approach, treating the patients as a physical, emotional, and social being, has an excellent bedside manner, and an admirable ability to establish rapport with the patient. He also has exceptional skills in imparting health related teachings for a complete and speedy recovery of his patients and has an incomparable critical thinking and analytical skills.

This doctor is not available for online consultations on the platform anymore.

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