Malignant Ascites is an accumulation of fluid in the abdomen usually as a result of an imbalance of plasma in the blood and lymphatic vessels. This is usually known as ‘abdominal dropsy’. Ascites is mostly seen in patients with cirrhosis of the liver heart diseases, nephrotic syndromes and pancreatic diseases.
Malignant ascites is a condition that is very common in patients living with some forms of tumor, especially tumors of the ovary, uterus, cervix, gastrointestinal tract and breast. Malignant ascites is somewhat different from the normal ascites in that in ascites the fluid collection in the abdomen is fluid from blood and lymphatic vessels with no relation to cancer or cancerous cells but in malignant ascites the accumulation of fluid in the abdomen is a buildup of fluid which has cancerous cells in them. The presence of the cancerous cells in the fluid makes malignant ascites a situation to worry about more than as seen in a normal ascites.
The spread of cancerous cells into the abdominal cavity causes a dysregulation of the normal flow in the peritoneum in a lot of ways. This results in patients with malignant ascites having a poor prognosis or survival option especially as it affects the peritoneum. They usually die within 1 to 4 months, though this majorly depends on the type of and stage of the cancer of the person.
Presently there is yet no set down guide on how malignant tumor should be treated regardless of its high morbidity rate. The Available therapeutic methods of treatment have only palliative treatment and not cure of this condition, therefore they only relieve the symptoms temporarily. These palliative measures include, paracentesis (abdominal cavity puncture), intraperitoneal chemotherapy.
When malignant ascites develops it results from metastasis of cancer from other organs into the abdominal cavity. For examples cancer of the ovaries is a major cause of malignant ascites. In some patients suffering from malignant ascites the primary tumor location is rarely known.
The cancer cells which infiltrate into the abdominal cavity disturbs the regulation of the flow of fluid and simultaneously cause a greater than normal plasma to flow in and decrease the lymphatic outflow in the cavity. The infiltrating cancer cells usually release vascular endothelial growth factor (VEGF) which leads to formation of new tumor vessels.
The infiltrating tumor cells disrupt the normal regulation of fluid flow in the peritoneal cavity by causing a greater plasma inflow into the abdominal cavity, and a reduced lymphatic outflow. VEGF also cause an increase in permeability of the capillaries of the tumor as well as of the peritoneum. Therefore these new tumor vessels and vessels of the peritoneum contribute to increased fluid inflow into the abdomen. VEGF does also block lymphatic channels which obstructs the lymphatic drainage system and fluid accumulation in the cavity.
Malignant ascites is a form of metastasis and it is generally known that the faster the metastasis the more dangerous to life, a metastasis in the peritoneum is one fast way for any cancer to be fatal in little time.The treatment of malignant ascites is for temporary relieve as it does not have a permanent cure.