Cancer ascites: why it occurs, how it looks and how to treat it
What is ascites?
Ascites is a collection of uninfected, that is, sterile fluid in the abdominal cavity. This fluid is nothing else than filtered blood plasma, which for various reasons has been released into the abdominal cavity. Ascites is not a separate disease, it is a symptom of many diseases, among which the majority is in liver damage.
Cancer ascites - a permanent symptom?
Accumulation of fluid (plasma ultrafiltrate) in the abdominal cavity does not appear in all types of cancer. It is a symptom of either liver cancer itself, or cancer of the metastases in the liver, or ozlokachestvleniya cirrhosis of the liver (this is called "cirrhosis of cancer"). Ascites may accompany the final stages of pancreatic and ovarian cancer. Also, accumulation of fluid in the abdomen can manifest tumors of the peritoneum (a special membrane, one part of which covers the walls of the abdominal cavity, the other - wraps intestinal loops and some other organs) or metastases of another cancer into the peritoneum.
Why does ascites develop in cancer?
- If ascites revealed a tumor of the peritoneum or metastases in it, then the mechanism of the development of the process can be described as follows. Normally, the peritoneum secretes a certain amount of fluid. This fluid is needed so that the organs do not stick together among themselves and can function normally. It is completely absorbed into the blood, instead of it a new one is released, that is, there is a constant exchange. In tumors of the peritoneum, the function of absorption is disturbed, and ascites develops.
- Ascites in liver cancer, primary or metastatic, has a slightly different character.
a) In this case, in the main vein of the liver (it is called the “portal”) pressure increases due to compression of the ducts by a dense foreign tissue. Due to the violation of the outflow in the lymphatic system of the liver, pressure also increases. Therefore, the lymph begins to flow into the peritoneal cavity.
b) In addition, the damaged liver begins to produce less albumin (it is the main protein that holds the liquid portion of blood in the channel). According to the pressure gradient, the fluid begins to migrate to where this protein is greater, that is, into the abdominal cavity.
c) The kidneys react to a decrease in the amount of the liquid part of the blood so that they produce special substances,which increase blood pressure and also reduce the amount of urine. This also affects the increase in the amount of ascitic fluid.
How is ascites diagnosed in cancer?
The accumulation of fluid in the abdominal cavity is not always visible to the eye or felt by a person if this fluid is not enough. Such methods as ultrasound, computed tomography help to identify free fluid. When there is a lot of ascitic fluid, a noticeable increase in the abdomen, the person stops getting into the clothes he has recently bought.
What can be detected during the examination?
Ascites, the symptoms of which the doctor checks, will be detected as follows: fluctuation of the abdominal wall (fluctuations caused by the accumulation of fluid, fat or muscles will not move so), dull percussion sound over a big belly, shifting dullness of sound down, if the patient is asked to turn on his side .
It is carried out in several stages. The effectiveness of treatment is judged by weight, volume of the abdomen. Initially, a person is prescribed a diet without salt and with a limited amount of liquid. If the reaction is insufficient, the patient is hospitalized and diuretic drugs begin to be given: first,which do not remove potassium ("Veroshpiron") in an increasing dosage, then connect the usual diuretic ("Lasix", "Trifas"). If such measures are ineffective, then you have to puncture the anterior abdominal wall (abdominal paracentesis), through which ascitic fluid is removed.