Renowned Harvard-trained American cancer surgeon explains how gastrointestinal cancers metastasize and spread in the abdomen. Colorectal cancer, ovarian cancer, pancreatic cancer and gastric cancer often spread widely in the peritoneal cavity. Dr. Paul Sugarbaker and colleagues developed and refined The Sugarbaker procedure. It is cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy. HIPEC is used to treat metastatic stage 4 cancers that spread in the abdomen. How cancer spreads in the abdomen? Dr. Anton Titov, MD. Peritoneal cancer spread and peritoneal metastases. Dr. Paul Sugarbaker, MD. Appendiceal cancer can be treated successfully. Colon cancer, gastric cancer, ovarian cancer spread in the abdomen and peritoneal cavity. Peritoneal metastases in advanced stage 4 colon cancer treatment by cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC), hot chemo bath, heated chemotherapy. Dr. Anton Titov, MD. Medical second opinion clarifies colon cancer or ovarian cancer diagnosis. Medical second opinion confirms that cure is possible in metastatic colon cancer. Intraperitoneal chemotherapy treatment for advanced stage 4 cancer with metastatic lesions in the abdomen. Medical second opinion helps to select a precision medicine treatment for stage 4 ovarian cancer or stage 4 colon cancer or metastatic stage 4 gastric cancer. Dr. Paul Sugarbaker, MD. Get medical second opinion on advanced cancer with peritoneal metastases. Best peritoneal metastatic advanced cancer treatment by surgical operation and regional chemotherapy. Video interview with Dr. Paul Sugarbaker. Dr. Anton Titov, MD. Leading expert in peritoneal metastatic cancer treatment (cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC), hot chemo bath, heated chemotherapy. Peritoneal cancer spread and peritoneal metastases. Dr. Anton Titov, MD. Let's start with a general question of how gastrointestinal cancer spreads alongside a peritoneum? Dr. Anton Titov, MD. Maybe you could give example of gastrointestinal cancers that can spread into the peritoneal cavity. How the cancer cells get entry to the peritoneal cavity? Where do cancer cells go in the peritoneal space? Dr. Anton Titov, MD. What is the peritoneal cancer treatment strategy when that happens? Dr. Paul Sugarbaker, MD. Renowned Gastrointestinal Cancer Surgeon. Maybe we could even be a little bit more general. We can ask the question how does a malignancy within the abdominal cavity disseminate? Well, cancer can go to the lymph nodes. the surgeon can remove these lymph nodes if they are involved with cancer. Dr. Paul Sugarbaker, MD. Gastrointestinal cancer or ovarian cancer can go through the bloodstream to the liver and give rise to liver metastases. An alternative pathway for cancer dissemination is through the bowel wall. This is bowel cancer, rectal cancer, gastric cancer. Dr. Paul Sugarbaker, MD. Cancer spreads through the wall of the colon or through the wall of the stomach. Then those cancer seedlings just spread in a random manner in and around the peritoneal space. It is usually full thickness invasion of the bowel wall by gastrointestinal cancer. There are gynecologic malignancies such as ovarian cancer. In ovarian cancer the dissemination into the peritoneal space happens very early in the natural history of ovarian cancer. The ovary has very thin capsule, or the ovarian cancer comes from the fallopian tubes. Dr. Paul Sugarbaker, MD. Renowned Gastrointestinal Cancer Surgeon. Ovarian cancer goes in retrograde manner out into the peritoneal space. It is generally a gastrointestinal or ovarian cancer somewhere else that then finds access to the peritoneal cavity. Dr. Anton Titov, MD. Therefore cancers can gain entry to the peritoneum and spread in the peritoneal cavity. It is colorectal cancer, colon cancer and rectal cancer, and more rare malignancy, such as peritoneal mesothelioma or appendix cancer. Dr. Paul Sugarbaker, MD. Renowned Gastrointestinal Cancer Surgeon. Correct. What we would like for our cancer treatments to be maximally effective. We treat the peritoneal dissemination, peritoneal metastases. Dr. Paul Sugarbaker, MD. We ensure it is the only site for metastatic disease. Sometimes you have a lymph node metastases and liver metastases and peritoneal metastases. Then the likelihood that some surgical strategy will be helpful in cancer treatment is very small. Dr. Paul Sugarbaker, MD. Renowned Gastrointestinal Cancer Surgeon. For example, appendiceal cancer (appendix cancer) almost never metastasizes to the liver. Dr. Paul Sugarbaker, MD. Only a few percent of appendix cancer metastasize to the liver. Appendix cancer very rarely metastasizes to the lymph nodes. But early in the natural history of appendix cancer the appendix bursts. These mucinous cancer cells go all over the place. Our best results and where this all started was with appendiceal cancer malignancy. Dr. Anton Titov, MD. How cancer spreads in the abdomen? Leading cancer surgeon explains how gastric cancer, ovarian cancer, colon cancer spread in peritoneal cavity. HIPEC therapy.