Malignant Ascites: Symptoms, Treatment, Diagnosis

Ascites is a condition where there is accumulation of fluid in the peritoneal cavity, which is the space surrounding the organs present within the abdomen. Some of the causes of Ascites include kidney disease, liver disease, heart failure and cancer.

When the Ascites occurs as a result of some malignancy or cancer, then it is known as malignant ascites. Malignant ascites is commonly seen with the following cancers: breast cancer, gastrointestinal tract cancer, colon cancer, ovarian cancer, uterine cancer and pancreatic cancer.

Patient experiences discomfort from ascites and other symptoms of malignant ascites are:

• Shortness of breath.
• Weight gain/loss.
• Abdominal swelling.
• Bloating or sense of fullness.
• Sense of heaviness.
• Nausea or vomiting.
• Indigestion.
• Hemorrhoids, due to which the patient has painful swelling near the anus.
• Changes to the belly button.
• Fatigue.
• Swelling in the ankles.
• Decreased appetite.

The doctor examines the patient’s abdomen and the following tests may need to be done to diagnose malignant ascites: x-ray, ultrasound, computerized tomography (CT) scan, paracentesis where the abdominal fluid is removed using a needle and sent to lab for analysis.

Palliative care is needed in cancer care and treatment. The aim of treatment for malignant ascites is to relieve the symptoms of discomfort. If the malignant ascites is not causing discomfort, then patient may not need any treatment. Treatment of malignant ascites can lead to some side effects also. Given below are some treatment options for malignant ascites:

Reducing Salt & Water Intake: There is no concrete proof that restricting the salt and water intake helps in relieving the symptoms of malignant ascites. Patient needs to talk to his/her doctor before making such changes.

Diuretics: These are the medicines, which help in reducing the amount of water in the body. Diuretics are not always helpful in relieving the symptoms of malignant Ascites and can cause significant side effects in some patients which include: frequent urination, loss of sleep, imbalance of minerals in the blood, skin problems, hypotension and fatigue.

Paracentesis: This is a procedure where a catheter is placed in the abdomen to remove the excess fluid in Ascites which relieves any discomfort from abdominal fullness or breathing problems.

Chemotherapy: Chemotherapy helps in malignant ascites from certain types of cancer, such as breast cancer, lymphoma and ovarian cancer. Chemotherapy, however, is rarely used for managing Ascites alone.

Shunt: This is a device which helps in diverting or bypassing the fluid from one place to another.