Omental Infiltration

Hello ladies, I have just received the copy leter from my oncologist which states that the CT scan shows omental infiltration. I had never heard of this but it is part of the abdomen lining and is causing bloating and digestive issues. It is also really painful so feeling a bit sorry for myself. Apparently lobular cancer can cause omental infiltration. I just wondered if anybody else had experienced this type of spread? I started Tamoxifen mid Dec so have agreed to hold off until mid Feb to see if this will start to bring under control, if not then more chemo. Had docetaxol last March so was hoping for a little longer break but if it alleviates some of the symptoms I would gladly have it at the moment.xx

Hi, I have heard of this spread, hope Tamoxifen can hold it, make you more comfortable and give you a longer chemo break. Have you looked on the bcmets.org site? They have a search facility there, might be some posts from others. Take care. X

Hi Porkie, sorry to read that you have this further worry

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Take care
Lucy BCC

I have peritoneal mets, had them for 6+ years, I now have a permenant drain in my abdomen to drain off the acites. I have had good response to hormones and FEC, now on carboplatin. 

It is quite some time after the last post on this topic.  20 years after my initial breast cancer (with no indication of spread previously) I was taken ill and had to have an ileostomy due to metastatic breast cancer in my peritoneum (in the omentum).  This was in March 2015.  Shortly afterwards it was discovered I also had multiple bony metastasis, which must have been there for some time.  I had chemotherapy (something with three initials starting with F) which had positive results.  I am now on Anastrozole tablets.  I also have denosumab injections every 4 weeks and am on Warfarin as I also had a pulmonary embolism at the time I was taken ill.  I have not heard of anyone else having to have an ileostomy for this reason, nor have I seen anything else about breast cancer spread to the omentum until I came across this thread.  I am currently awaiting the results of my latest CT scan, so have my fingers crossed.  Previous CT scans have shown “no progressive disease” but I know this can change at any time.  Like everyone else I was told that I cannot be cured but can be treated.  Up to now I wouldn’t know I had cancer in my bones as I don’t get pain from it.  I do worry that the cancer in my omentum could get worse.  CT scan reports seem to only comment on “shadowing”, “stranding”, etc.  The ileostomy stopped the pain and sickness I was having, but has brought its own problems.  I just wondered if anyone else out there has had to have one because of cancer spread to the omentum, or just if anyone else has secondaries in this area.

windflower

Hi Windflower,

im sorry to hear your chemo break was so short lived and you have to start up again. I was diagnosed with peritoneal mets 18 months ago, not sure exactly where mine are but the Omentum is part of the peritoneum near the stomach, according to google. I think the peritoneum covers a large area and lines the abdominal cavity with folds in and out around the organs. They call it the ‘apron of fat’ - charming!

i also get the impression that rather than distinct tumours with a clear edge, it’s more like threads and thickening within the stretchy tissue. It’s hard to picture it isn’t it? And to imagine which organs are nearby.

im on Kadcyla as I’m Her+ and had a good response to herceptin over 9 years (I know Im lucky I got started before NICE pulled the plug on it). It’s chemo combined with herceptin. Been on it a year and it’s keeping things stable.

i really hope your treatment is tolerable and does the trick, holding things in check for a good long time. Be gentle on yourselves ladies, our bodies are working hard in there, fighting back.

Jacksy xx

Hi Porkie, my history is first BC 1997, second BC 2002 - Metastatic 2016 (lung/few areas of bones) - treated with Xeloda - good results.  A few months stabilised then recently 2018 identified as metastases in the omentum.  Xeloda not producing good results this time so Tamoxifen changed to Letrozole and now taking Ribociclib - a new drug.  Side effects not particularly pleasant.  I am in Australia and everyone is surprised at a spread to the omentum - quite rare.  My BC is oestrogen receptive but I understand the pathology morphs with BC and the omentum is associated with lobular BC.  I’m just relieved to find someone who has this also in the omentum!!  Idea of Ribociclib is to stabilise.

Hi TB and Porkie,

I haven’t posted on here for some time, but I am still around and still doing fine.  My last scan in May (12 months after the last one), showed that everything is still stable, cancer-wise.  So I am still on Anastrozole and Denusomab for my “multiple bone mets” (which haven’t got any worse.  The last scans haven’t mentioned my omentum or peritoneum at all, so I don’t know if the mets have gone, although I can’t see it, somehow, if they were bad enough to cause me to have an ileostomy (which I’ve still got).  Apparently it is very rare to get secondaries in this area, especially if they haven’t been found somewhere else first.  I believe the mets were in my bones for quite some time before they were discovered and I don’t get pain from them.  They only came to light because of the mets in my peritoneum.  

I sometimes feel very fortunate, compared with other people who have to try different medication all the time, but I assume that as my mets weren’t discovered until twenty years after my primary (three and a half years ago) that my cancer is slow growing.  I know this can change in the future though.

Best wishes to you both.

Windflower xxx

Hello Rah,

im sorry to hear about your relative. It does sound as though the cancer has spread to her omentum. The tumours there don’t tend to be in round blobs, but spread through the omentum or peritoneum a bit like a picture of the Milky Way in space. Given that they have also found bone metastasis the assumption would be that what they are seeing on the CT scan is also metastases . Now that the cancer has spread from the breast it is considered to be incurable, and the assumption is that there will be other ‘seeds’ that have escaped around the body, which could start to grow into secondary tumours. That is why we tend to be given systemic treatments that travel throughout the body and target any cells they find. The good news is that there are lots of treatments available and people are living for many more years on treatments that control or stop them growing.  so secondary cancer can be rather like a chronic illness, but strictly speaking it is not. I hope this answers your question, I can’t see it to re-read it, sorry!

it is encouraging to hear of others with spread to the omentum and peritoneum, it makes me feel less alone and unusual.

all the best to everyone, take care of yourselves

Jx