Management of Malignancy-related Ascites

Anne Marie C. Flaherty, MSN, RN, APNc, AOCNS®


Oncol Nurs Forum. 2015;42(1):96-99. 

In This Article

Malignancy-related Ascites

Malignancy-related ascites are caused primarily by three conditions: peritoneal carcinomatosis, extensive liver metastases, or a combination of both (Runyon, 2014; Runyon et al., 1992). Malignant tumors such as gastric, colon, pancreas, lung, and breast are most often associated with liver metastases and peritoneal carcinomatosis, whereas ovarian and bladder cancers most frequently cause peritoneal carcinomatosis. Lymphoma can obstruct lymphatic drainage, resulting in chylous ascites, and hepatocellular cancer (HCC) occurs in the setting of cirrhosis of the liver, which also is associated with ascites (Runyon, 2014). This article will not address malignant ascites of lymphoma or hepatocellular cancer.

Malignancy-related ascites of advanced cancer carries a poor prognosis and limited lifespan of 1–4 months, except in untreated ovarian cancer (Ayantunde & Parsons, 2007). Ovarian cancer is very chemosensitive and responds to systemic as well as intraperitoneal chemotherapy and has a different disease trajectory. Ascites will impact on the patient's quality of life, causing an array of symptoms such as abdominal distention and discomfort, shortness of breath, anorexia and early satiety, nausea and vomiting, reflux, lower extremity edema, fatigue, and decreased mobility (Tapping, Ling, & Razack, 2012). Efficient and safe management of this debilitating complication of cancer will certainly impact on quality and palliation at the end of life.