Information
Malignant ascites is the accumulation of protein rich fluid containing cancer cells in the peritoneal cavity. Ascites typically develops in the setting of recurrent and/or advanced cancer, the commonest tumour sites being ovarian, breast, gastro-intestinal tract and pancreatic.
Most common symptoms are weight gain, dyspnoea, abdominal swelling, sense of fullness, bloating or heaviness.
Who to refer:
Patients with a cancer diagnosis and symptoms suggestive of malignant ascites. You may be advised that assessment will be arranged electively depending on patient’s symptoms.
Who not to refer:
If in doubt please do not hesitate to call the on call oncology team. Palliative ascitic drainage is usually safe but can result in deterioration of some patients, particularly upper GI/ pancreas or patients of poor performance status. These patients will need to be carefully assessed before proceeding. We do not routinely perform diagnostic taps or drain non-malignant ascites.
How to refer:
Contact the Acute Oncology team at the Edinburgh Cancer Centre Acute Oncology team on 07798774842 or 0131 537 1000 and ask to speak to Acute Oncology team for oncology
If the patient is being admitted electively for ascitic drainage we may ask that pre procedure bloods are taken at the practice (FBC, U&Es, LFTS and coagulation screen).
Diuretics are sometimes used in the management of malignant ascites but we recommend discussion with oncology, particularly if they are on SACT.
All patients on or within 6 weeks of treatment should be encouraged to monitor symptoms and call Cancer Treatment Helpline (CTH) on 08009177711 if any treatment related concerns. Please note the CTH is a call operator service provided by NHS 24 who then refer on to acute care specialist. They are not able to give specialist advice. Note if a patient has presented to primary care for assessment the patient should not be advised to call the CTH to pass on this information or seek further advice. The primary care clinician should call the Acute Oncology teamat the Edinburgh Cancer Centre to discuss if appropriate.
Link to Acute Oncology Initial Management Guidelines:
UKONS | Acute Oncology Initial Management Guidelines (sundownsolutions.co.uk)
