Can someone explain these cancer names?

Question

I am looking at the death certificate of a relative, and I do not understand these names.

Colon Carcinoma
    due to or as a consequence of
Abdominal Carcinomatosis
    due to or as a consequence of
Liver & Lung Metastatic Carcinoma

Thanks!

Answer 1

The causal sequence indicated here doesn’t make a lot of sense to me. Having signed many death certificates, I can sympathize with the doctor who signed off on it. Generally, these have to be typed up in a form (in my experience, on a typewriter....). Someone other than the doctor usually does that, which means there is some verbal communication between the doctor and an administrative person about what should go in the blanks and... it doesn’t always come out exactly perfectly.

Colon carcinoma is generally used to indicate a primary tumor of the epithelial cells of the colon. That is, the cells lining the inside of the colon underwent a mutation of some sort that caused a cancerous growth.

Abdominal carcinomatosis is what happens when cancer cells fall off (basically) the tumor and “seed” the peritoneal space, which is the area outside the gut but inside the abdomen. The cells land in various places and start growing more tumors. Often, this is accompanied by secretion of fluid which results in ascites, and the cancer can also spread by falling into this fluid and landing elsewhere.

Metastatic carcinoma (here to lung and liver) is what happens when the cancer cells get in the bloodstream or lymphatic system and spread to ‘distant’ organs. There they set up new tumors, but the cells can still be identified as having originated from the colon.

The causal sequence is then:

colon carcinoma → abdominal carcinomatosis
colon carcinoma → metastatic carcinoma (sites: liver and lung)

Generally it would also be possible to state a more proximate factor that directly resulted in death. For cancer metastatic to lung, that might be ‘hypoxemic respiratory failure’ (lack of oxygen).

One way to indicate that on a death certificate would be;

 PART I. Enter the chain of events.....:

         Hypoxemic respiratory failure 
              due to (or as a consequence of): 
         Metastatic Liver and Lung Carcinoma
              due to (or as a consequence of): 
         Colon carcinoma  

 PART II. Enter other significant conditions contributing to death....:

         Abdominal carcinomatosis