07/09/2015

learning new words ….. omentectomy


(image from https://en.wikipedia.org/wiki/The_Omen)

As well as the enormity of dealing with being told you have cancer, cancer brings with it a whole new language to learn, and words to get tongue-tied with.  One of my favourite (umm not sure 'favourite' is entirely appropriate) is omentectomy, which immediately made me think of Damien and 'The Omen'.  My next thought was what the hell is an omentum and how can I have hung out with this body of mine for forty one years and have not a clue that I even had an omentum? I find medical words hard to pronounce, but they are put together like lego blocks, making their meaning slightly more easy to understand. The suffix 'ectomy' comes from the greek εκ-τομια meaning the act of cutting out or in medical terms the surgical removal of a specified body part; as in appendectomy, removal of the appendix. Wikipedia has a list of all the possible 'ectomies' that can be done - who knew there were so many body parts that can be removed - ouch! The name omentum stems from the embalming practice of the ancient Egytpians, who would assess a persons 'omens' by looking at the structure of the the organ that we now call the omentum.

So I learnt that an omentectomy was not the removal of the 'Omen' from me (but considering the nature of ovarian cancer 'The Omen' would be a suitable name for it).  Instead an omentectomy is the removal of the omentum; a sheet of tissue, or more correctly a layer of two membranes, containing  blood vessels, nerves, lymph vessels, lymph nodes and fat that lines the abdomen.  The omentum, or to give it it's correct name the greater omentum (there's a smaller one too), lines the stomach and other abdominal organs.  The omentum is not the first organ that comes to mind when you think of a body part, and in a similar vein for a long time surgeons/medics didn't give it much of a thought or have clue as to what it did or why we have one.  It is now known that the omentum acts as an abdominal bouncer or body guard; it plays a central role in defending the abdomen from infections by sealing off infected and inflamed areas; providing a rich source of leukocytes (or white blood cells), the cells that can seek out and destroy bacteria, and promoting  healing.

With ovarian cancer the omentum is removed as ovarian cancer cells have a predisposition to migrate (or to give cancer cell migration it's proper name - metastasise) to the omentum; it's removal firstly helps to stage the cancer (i.e. are there metastatic cancer cells already in the omentum) and secondly provides a therapeutic benefit as it can decrease the possibility of the cancer cells spreading from the ovaries via the omentum to other organs such as the stomach and intestines.  Removal of the whole of the greater momentum is called a supracolic omentectomy, which is ironic as I since had an awful bought of colic after my omentectomy! The long-term impact of having an omentectomy is not fully understood; reviews that I have read caution that careful consideration needs to be given before it is removed - which for me just adds to the sense of foreboding and seriousness that, as my omentum-free intestines grumble away, comes with a diagnosis of ovarian cancer.