Primary Peritoneal Cancer

Abdomen (tummy) is lined with a thin layer of tissue called perionium. The tissue also lines the surfaces of all the other organs. Ovarian, fallopian tube and primary peritoneal cancer have similar clinical presentation and have similar staging and treatment.

What are the causes?
  • Risk increases with age
  • Obesity or being overweight
  • Risk is slightly higher in women who have not had children and in women who have had early menarche (first menstruation) and late menopause
  • If there is family history of ovarian or breast cancer (genetic BRCA1 and BRCA2). 1% of ovarian cancers may be due to hereditary
What are the symptoms?
  • Abdominal pain
  • Abdominal swelling.
  • Swollen abdomen
  • Feeling full even with small meal
  • Loss of appetite
  • Loss of weight
  • Frequency of passing urine
  • Constipation
  • Heartburn
What test will be required for diagnosis?
  • 1. To confirm the diagnosis
    • Doctor will usually do a vaginal examination (internal examination) if you have symptoms that may possibly be like cancer.
  • 2.  Assessing the extent and spread
    • Further tests may be advised to assess if the cancer has spread to other organs such as, an ultrasound scan, a CT scan, PET CT an MRI scan, a chest X-ray, blood tests like CA125 tumor markersor other tests.
    • This assessment is called staging of the cancer, done to asses the extent of the spread and to know the stage.
    • If your tummy is swollen with fluid (called ascites) of mass, you may be advised to have this fluid drained or have biospy of the mass. This is usually done with the help of ultrasound (ultrasound guidance). The removed fluid or biopsy of the mass may be checked for cancer cells.
What are the treatment options available?
  • Surgery is the mainstay of treatment. The type of surgery will depend on the stage of cancer and age of the patient.
  • Guideline is to remove womb with cervix (total hysterectomy), both ovaries and fallopian tubes (bilateral salpingo-oophorectomy), fatty apron near the stomach (omentum) and fatty tissue (lymph glands) and to remove all the visible tumor, this surgery is known as cytoreductive surgery (CRS). There are various surgical treatment for ovarian cancer depending on the stage of the cancer and other considerations. Aim of the surgery is – not gross tumor left behind.
  • In young patients – fertility sparing surgery can be offered in early stages, wherein only the effected ovary with cancer, omentecomy and lymph glands are removed. Here the uterus and opposite ovary will be retained.
  • HIPEC
  • When the cancer is in advance stages, you may be advised to have neo-adjuvant chemotherapy (NACT) to shrink the tumor and then go for CRS.
  • Chemotherapy
    • In chemotherapy treatment drugs are used to kill or slow the growth of cancerous cells. It’s usually given through an IV injection.
Follow-up after treatment
  • You should strictly follow-up with your doctor as per their advice.
  • In addition to receiving treatment for cervical cancer your success of treatment will depend only when you have regular follow-up.