The peritoneum is a membrane that lines the abdominal cavity.
It houses the digestive tract, liver, and other organs.
Symptoms of peritoneal cancer are often vague, making it difficult to diagnose until the cancer is advanced.
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It is often fatal, though new treatments for peritoneal cancer are improving survival rates.
This article details the anatomy of the peritoneum and how peritoneal cancer is diagnosed and treated.
It lines the abdominal and pelvic cavity organs, covering the digestive tract, liver, and reproductive organs.
Risk factors include:
Using talc below the waist is also linked with an increased risk.
In contrast, some factors are associated with a decreased risk of developing the disease.
Primary Peritoneal Cancer vs.
Ovarian Cancer
Up to 15% of advanced serousovarian cancerpatients could have primary peritoneal cancer.
Epithelial ovarian cancer occurs in roughly 120 out of 1 million people.
The peritoneum and the surface of the ovarian stem form from the same tissue in fetal development.
After listening to symptoms and performing a physical exam, there are severaltests doctors may orderwhen considering the diagnosis.
Imaging Tests
Imaging studies can help evaluate the symptoms of peritoneal cancer.
An ultrasound (transvaginal ultrasound) is often the first test performed.
In addition, an upper and or lower GI series may be ordered.
Biopsy and Laparoscopy
Most often, a biopsy is needed for a definitive diagnosis.
When ascites are present,paracentesismay be done.
A needle is inserted through the skin into the abdominal cavity to drain fluid.
This fluid can be examined under a microscope to look for the presence of cancer cells.
A laparoscopy may also help guide treatment.
Differential Diagnosis
Several conditions can mimic primary peritoneal cancer.
This disease is always defined as stage 3 or stage 4 at diagnosis.
Surgery
The surgery most often performed is cytoreduction or debulking surgery.
During cytoreduction surgery, the surgeon removes all visible tumors.
If the tumor cannot be separated from an organ, it may be partially or completely removed.
Sometimes the omentum, the fatty layer of tissue surrounding the intestines, is also removed (omentectomy).
Chemotherapy
Chemotherapyis commonly used for treating peritoneal cancer.
It can be started during or after surgery, or used alone for tumors that are widespread.
Chemotherapy can be given intravenously or injected directly into the abdominal cavity (intraperitoneal chemotherapy).
Hyperthermic intraperitoneal chemotherapy is a fairly unique treatment that has proven beneficial for peritoneal cancer.
During this procedure, chemotherapy drugs are heated to 107.6F, before being injected into the abdomen.
It is most often used shortly after cytoreductive surgery has been completed for advanced peritoneal cancer.
Immunotherapy may be used in some cases.
Avastin (bevacizumab) is approved for use along with chemotherapy (followed by Avastin alone).
Yet, there are many things that can be done to improve quality of life.
A diagnosis of peritoneal cancer is made through bloodwork, imaging studies, and a biopsy.
2018;41(10):938-942. doi:10.1097/COC.0000000000000413
University of Tennessee Medical Center.Hyperthermic intraperitoneal chemotherapy (HIPEC).
2023;128(6):1021-1031. doi:10.1002/jso.27448
