Peritoneal Cancer

Peritoneal cancer is a rare form of cancer that forms in the tissue that lines the abdominal wall.

The peritoneum is the tissue lining of the abdominal wall, which covers most of the organs in the abdomen.

When the cells of the peritoneum transform into cancer cells, or when cancer spreads from another part of the body to the peritoneum, this is called peritoneal cancer.

What is peritoneal cancer?

Peritoneal cancer is a rare cancer that forms in the tissue lining your abdomen, called the peritoneum. The peritoneum also covers the bladder, intestines, rectum, and uterus. The peritoneum creates fluid that lets your organs move inside the abdomen.

Peritoneal cancer types

There are two types of peritoneal cancer. The type depends on where the cancer starts.

• Primary peritoneal cancer starts in the peritoneum.
• Secondary peritoneal cancer starts somewhere else in the body, like the intestines or pancreas, and spreads to the peritoneum.

Peritoneal cancer risk factors

Women are at higher risk of primary peritoneal cancer than men.

Risk factors for primary peritoneal cancer can include:

• Age
• Endometriosis
• Genetics
• Height
• Hormone therapy after menopause
• Obesity
• Infertility or not having children

The main risk factor for secondary peritoneal cancer is having advanced or metastatic cancer, including colorectal cancer or pancreatic cancer.

Symptoms

Most people with peritoneal cancer do not experience noticeable symptoms during the early stages of the disease.

Symptoms usually occur after the cancer has progressed.

Many symptoms are caused by a buildup of fluids in the abdomen. These symptoms may include:

• Belly pain
• Bloating or fullness in the belly (called abdominal distention)
• Nausea
• Diarrhea
• Constipation
• Frequent urination
• Loss of appetite
• Unintentional weight loss or gain
• Rectal bleeding
• Abnormal vaginal bleeding
• Shortness of breath

Testing and diagnosis

If a doctor suspects you may have peritoneal cancer, there are several tests that can help with the diagnosis. This process usually begins with asking about your symptoms, reviewing your medical history, and doing a physical exam.

Some tests that can help diagnose peritoneal cancer include:

• Blood tests may help measure levels of certain chemicals that could be elevated if peritoneal cancer is present. These chemicals are markers that could mean there is peritoneal cancer, but these chemicals could be elevated for other reasons, so this test cannot confirm a diagnosis of peritoneal cancer.
• Imaging studies, like a CT scan, MRI, or ultrasound can identify peritoneal cancer and help determine the extent of the disease.
• A surgeon may perform a biopsy, removing a small sample of tissue to confirm the presence of cancer. This biopsy can also help the doctors determine the best treatment plan for the patient.

Peritoneal cancer treatment

Each case of peritoneal cancer is different. Peritoneal cancer specialists at WashU Medicine and Siteman Cancer Center provide personalized treatment based on the needs of each patient.

Treatments for peritoneal cancer include:

• Cytoreductive surgery: Surgery to remove all tumors on the peritoneum and nearby abdominal organs
• Hyperthermic intraperitoneal chemotherapy (HIPEC): Heated chemotherapy applied directly inside the abdomen after cytoreductive surgery
• Chemotherapy: Drugs taken orally or by injection to treat peritoneal cancer cells

Learn more: What is HIPEC surgery?

Our peritoneal cancer surgeons