Peritoneal Malignancies

Overview
Peritoneal malignancies are cancers that originate in or spread to the peritoneum, the thin membrane lining the abdominal cavity and covering abdominal organs. These cancers can be primary, such as peritoneal mesothelioma or primary peritoneal carcinoma (PPC), or secondary, meaning they spread from other cancers like ovarian, colorectal, or stomach cancer.

Peritoneal cancers are often aggressive and difficult to detect early, making awareness and early intervention crucial.

Causes and Risk Factors
Several factors increase the risk of developing peritoneal malignancies:

Metastasis from other cancers – Colorectal, ovarian, gastric, or pancreatic cancer can spread to the peritoneum

Genetic mutations – BRCA1 and BRCA2 gene mutations increase the risk of peritoneal carcinoma

Asbestos exposure – Linked to peritoneal mesothelioma

Chronic peritoneal irritation or inflammation

Weakened immune system

Age and gender – Primary peritoneal cancer is more common in older women

Symptoms
Symptoms of peritoneal malignancies can be vague and may include:

Abdominal bloating and swelling (due to fluid buildup, known as ascites)

Unexplained weight loss

Loss of appetite or feeling full quickly

Abdominal pain or discomfort

Changes in bowel habits (diarrhea or constipation)

Nausea and vomiting

Fatigue and weakness

Since these symptoms can mimic other conditions, early diagnosis is essential.

Diagnosis
To diagnose peritoneal malignancies, doctors may use:

Imaging tests – CT scan, MRI, or PET scan to detect tumors and fluid buildup

Blood tests – Tumor markers like CA-125 (elevated in ovarian and peritoneal cancer)

Paracentesis – Removing and analyzing abdominal fluid for cancer cells

Biopsy – Tissue sample taken during laparoscopy (a minimally invasive surgery)

Treatment Options
Treatment depends on the cancer type, stage, and patient health. Common treatment options include:

1. Surgery

Cytoreductive surgery (CRS) – Removing visible tumors from the peritoneum

Debulking surgery – Reducing tumor size to improve treatment effectiveness

2. Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

Heated chemotherapy delivered directly into the abdominal cavity after surgery to kill remaining cancer cells

3. Systemic Chemotherapy

Intravenous (IV) drugs that target cancer cells throughout the body

4. Targeted Therapy & Immunotherapy

Advanced treatments that block cancer growth pathways or boost the immune system to fight cancer

5. Palliative Care

Supportive treatments to manage symptoms and improve quality of life in advanced stages

Prognosis and Prevention
Peritoneal malignancies have a variable prognosis depending on the cancer type, stage, and treatment response. Early detection and aggressive treatment improve survival rates.

Prevention Tips:

Regular screenings if you have a family history of ovarian, colorectal, or peritoneal cancer

Healthy lifestyle choices – Balanced diet, regular exercise, and avoiding tobacco

Genetic testing – If you have BRCA mutations, discuss risk-reducing strategies with a doctor

Early treatment of primary cancers to prevent peritoneal spread

Since peritoneal malignancies can be aggressive, early diagnosis and specialized treatments like HIPEC offer the best outcomes. If you experience persistent abdominal symptoms, seek medical attention immediately.