Understanding Peritoneal Cancer and Its Effects on the Abdomen

Written by Medicover Team and Medically Reviewed by Dr Kovvuru Bhaskar Reddy , Oncologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Peritoneal cancer is a rare cancer that develops in the peritoneum, the thin layer of tissue that lines the abdominal cavity and covers many abdominal organs. It may arise primarily in the peritoneum or occur when cancer from another organ spreads to the peritoneal lining.

Peritoneal cancer can cause abdominal swelling, pain, changes in bowel habits, reduced appetite, and unexplained weight loss. Early evaluation is important because symptoms can be nonspecific and may resemble other abdominal conditions. Treatment depends on the type and stage of cancer and may include surgery, chemotherapy, targeted therapy, immunotherapy, or other specialized treatments.

What Are the Types of Peritoneal Cancer?

Peritoneal cancer includes several conditions involving malignant cells in the peritoneum. Some originate in the peritoneum, while others develop when cancer from another part of the body spreads to the abdominal lining.

Primary peritoneal cancer: A cancer that begins in the peritoneal lining and is biologically similar to certain ovarian cancers.
Peritoneal mesothelioma: A rare cancer arising from mesothelial cells of the peritoneum. Some cases are associated with asbestos exposure.
Peritoneal carcinomatosis: Cancer involving the peritoneum after spreading from another organ, commonly the colon, stomach, appendix, or ovaries.
Pseudomyxoma peritonei: A rare condition in which mucin-producing tumor cells accumulate within the abdominal cavity, most often originating from the appendix.
Secondary peritoneal cancer: Cancer that has spread to the peritoneum from a primary tumor elsewhere in the body.

The specific type of peritoneal cancer is important because treatment and prognosis vary according to the origin, extent, and biological characteristics of the tumor.

What Are the Symptoms of Peritoneal Cancer?

Peritoneal cancer may cause symptoms as tumors develop or fluid accumulates within the abdominal cavity. Early symptoms can be subtle and may resemble common digestive problems.

Common symptoms include:

Abdominal swelling or bloating: Increasing abdominal size may occur because of tumor growth or accumulation of fluid called ascites.
Abdominal pain or discomfort: Persistent or recurrent pain, pressure, or discomfort may occur as the peritoneum becomes affected.
Loss of appetite: Reduced appetite or feeling full after eating small amounts can occur.
Unexplained weight loss: Unintentional weight loss may develop as the disease progresses.
Changes in bowel habits: Constipation, diarrhea, abdominal cramping, or changes in stool patterns may occur.
Nausea and vomiting: These symptoms may develop when tumors or fluid affect normal digestive function.
Fatigue and weakness: Persistent tiredness may occur because of cancer-related changes or reduced nutritional intake.
Shortness of breath: Significant abdominal fluid accumulation can put pressure on the diaphragm and make breathing uncomfortable.

These symptoms do not necessarily indicate peritoneal cancer and can occur with many other conditions. Persistent or worsening symptoms should be evaluated by a healthcare provider.

What Causes Peritoneal Cancer?

The exact cause of primary peritoneal cancer is not always known. Cancer develops when cells acquire genetic changes that allow them to grow and divide uncontrollably. In many cases, no single cause can be identified.

Peritoneal cancer can also occur when malignant cells from another organ spread to the peritoneum.

Genetic mutations: Inherited or acquired changes in genes involved in cell growth and DNA repair may increase cancer risk.
BRCA gene mutations: Inherited changes in BRCA1 or BRCA2 can increase the risk of certain cancers involving the ovary, fallopian tube, and peritoneum.
Spread from another cancer: Cancers of the colon, stomach, appendix, ovaries, and other abdominal organs can spread to the peritoneum.
Asbestos exposure: Exposure to asbestos is associated with an increased risk of peritoneal mesothelioma.
Hereditary cancer syndromes: Conditions such as Lynch syndrome can increase the risk of several gastrointestinal and gynecological cancers.

Some previously proposed factors, such as chronic inflammation or endometriosis, may be associated with particular cancers but should not be considered established direct causes of all forms of peritoneal cancer.

When Should You See a Doctor for Peritoneal Cancer?

Consult an oncologist or healthcare provider if you develop persistent or unexplained abdominal symptoms, particularly when they gradually worsen or are accompanied by weight loss or changes in bowel habits.

Persistent abdominal pain, bloating, or swelling
Unexplained weight loss or persistent loss of appetite
Feeling full after eating only a small amount
Persistent changes in bowel habits
Unexplained nausea, vomiting, fatigue, or weakness

Get medical help immediately if:

Severe or rapidly worsening abdominal pain
Persistent vomiting with inability to keep fluids down
Severe abdominal swelling with difficulty breathing
Inability to pass stool or gas with severe abdominal pain or vomiting
Sudden severe weakness, confusion, or signs of significant dehydration

Prompt medical evaluation can help identify the cause of symptoms and, when cancer is present, allow treatment to begin as early as appropriate.

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How Is Peritoneal Cancer Diagnosed?

Diagnosing peritoneal cancer usually requires a combination of medical history, physical examination, imaging studies, laboratory tests, and tissue sampling. Because symptoms may be nonspecific, doctors may perform several investigations to determine whether cancer is present and whether it originated in the peritoneum or another organ.

Physical examination: The healthcare provider may examine the abdomen for swelling, tenderness, masses, or signs of fluid accumulation.
CT scan: Computed tomography can identify abdominal masses, enlarged lymph nodes, ascites, and areas of peritoneal involvement.
MRI: Magnetic resonance imaging can provide detailed images of soft tissues and may help assess the extent of disease in selected cases.
Ultrasound: Ultrasound can detect abdominal fluid and some masses and may assist with image-guided procedures.
Blood tests: Routine blood tests can assess general health, while selected tumor markers may support evaluation but cannot confirm peritoneal cancer on their own.
Biopsy: A tissue sample is examined under a microscope to confirm the presence and type of cancer.
Laparoscopy: In selected patients, minimally invasive surgery may allow direct examination of the peritoneum and collection of tissue samples.
Fluid analysis: When ascites is present, a sample of abdominal fluid may be examined for malignant cells.

Additional tests may be performed to identify the primary site of cancer and determine its stage, which helps guide treatment.

What Are the Treatment Options for Peritoneal Cancer?

Treatment for peritoneal cancer depends on the type of cancer, its stage and extent, the location of disease, previous treatments, and the patient's overall health. Management is often planned by a multidisciplinary cancer team.

Surgery: Cytoreductive surgery may be performed to remove as much visible cancer as possible from the abdominal cavity when the disease is suitable for surgery.
Systemic chemotherapy: Anti-cancer medicines may be given intravenously or orally to destroy cancer cells throughout the body.
Intraperitoneal chemotherapy: In selected cases, chemotherapy may be delivered directly into the abdominal cavity to target cancer cells in the peritoneum.
HIPEC: Hyperthermic intraperitoneal chemotherapy involves circulating heated chemotherapy medicine inside the abdominal cavity during or after cytoreductive surgery in selected patients.
Targeted therapy: Medicines that act on specific molecular pathways involved in cancer growth may be appropriate for tumors with particular biological characteristics.
Immunotherapy: Certain cancers may respond to medicines that help the immune system recognize and attack cancer cells.
Radiation therapy: Radiation may be used in selected situations, depending on the cancer type and location.
Supportive and palliative care: Treatments may be provided to control pain, nausea, abdominal fluid buildup, nutritional problems, and other symptoms and to improve quality of life.

Not every patient is suitable for every treatment. The cancer team determines the most appropriate approach after evaluating the tumor type, disease extent, and overall health.

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What Are the Risk Factors for Peritoneal Cancer?

Several factors may increase the risk of developing certain types of peritoneal cancer. Risk factors vary according to whether the cancer originates in the peritoneum or has spread from another organ.

Older age: The risk of many cancers increases with advancing age.
Family history of cancer: A strong family history of ovarian, colorectal, or related cancers may indicate an inherited cancer susceptibility.
BRCA1 or BRCA2 mutations: These inherited mutations can increase the risk of primary peritoneal and related cancers.
Lynch syndrome: This hereditary condition increases the risk of colorectal and several other cancers that may spread to the peritoneum.
Asbestos exposure: Long-term exposure is an important risk factor for peritoneal mesothelioma.
Previous cancer: A history of abdominal or pelvic cancers can increase the risk of secondary involvement of the peritoneum.
Sex and reproductive factors: Certain primary peritoneal cancers occur predominantly in women and may share risk factors with epithelial ovarian cancer.

What Are the Complications of Peritoneal Cancer?

Complications depend on the extent and location of the cancer. Tumor growth and fluid accumulation within the abdomen can interfere with the normal function of nearby organs.

Ascites: Cancer involving the peritoneum can cause fluid to accumulate within the abdominal cavity, resulting in swelling and discomfort.
Bowel obstruction: Tumors or extensive peritoneal disease can interfere with the normal passage of intestinal contents.
Malnutrition: Reduced appetite, early fullness, nausea, and increased nutritional demands can contribute to weight loss and poor nutritional status.
Abdominal pain: Extensive disease may cause persistent pain or pressure within the abdomen.
Breathing difficulty: Severe abdominal fluid accumulation can place pressure on the diaphragm and make breathing difficult.
Spread of cancer: Peritoneal cancer may spread to nearby organs, lymph nodes, or other parts of the body depending on its origin and stage.

How Can Peritoneal Cancer Be Prevented?

There is no guaranteed way to prevent all forms of peritoneal cancer because some cases are associated with inherited genetic changes or occur without a clearly identifiable cause. However, certain measures may help reduce risk or support early detection.

Avoid asbestos exposure: Appropriate workplace safety measures can reduce exposure and the risk of asbestos-related diseases.
Know your family history: Discuss a strong family history of ovarian, colorectal, breast, or related cancers with a healthcare provider.
Consider genetic counseling: People with a significant family history may benefit from assessment for inherited cancer syndromes.
Follow recommended cancer screening: Appropriate screening for colorectal and other cancers can help detect certain cancers before they spread.
Maintain a healthy lifestyle: Regular physical activity, a balanced diet, healthy weight management, and avoiding tobacco can support overall cancer and cardiovascular health.