Primary peritoneal cancer (PPC) is an extremely rare form of cancer that usually afflicts women of advanced age. Primary peritoneal cancer is a form of cancer that originally develops in the peritoneum.
The peritoneum is a thin, moist and cellophane-like tissue that can be found in the abdominal cavity. It protects and supports the organs within the abdominal cavity like the liver, bladder, and stomach. Moreover, it prevents the organs from sticking to one another and allows for effortless movement within the abdominal cavity.
Primary peritoneal cancer is also known as serous surface papillary carcinoma, extra-ovarian serous carcinoma, primary serous papillary carcinoma, and psammomacarcinoma. It was previously referred to as carcinoma of unknown primary (CUP).
Often, PCC is mistaken for certain forms of ovarian cancer. This is because the peritoneum lining develops from the same cells that line the surface of the ovaries. However, a woman can still develop primary peritoneal cancer despite having both ovaries removed. Moreover, in some research, studies have shown that 15 percent of serous ovarian cancers are thought to have originated from primary peritoneal cancer.
The underlying cause of primary peritoneal cancer is still unknown, however; certain groups are identified to be in the high-risk group. These individuals are those with the family history of primary peritoneal cancer, individuals who are over the age of 60, women and individuals who have a penchant for drinking and smoking.
The general symptoms of PCC are gastrointestinal in nature instead of gynecological. These symptoms would include abdominal pain, loss of appetite, bloating, constipation, diarrhea, nausea and vomiting. Abnormal vaginal bleeding is a symptom but is rarely seen in patients.
Stages of Primary Peritoneal Cancer
Primary peritoneal cancer is a very aggressive form of cancer and generally, the prognosis is not favorable. The reason is that this disease is usually diagnosed in the advanced stages wherein patients would complain of severe abdominal swelling and bloating. Hence, often, primary peritoneal cancer is diagnosed with stage 3 or 4.
Stage 3 primary peritoneal cancer refers to the cancerous cells being confined within the lining abdominal cavity or the peritoneum while stage 4 would have already spread to the other organs like the liver, lungs or lymph nodes. However, there is no definitive cancer staging parameter set for primary peritoneal cancer and staging is derived from ovarian cancer since they are closely similar.
The medical practitioner also further categorizes the abnormal cell growth into grades depending on how fast the cancerous cells are developing. A grade one cancer growth and spread is typically slow and when viewed under a microscope looks like normal healthy cells.
Grade two cancer growth still looks relatively like normal healthy cells however, the growth and spread is a bit faster. Grade three cancer is the fatal kind because the cells not only looks abnormal but the growth and spread are rapid.
The symptoms are similar to the symptoms of ovarian cancer, including abdominal pain or swelling, nausea and vomiting, indigestion and a change in bowel habits. In general, women with primary peritoneal cancer receive the same treatment as women with ovarian cancer that has spread widely and the prognosis is probably similar.
These treatments for cervical cancer could include surgery to remove as much cancer as possible, followed by chemotherapy like the one given for ovarian cancer. After treatment, you will have a follow-up appointment to assess whether primary peritoneal cancer treatment has resulted in any additional difficulties or new symptoms.
Treating Primary Peritoneal Cancer
Ideally, primary peritoneal cancer should be treated by a qualified gynecologic oncologist. These are board certified obstetrician-gynecologist who underwent additional three to four years of training specializing in the surgical and medical care of cancer afflicting the female reproductive system including the peritoneum.
Gynecologic oncologists are able to provide medical attention from diagnosis until treatment. Moreover, it has also been noted that patients who sought medical attention from gynecologic oncologists are found to have a higher survival and cure rate than those who sought medical attention from other physicians.
The treatment of your primary peritoneal cancer would depend on the stage and grade, size and location of cancer cells and your age and overall health. Typically, the first treatment option is surgery.
Gynecologic oncologists are ideal physicians to perform this because they have a better chance at removing the cancer entirely. In the event that surgery is not a viable first treatment option, chemotherapy is done first prior to doing surgery. This happens when the cancerous cells in the abdomen do not allow for surgery.
Often, in surgery, the gynecologic oncologist would be removing the ovaries and fallopian tubes, uterus, and cervix or the omentum or the fatty tissues that cover the intestines. In rare cases, some lymph nodes will also be removed depending on the findings. The surgeon’s primary goal is to remove as many cancerous cells as possible to improve the chance of survival and cure of primary peritoneal cancer.