Primary Peritoneal Carcinoma (PPC) is a rare and aggressive form of cancer where the proliferation of malignant cells usually occurs in the peritoneum, the thin membrane lining the abdominal cavity. Although it shares similarities with ovarian cancer, PPC develops in the peritoneum itself, rather than the ovaries. Primary Peritoneal Carcinoma is a rare and challenging cancer in terms of early detection and treatment, often presenting with non-specific symptoms. Early detection and a multidisciplinary approach to treatment are essential for improving outcomes.
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Causes

Although the exact cause of PPC remains unknown, like many other cancerous conditions, it is believed to result when there is a genetic mutation in the DNA of the peritoneum layer that causes the healthy cells to grow and multiply rapidly without dying on time. These irregularly shaped cells agglomerate to form tumourous structures, leading to PPC. While the precise origins of this malignancy are elusive, some theories suggest that it may develop from cells left behind during embryonic development.

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Risk Factors

While PPC can occur in individuals with no known risk factors, certain factors may increase the likelihood of developing this rare cancer:

Gender: PPC is more common in women, although it can affect men as well.

Age: PPC is typically diagnosed in postmenopausal women, but it can occur at any age.

Height: Taller people are more likely to get primary peritoneal cancer.

Genetics: A first-degree relative with peritoneal cancer, fallopian tube cancer, or ovarian cancer increases your risk. Women who carry BRCA1 or BRCA2 gene mutations are also at an aggravated risk of PPC. People who have Lynch syndrome genes have a higher incidence of this type of cancer as well.

Hormone Replacement Therapy: Women who have undergone hormone replacement therapy after menopause are at a higher risk of PPC.

Obesity: People who are obese or have a higher percentage of body fat are at an increased risk of PPC.

Reproductive History: People who have had infertility and/or have no biological offspring may be at a higher risk.

Endometriosis: Women with endometriosis may have a higher risk of developing PPC.

Symptoms

Recognizing the symptoms of PPC can be challenging, as they are often vague and non-specific. Some of the common characteristic symptoms include:

  • Pain in the abdomen and/or pelvis
  • Abnormal vaginal haemorrhage or discharge
  • Changes in the bowel
  • Rectal haemorrhage
  • Urinating frequently
  • Bloating or a feeling of fullness in the abdominal region
  • Indigestion
  • Loss of appetite
  • Sudden unexplained weight loss
  • Buildup of fluid in the abdomen
  • Nausea
  • Shortness of breath
  • Swelling and pain in your legs
  • Fatigue

Diagnosis And Treatment

If you detect any of the above-mentioned signs and symptoms, visit a gynaecologist or expert immediately to get them checked and proceed with treatment as soon as possible. The common diagnostic procedure for PPC involves:

Medical History and Physical Examination: The healthcare provider gathers a detailed medical history and performs a physical examination to assess symptoms and overall health.

Blood Tests: Blood tests may be conducted to assess tumour markers like CA-125, which can be elevated in PPC.

Imaging Studies: CT scans, MRI scans, and ultrasounds are essential for visualizing the abdominal area and identifying any abnormalities or tumours.

Biopsy: A definitive diagnosis often requires a biopsy, where a small tissue sample is taken for examination. This can be performed through surgery or minimally invasive procedures.

Treatment

PPC treatment usually involves a multi-modal approach tailored to the individual patient depending on their age, physical condition, and stage of the tumour. The latest treatment options include:

Surgery: The primary treatment for PPC is surgery to remove as much of the cancer as possible. This often includes a hysterectomy and removal of the ovaries, fallopian tubes, and any visible tumours in the peritoneum.

Chemotherapy: After surgery, chemotherapy is typically recommended to target any remaining cancer cells. Chemotherapy may be administered intravenously or directly into the peritoneal cavity (intraperitoneal chemotherapy).

Radiation Therapy: Radiation therapy is sometimes used in combination with surgery and chemotherapy to treat localized areas or as palliative care to alleviate symptoms.

Clinical Trials: Participation in clinical trials may offer access to innovative treatments and therapies being studied for PPC.

Supportive Care: Supportive care, including pain management, nutritional support, and emotional support, is vital for improving the patient's quality of life during treatment.