The short answer
Treatment may involve surgery, chemotherapy, targeted or maintenance treatment for selected patients, and clinical trials, but the right discussion depends on stage, pathology, surgical findings, biomarkers, health, and goals.
Treatment categories may include surgery, chemotherapy, targeted or maintenance treatment for selected patients, and clinical trials.
The plan depends on stage, pathology, surgical findings, biomarkers, health, and goals.
Because it arises from the same tissue as ovarian and fallopian tube cancer, it is treated the same way and covered by the same NCI summary.
This cancer is often found at an advanced stage, so ask plainly what stage you are and whether intraperitoneal chemotherapy or HIPEC applies to you.
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The full explanation.
The short answer
Primary peritoneal cancer forms in the peritoneum. This is the thin lining inside your abdomen. It comes from the same type of tissue as ovarian and fallopian tube cancer. Because of this, doctors treat it the same way they treat ovarian cancer. Treatment usually combines surgery and chemotherapy.
Surgery: removing as much cancer as possible
For advanced disease, surgery aims to remove as much visible cancer as it can. This is called debulking surgery. It often includes a hysterectomy, removal of the uterus. Both ovaries and fallopian tubes are removed too. Surgeons often remove the omentum as well. This is a fatty layer that covers the abdominal organs, and cancer can spread there. Nearby lymph nodes are checked and often removed. Tissue samples are taken to confirm how far the cancer has spread.
Chemotherapy given through a vein
Standard chemotherapy travels through your bloodstream. It reaches your whole body. This usually follows debulking surgery. Your team will explain which drugs fit your specific situation. They will also tell you how many cycles they expect you to need.
Chemotherapy given directly into the abdomen
Some patients also receive intraperitoneal chemotherapy. Here, the drug goes straight into the abdominal cavity through a catheter, not through a vein. The goal is a higher concentration of the drug right where the cancer is. Ask your team whether this approach fits your situation. It is not used for everyone.
Heated chemotherapy during surgery
A newer approach, called HIPEC, delivers warmed chemotherapy into the abdomen during surgery itself. Researchers are still studying how well this works for primary peritoneal cancer specifically. Ask your team whether this is an option at your center. Also ask what the evidence looks like for your situation.
Targeted therapy
PARP inhibitors block a specific repair process some cancer cells rely on. Three of these drugs are olaparib, rucaparib, and niraparib. They are used as maintenance therapy after chemotherapy, mainly for cancer that has come back. Bevacizumab is a different type of targeted drug. It blocks blood vessel growth that tumors need to grow. It may be combined with chemotherapy for advanced or recurrent disease. Whether either fits your case often depends on specific tumor testing. Ask your team what tests have been done and what they showed.
How stage changes the plan
Say the cancer is caught early, before it has spread far. Treatment is typically surgery alone, or surgery followed by chemotherapy. More advanced stages combine surgery with chemotherapy, and sometimes targeted therapy too. Primary peritoneal cancer is often found at an advanced stage. Ask your team plainly what stage you are. This shapes almost everything else about your plan.
Side effects worth knowing about
Surgery in the abdomen carries the usual risks of major surgery. These include infection, bleeding, and a real recovery period. Chemotherapy commonly causes fatigue, nausea, and hair loss. It also causes a temporary drop in blood counts that raises infection risk. Intraperitoneal chemotherapy can cause abdominal pain or discomfort tied to the catheter. Ask your team what to expect from your specific combination before you start.
Which symptoms cannot wait
Once chemotherapy has started, a fever of 100.4°F (38°C) or higher is an emergency, not a message for the clinic. Chemotherapy for this cancer drops your blood counts, and the CDC calls a fever during chemotherapy a medical emergency. Phone your oncology team at once, at any hour. If you cannot get hold of them, go to an emergency department and say you are on treatment. If you are still in the surgical phase and have had no chemotherapy, a same-day call about a fever is enough. Heavy bleeding that pressure will not slow is an emergency department trip, or a 911 call, rather than a message for the clinic. Contact your care team the same day for severe abdominal pain or signs of infection at a surgical or catheter site. These need prompt evaluation, not a wait for your next scheduled visit.
What to ask your care team
- What stage is my cancer, and how does that shape your treatment recommendation?
- Am I a candidate for intraperitoneal chemotherapy or HIPEC?
- Has my tumor been tested for markers that would make PARP inhibitors or bevacizumab a good fit?
- What side effects should I expect, and which ones need a same-day call?
Sources
Words to know
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Common questions
Why am I being sent guidance about ovarian cancer?
Because primary peritoneal cancer comes from the same type of tissue as ovarian and fallopian tube cancer. NCI covers all three in one treatment summary, and the treatment approach is the same.
What does debulking surgery involve?
Removing as much visible cancer as possible. For advanced disease that usually means the uterus, both ovaries and fallopian tubes, and the omentum — the fatty layer covering the abdominal organs, where this cancer commonly spreads. Nearby lymph nodes are checked and often removed, and tissue samples are taken to establish how far the cancer has gone.
What is the difference between intraperitoneal chemotherapy and HIPEC?
Intraperitoneal chemotherapy is given through a catheter into the abdominal cavity over a course of treatment, to get a higher drug concentration where the cancer is. HIPEC delivers warmed chemotherapy into the abdomen during the operation itself. Neither is used for everyone, and HIPEC in particular is still being studied for this cancer.
Would a PARP inhibitor or bevacizumab help me?
That usually depends on tumor testing. PARP inhibitors — olaparib, rucaparib and niraparib — block a repair process some cancer cells rely on, and are used as maintenance after chemotherapy, mainly for cancer that has come back. Bevacizumab blocks the blood vessel growth tumors need and may be combined with chemotherapy for advanced or recurrent disease. Ask what tests have been done and what they showed.
Questions to ask your doctor
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Sources last checked: 2026-08-13 what this meansLast updated: 2026-08-19Next planned review: 2027-01-22
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How this page was created
Cancer Explained does not originate medical claims. Every page restates guidance already published by the National Cancer Institute, the CDC, the USPSTF and the FDA, in plain language, with the source cited so you can check the original yourself. AI does the translating and organizing; automated checks test claims, citations, clarity and safety before anything publishes. We do not employ clinicians and do not intend to — our work is translation and navigation, not clinical judgment. Nothing here is personal medical advice, and no page can account for your particular situation.
Editorial status: Source checked — This page was written with AI assistance and checked line by line against the sources listed on it. That confirms the sources support what the page says. It is not a medical review, and it does not confirm the page is complete or right for your situation.
Human medical review: not completed. Pages here are not signed off by a clinician before they publish. That is not an oversight we are quietly working around: we restate published guidance and cite it, so the authority belongs to the source rather than to us, and every page names where its claims come from — you can verify us instead of trusting us. Where a volunteer clinician has reviewed a page, their name and credentials appear on it; where no name appears, no clinician has checked it. We are glad to have reviewers and are recruiting them, and we do not hold pages back waiting for one. Use this site to understand your situation and to ask better questions of the people treating you.
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