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Peritoneal Cancer

Learning you may have cancer in your belly can be a shock. Especially when you didn’t really notice anything wrong — except maybe a little bloating and gas.

You may not have had any signs of peritoneal cancer at first. This rare cancer begins quietly in the tissues lining the inside of your abdomen (peritoneum). And by the time you may have symptoms, the cancer has usually progressed. Now, you’re left wondering about treatment and your future.

It’s a lot to absorb. That’s why our compassionate healthcare providers are here to guide you through it all. You can breathe a little easier knowing that you have a team of experts on your side who regularly treat peritoneal cancer. So, while it’s considered a rare cancer, it’s not uncommon to us. We make sure you have the best care, support and resources you need through diagnosis, treatment and beyond.

Why Choose Cleveland Clinic for Peritoneal Cancer Care?

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Industry leaders:

We’re known for the highest quality cancer care as a National Cancer Institute (NCI) Designated Comprehensive Cancer Center. This means our healthcare providers consistently meet and exceed high standards for cancer research, diagnosis, and treatment.

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Collaborative care:

Our team-based approach to care gives you the support and expertise of all the healthcare providers you need in one place. Your care team will work together to make sure you get the most personalized treatment and follow-up for your specific needs. Meet our team.

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Caring approach:

A rare cancer diagnosis can affect every part of your life. Our experts understand this ripple effect. That’s why we do everything we can to make things easier for you. We connect you with resources and a supportive community that can help. We’re here for you no matter what.

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Innovation and research:

Cleveland Clinic specialists lead and take part in research and clinical trials of new treatments for peritoneal cancer. We never stop working to improve health outcomes before, during and after treatment.

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Virtual visits:

If getting to your provider’s office is tough, you might want to think about having a virtual visit. You’ll get the same great care but from the comfort and convenience of your home. All you need is an internet connection and your smartphone, computer or tablet.

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National recognition:

Cleveland Clinic is a trusted healthcare leader. We're recognized in the U.S. and throughout the world for our expertise and care.

Diagnosing Peritoneal Cancer at Cleveland Clinic

Your peritoneum is a thin membrane lining your abdomen (belly) and pelvis. Tissue called epithelium forms this membrane. It covers many of the organs inside your abdomen. It also covers your bladder, intestines, rectum and uterus.

When cancer grows in these epithelial cells, you might develop:

  • Primary peritoneal cancer: This cancer happens when epithelial cells in the peritoneum grow in ways they shouldn’t.
  • Peritoneal mesothelioma: This cancer is more common among people who work with or have had exposure to asbestos.
  • Secondary peritoneal cancer: Secondary peritoneal cancer begins somewhere else in your body and spreads to your peritoneum. It’s a metastatic cancer.

Often, primary peritoneal cancer can be confused with ovarian cancer because ovarian cancer can spread to your peritoneum. These two cancers can have some of the same symptoms, like abdominal bloating and pain, unexplained weight loss, constipation and abnormal vaginal bleeding. Primary peritoneal cancer can develop even if your ovaries have been removed. In most cases of peritoneal cancer, the ovaries are minimally involved. The treatment of peritoneal cancer is similar to that of ovarian cancer.

What to expect during your first visit

A rare cancer diagnosis often carries added weight and worries that your providers aren’t familiar with your uncommon condition. When you come to Cleveland Clinic, your condition’s anything but uncommon.

Our team is experienced in treating rare cancers. And we’ll never mention how uncommon peritoneal cancer is. To us, it isn’t. And we’re here to help care for you in the most personalized and attentive way possible.

That’s why, when you come in for your first appointment, we’ll ask you to tell us your story — in your own words. It’s important for us to understand how your cancer is affecting your life. You’ll want to be prepared to share:

  • What symptoms you’re having.
  • When you first noticed your symptoms.
  • How your symptoms are affecting your life.
  • Your personal and family medical history.

Your provider will also do a physical exam, including a pelvic exam of your reproductive organs. They may also order more tests to help diagnose peritoneal cancer.

Blood tests

The CA-125 blood test lets us check your blood for levels of proteins called cancer antigen 125. These proteins are often higher (elevated) when you have peritoneal cancer.

Imaging tests

Our experts use technology to see detailed views of your abdomen and pelvis. You may have:

Fluid sample testing (paracentesis) or biopsy

Sometimes, peritoneal cancer causes fluid to build up in your abdomen (ascites). If this happens, we’ll use a needle to remove some of the fluid and test it. We can also remove fluid in this same way to help with pain and discomfort. A biopsy can also be done by a radiologist to confirm the diagnosis and help us decide on the best treatment.


Our trained surgeons may do laparoscopy to check out the organs in your abdomen and pelvis firsthand. During this, they may do a biopsy of peritoneal tissues. Pathologists at the lab will look at these samples under a microscope to see if cancer is there. They can also stage peritoneal cancer to help us decide on the best treatment for you.

Second Opinions for Peritoneal Cancer

Learning you may have cancer can be overwhelming. There are so many things to think about. So much to digest. You likely want the best possible care — and to feel confident you’re working with a team of healthcare providers you trust completely. That’s why we encourage second opinions.

Our highly skilled, experienced and compassionate cancer specialists will spend time with you to help you better understand your diagnosis and what treatment options might best meet your needs. And because we know that cancer doesn’t wait, we always try to meet with you as soon as possible. Getting a second opinion can make you feel in control of your care and give you peace of mind, knowing you’re in the most capable hands.

Meet Our Peritoneal Cancer Team

When you come to Cleveland Clinic, you’ll have a team of expert healthcare providers from different specialties. We build this team based on your unique diagnosis and needs. They work together to make sure you’re getting the best care possible. Your care team could include:


Our healthcare providers see patients at convenient locations throughout Northeast Ohio, Florida and London.

Treating Peritoneal Cancer at Cleveland Clinic

Our providers use the latest peritoneal cancer treatments. Your care plan depends on the type of peritoneal cancer you have, its stage, and your age and health. Your healthcare team will go over all of the best options with you, and we may use a combination of treatments.

Minimally invasive surgery

Surgery is the most common treatment for peritoneal cancer. Our surgeons often try to use laparoscopic surgery and robotic surgery whenever possible, but open abdominal surgery (laparotomy) is more common.

Depending on the location and stage of the cancer, we may do:

  • Cytoreduction: Removes cancer from your abdomen. We may also remove part of your peritoneum and other abdominal organs if the cancer has spread.
  • Omentectomy: Removes a fatty layer called the omentum that covers some organs in your abdominal cavity.
  • Hysterectomy: Removes your uterus, if it’s been affected.
  • Bilateral salpingo-oophorectomy: Removes both of your fallopian tubes and ovaries.

Systemic therapy

Sometimes, you may need medications that work throughout your body (systemic therapy). These drugs destroy cancer cells and stop tumors from growing. You may have these medications after surgery or without surgery, either alone or in combination:

Hyperthermic intraperitoneal chemotherapy (HIPEC)

Our experts may treat you with hyperthermic intraperitoneal chemotherapy (HIPEC). We flush your abdominal cavity with heated chemotherapy drugs right after surgery while you’re still under anesthesia. HIPEC treatment helps make sure no cancer cells remain after surgery.

Taking the Next Step

No cancer diagnosis is easy to accept. But when you come to Cleveland Clinic for peritoneal cancer diagnosis and treatment, you’ll get expert and compassionate care every step of the way. We’re here to help you understand what’s going on, what to expect and how to move forward. We listen to you, answer your questions and provide the best possible treatment for your unique diagnosis and specific needs.

Getting an appointment with Cleveland Clinic’s peritoneal cancer experts is easy. We’ll help you get the care you need.


Getting an appointment with Cleveland Clinic’s peritoneal cancer experts is easy. We’ll help you get the care you need.

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Learning you have cancer can be stressful, shocking and challenging. From the moment you get the news, you're a survivor. As you face the challenges that go along with cancer treatment and recovery — physical and emotional — we’ll be right there with you.

At Cleveland Clinic, survivorship care is one part of your journey. We offer a wide range of services, resources, clinics and support groups to help with any physical, emotional, financial and spiritual needs you might have related to your cancer diagnosis. Lending a helping hand along the way, we want you to not only survive, but thrive on this journey and beyond.

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