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.
NCI groups primary peritoneal cancer at stages II to IV with advanced cancers. Ask what stage you are and whether intraperitoneal chemotherapy or HIPEC applies to you.
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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. NCI lists them for advanced cancer, with or after chemotherapy, and as maintenance 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
NCI's staging treats stage I only for ovarian and fallopian tube cancer. Primary peritoneal cancer is staged from stage II up, and NCI says stages II, III and IV are treated as advanced cancer. Advanced treatment combines surgery with chemotherapy, and sometimes targeted therapy too. 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 is major surgery, with risks such as infection and bleeding. Chemotherapy can lower the white blood cells that fight infection. 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. The CDC calls a fever during chemotherapy a medical emergency and says to call your doctor immediately. 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, call your care team right away about a fever. Heavy bleeding that pressure will not slow is an emergency department trip, or a 911 call, rather than a message for the clinic. Call your care team right away, at any hour, for severe abdominal pain or signs of infection at a surgical or catheter site, such as swelling or redness (CDC). For emergencies call 911 or go to the ER. 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
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 cancer can spread. 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 NCI lists them for advanced cancer and as maintenance 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.
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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, and this 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 then compared with the sources listed on it, looking for statements those sources do not back up. That check is not a sentence-by-sentence record and can miss errors. 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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