What is the first treatment for primary peritoneal cancer?

Primary peritoneal cancer develops in the lining of the abdomen and can behave similarly to some ovarian and fallopian-tube cancers. Chemotherapy is a systemic treatment, so it can reach cancer cells in different areas of the body. The oncology team may use it before an operation to shrink or control disease, or after surgery to treat cells that cannot be seen during the procedure.

Surgery may remove visible tumour deposits from the abdominal lining and nearby tissues. This is often called ovarian cancer debulking surgery, even when the main cancer is in the peritoneum. The order of treatments depends on imaging, biopsy results, the distribution of disease, symptoms, nutrition, other illnesses and whether an operation can be performed safely.

Ask the oncology team to explain the proposed sequence: chemotherapy first, surgery first, or a combination followed by further treatment. Ask what the scans show, what the biopsy confirms, and how treatment response will be checked. Before chemotherapy, discuss medicines, infection precautions, fertility or menopause concerns, nutrition and how to report side effects.

Before surgery, ask whether the aim is to remove all visible disease, what organs might be involved, how recovery will be supported and whether a hospital stay is expected. Keep a written list of medicines and symptoms, and take it to every appointment.

Contact the cancer team promptly for fever, chills, new breathlessness, repeated vomiting, inability to drink, worsening abdominal swelling, severe pain, confusion or very little urine during treatment. Seek urgent help for sudden severe abdominal pain, fainting, heavy bleeding or difficulty breathing. These symptoms need assessment because infection, dehydration, bowel problems or other treatment complications may require quick care.

Which treatment do you recommend first, and what finding led to that choice? Is surgery planned now or after chemotherapy? What does the operation involve? How will you monitor response and decide the next step? Which side effects should prompt a same-day call?