Monday, April 19, 2021
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Primary peritoneal carcinoma

Is primary peritoneal cancer the same as ovarian cancer?

Primary peritoneal carcinoma, also known as serous surface papillary carcinoma, primary peritoneal cancer, small ovary peritoneal cancer, extra-ovarian serous carcinoma, primary serous papillary carcinoma, and rarely as psammomacarcinoma. That’s quite a mouthful for any of these, but it does not matter.  They basically behave the same way and are treated the same way.

Initially,  it was categorized as “carcinoma of unknown primary”. This is before we recognized the similarities.  At this point, we do know where it comes from so it is not unknown primary.  It is from the skin lining of your insides, called the peritoneum.

Under the microscope, it looks just like serous ovarian cancer, which is the most common epithelial ovarian cancer.

Causes of primary peritoneal cancer

Causes are not known, but a relationship with variations of the BRCA1 and BRCA2 gene has been described, just like ovarian cancer.  This is partly the reason that women with mutations of the BRCA gene still carry a 5% risk of developing primary peritoneal cancer even after prophylactic oophorectomy has been performed.

Similarly, it can express other gene defects like p53, BRCA, WT1, just like ovarian cancer and can also show overexpression of HER-2/neu.

It is also associated with vascular endothelial growth factor, just like ovarian cancer and some others.

Diagnosis, workup, testing, treatment

The entire evaluation and treatment process is essentially the same as for epithelial ovarian cancer, the most common type of ovarian carcinoma.

Survival rates

The odds of beating this cancer are similar, but can be a little shorter by two to six months, compared to an average case of ovarian cancer.  The point being, it is very treatable and responds to therapy quite well compared to the majority of other cancers, even in advanced stages.

Elevated blood protein (albumin) levels may mean a better prognosis.

While the treatment is evolving for all cancers, this one can also be treated effectively with a combination of surgery and chemotherapy.   Molecular signature profiling is also used to determine the best targeted biological and immunomodulation therapies.

Dr Steve Vasilev MD
“I help and guide women to defeat gynecologic cancers and advanced pelvic conditions such as endometriosis, using a unique combination of minimally invasive robotic surgery, precision medicine therapies and complementary holistic natural support towards thriving in survivorship." Dr. Vasilev is the only physician quadruple board certified in Ob-Gyn, Gynecologic Oncology and Integrative & Holistic Medicine in the United States. He is an accomplished advanced robotic surgeon and serves as Medical Director of Integrative Medicine and Integrative Gynecologic Oncology at Providence Saint John's Health Center, Professor at John Wayne Cancer Institute in Santa Monica, California and is Clinical Professor at Loma Linda University School of Medicine. He is former faculty and professor at UC Irvine, UCLA, USC and City of Hope. He is an active member of multiple medical societies and has been nationally listed in "Best Doctors" for 18 years.

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