Veteran Bollywood actress and politician Nafisa Ali is making headlines after she shared a bold and courageous photo on Instagram. In the post, Nafisa Ali is flaunting a bald look with grace and strength after being diagnosed with stage 4 peritoneal cancer. Peritoneal cancer is a rare but serious disease of the abdominal lining. It’s under-talked, often detected late, and misunderstood — which makes awareness all the more vital.
Here's what you should know about peritoneal cancer, its signs and symptoms, diagnosis, treatment, and what steps people might take to lower their risk.
What is Peritoneal Cancer?
Peritoneum is a thin, smooth membrane that lines the abdominal cavity and covers intestines, liver, stomach and other abdominal organs. A primary peritoneal cancer occurs from the cells of the peritoneum itself. However, secondary or metastatic peritoneal cancer occurs when cancer from another organ spreads to the peritoneum. It is a relatively rare and lesser-known type of cancer.
What are the signs to look out for?
As it is a rare type of cancer, there is less awareness about the symptoms. Another tricky part of the symptoms is that this peritoneal cancer is vague and shows very subtle symptoms early on. By the time the symptoms become clear, the disease has already advanced.
Common symptoms include:
- Bloating or swelling due to fluid accumulation—ascites
- A sense of fullness or discomfort and pain in the abdomen or pelvis
- Loss of appetite or reduced appetite
- Changes in bowel habits (diarrhoea, constipation) or gas, indigestion
- Inexplicable weight loss or weight gain due to fluid build-up
- Frequent urination or urinary symptoms if the tumour presses on the bladder
- Fatigue, nausea, sometimes shortness of breath (if fluid or masses push on organs)
In the advanced stages of the disease, one may also experience bowel or urinary obstruction or blockages.
How is peritoneal cancer diagnosed?
Many of the symptoms overlap with more benign conditions like IBS, indigestion or ovarian issues, hence the diagnosis is often delayed.
Diagnosis includes a combination of clinical evaluation, imaging, lab tests and tissue sampling. The doctor may ask about the duration of symptoms, changes in appetite and weight and whether you have a history of cancer in your family. Blood tests are a good marker for CA-125, which is often elevated in peritoneal or ovarian cancers. The doctor may also advise an ultrasound to look for masses or fluid, a CT scan to map , fluid and organ involvement. MRI or PET scans may also help in staging or detecting spread.
Laparoscopy/biopsy
A minimally invasive surgical procedure can visualise the peritoneum directly, obtain tissue samples (biopsy), and assess the extent of disease.
Paracentesis/fluid analysis
When there is ascites (fluid in the abdominal cavity), some fluid is drained (paracentesis) and examined under a microscope/cytology to look for cancer cells.
Staging is then done to classify how far the cancer has spread (often detected at stage 3 or 4).
What are the treatment option?
Many peritoneal cancers are detected at the advanced stage and involve a combination of removing as well as removing or reducing visible tumour burden to manage symptoms.
Key approaches include:
Cytoreductive surgery (debulking)
Surgeons aim to remove as much visible tumour as possible from the abdominal cavity.
HIPEC (Hyperthermic Intraperitoneal Chemotherapy)
After surgery, the abdominal cavity is bathed with heated chemotherapy (often 90 minutes) to kill remaining microscopic cancer cells. The warmth helps drug penetration.
Systemic chemotherapy
Cancer drugs are delivered through the bloodstream to reach areas beyond the peritoneum.
Also Read: What you eat could be increasing your cancer risk
Other local therapies
- PIPAC (Pressurised Intraperitoneal Aerosol Chemotherapy) — a newer, minimally invasive method delivering aerosolised chemo into the abdomen.
- Targeted therapy/immunotherapy, when molecular testing indicates possible benefit.
- Supportive/palliative care to manage pain, fluid build-up (via drains), nutritional issues, and improve quality of life.
Outlook depends strongly on stage at diagnosis, degree of tumour removal (how “complete” the cytoreduction), general health, cancer subtype, and response to therapy.
Because many cases are discovered late, the prognosis is often guarded. However, in selected patients, aggressive treatment with surgery + HIPEC can significantly improve survival and quality of life.
What are the risk factors to keep in mind?
- Genetic mutations or family history of ovarian, fallopian tube, or peritoneal cancer (e.g., BRCA1, BRCA2, Lynch syndrome)
- Age (more common in older adults, often over 50–60)
- Use of hormone replacement therapy (in postmenopausal women)
- Obesity / higher body fat
- Endometriosis (in women)
- Height (some studies show increased risk with taller stature)
Maintaining a healthy weight, regular physical activity, balanced diet (part of general cancer prevention)
Avoiding unnecessary hormonal exposures and careful use of hormone therapy after menopause
Genetic counselling and testing for high-risk individuals (with family history) to discuss options
In certain high-risk women (e.g. BRCA carriers), prophylactic removal of ovaries/fallopian tubes is sometimes considered — but note: even after removal, risk of peritoneal cancer remains (though reduced)
Also Read: Cancer relapse decoded: Causes, types, reasons for recurrence and prevention strategies
FAQs on Peritoneal Cancer:
1. What is peritoneal cancer?
Peritoneal cancer is a rare type of cancer that affects the thin membrane lining the abdominal cavity.
2. What are common symptoms of peritoneal cancer?
Common symptoms include bloating, abdominal pain, loss of appetite, changes in bowel habits, unexplained weight changes, and frequent urination.
3. How is peritoneal cancer diagnosed?
Diagnosis involves clinical evaluation, imaging tests (ultrasound, CT, MRI, PET scans), blood tests, and tissue sampling via laparoscopy or biopsy.
4. What are the treatment options for peritoneal cancer?
Treatment options include cytoreductive surgery, HIPEC, systemic chemotherapy, and supportive/palliative care.
5. What are the risk factors for peritoneal cancer?
Risk factors include genetic mutations, age, hormone replacement therapy, obesity, endometriosis, and height.
Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.
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