Understanding Why Primary Peritoneal Cancer Affects Women More

When it comes to women’s health, some conditions quietly stay in the background until they suddenly demand attention. Primary peritoneal cancer (PPC) is one of them. Even though it starts in the lining of the abdomen, it behaves almost exactly like ovarian cancer. And it affects women far more than men. But why? Let’s break it down.

It starts with how women’s bodies are built

The peritoneum (the thin layer covering the abdomen), the ovaries, and the fallopian tubes all come from the same kind of embryonic tissue.
This means:

• Their cells are similar.
• They respond to the same biological signals.
• They can develop the same types of cancers.

So even if a woman’s ovaries look normal, the peritoneum can still develop a cancer that behaves just like ovarian cancer. That’s why PPC is almost always seen in women.

Hormones play a quiet but powerful role

Throughout a woman’s life, her body goes through many hormonal shifts—periods, pregnancy, menopause, and sometimes hormone replacement therapy. These hormonal changes, especially those involving estrogen, can influence how certain cancer cells grow.

Since PPC behaves like ovarian cancer, hormones that affect the reproductive system also affect the peritoneum. This hormonal link is one more reason women are much more likely to develop PPC.

Genetics can increase the risk

Some women carry gene mutations like BRCA1 or BRCA2, which raise the risk of ovarian and breast cancers. These same mutations also increase the risk of developing primary peritoneal cancer. It’s not that men never have these mutations, but the organs affected by them (ovaries, fallopian tubes, and peritoneal lining) put women at a much higher risk.

Symptoms and diagnosis

PPC is tricky. Women may experience symptoms similar to advanced ovarian cancer:

• Bloating
• Abdominal discomfort
• Digestive issues
• Fluid buildup in the abdomen

But when doctors check the ovaries, sometimes they look normal. That’s when PPC becomes the most likely diagnosis. In men, peritoneal cancer is usually linked to something else—like asbestos exposure leading to mesothelioma. So PPC rarely enters their diagnostic pathway.

It looks and acts just like ovarian cancer

Under a microscope, PPC cells and ovarian cancer cells look almost identical.
This is why:

• The treatment is the same.
• The response to therapy is similar.
• The overall approach mirrors ovarian cancer management.

The difference is only where the cancer started and not how it behaves.

Understanding helps us act faster

The reason primary peritoneal cancer affects women so much more comes down to biology, hormones, and genetics. Knowing this helps doctors diagnose it earlier and treat it better. Most importantly, it empowers women to recognize symptoms, seek help, and understand their bodies more deeply.