What is hyperthermic intraperitoneal chemotherapy (HIPEC)?

Hyperthermic intraperitoneal chemotherapy (HIPEC) is a type of cancer treatment. “Hyperthermic” means an abnormally high temperature. “Intraperitoneal” means inside your abdominal cavity. HIPEC involves heating chemotherapy drugs and circulating them through your abdominal cavity (area inside your abdomen) at the time of your cancer surgery.

What does hyperthermic intraperitoneal chemotherapy (HIPEC) treat?

Healthcare providers may use HIPEC for types of cancer that affect your abdomen or chest. HIPEC may be a treatment for:

• Appendix cancer, which grows in the appendix (part of the colon and intestines).
• Colorectal cancer in any part of your large intestine (colon) or the passageway that connects your colon and anus (rectum).
• Gastric cancer (stomach cancer), cancer in your stomach’s inner lining.
• Ovarian cancer in the ovaries, which make eggs and produce female hormones.
• Peritoneal cancer, cancer in the cells lining your abdomen.
• Mesothelioma, cancer in your chest or abdominal lining, often from asbestos exposure.
• Soft tissue sarcomas, cancers in your connective tissues.
• Wilms’ tumor, a type of kidney cancer found mostly in children.

Is hyperthermic intraperitoneal chemotherapy (HIPEC) a standard cancer treatment?

Researchers are still learning more about the benefits of HIPEC. Providers don’t use HIPEC as often as other cancer treatments, such as surgery, radiation therapy or traditional chemotherapy. The benefit of HIPEC is limited to certain cancers and may not be right for everyone.

Who is a good candidate for hyperthermic intraperitoneal chemotherapy (HIPEC)?

Many patients can benefit from hyperthermic chemotherapy. To determine if you are a candidate for HIPEC, your healthcare provider will consider:

• If you have other medical conditions.
• Where cancer is in your abdomen.
• Your overall physical strength.
• Your surgical history.

Healthcare providers typically use HIPEC for people who have more advanced (widespread) abdominal cancers. Traditional chemotherapy or radiation therapy is often not as effective for severe abdominal cancers.

Who gives hyperthermic intraperitoneal chemotherapy (HIPEC) treatment?

Surgeons specially trained in cancer surgery (surgical oncologists or gynecologic oncologics) typically give HIPEC treatment.

What happens before hyperthermic intraperitoneal chemotherapy (HIPEC) treatment?

Before HIPEC, your surgeon removes any tumors from your abdominal cavity. These tumors may be in the stomach, intestines or ovaries.

Typically, your provider uses HIPEC immediately after surgery, while you are still in the operating room and under anesthesia (numbing medication).

What happens during a hyperthermic intraperitoneal chemotherapy (HIPEC) procedure?

First, your provider places a cooling blanket beneath you to keep your body at a safe temperature during treatment. Then your provider:

1. Heats chemotherapy medications to 103 degrees Fahrenheit (42 degrees Celsius) in a special machine.
2. Connects tubes from the machine to your abdomen.
3. Delivers the heated chemotherapy drugs directly to your abdomen.

The chemotherapy drugs circulate in your abdomen for about 1 to 1 1/2 hours. During treatment, your healthcare provider physically rocks you back and forth a few times to ensure that the drugs reach all areas of your abdominal cavity.

What happens after hyperthermic intraperitoneal chemotherapy (HIPEC) surgery?

After treatment, you stay in the hospital to recover. Typically, your hospital stay lasts four to 14 days.

Depending upon the extent of your surgery, you may not be able to take nutrition by mouth during initial recovery. You may receive intravenous (IV) nutrition or nutrition through a feeding tube.

What are the advantages of hyperthermic intraperitoneal chemotherapy (HIPEC)?

HIPEC offers some advantages over traditional chemotherapy. Benefits of HIPEC include:

• Decreased toxic side effects, since 90% of the chemotherapy drugs stay in the abdomen.
• More intense dose of chemotherapy, which can destroy more cancer cells.
• One treatment session, instead of multiple treatment sessions over several weeks.

What are the risks of hyperthermic intraperitoneal chemotherapy (HIPEC)?

Many patients tolerate HIPEC well — however the specific risks will depend upon the type of surgery required to remove your cancer, as well as the specific drugs used with the HIPEC therapy. It is best to discuss this with your surgeon.

Although HIPEC is effective for many patients, there is also a risk that it will not destroy all cancer cells or that cancer will return.

What is the recovery time after hyperthermic intraperitoneal chemotherapy (HIPEC) treatment?

After you return home from the hospital, you will follow up with your oncologist (doctor specializing in cancer) in one to two weeks. Recovery may be four to 12 weeks depending upon the extent of your surgery.

Your oncologist will continue to follow your cancer periodically. In some situations, no further chemotherapy is required. In other diseases, additional IV chemotherapy is recommended. Again, this will be determined by your doctor.

Is hyperthermic intraperitoneal chemotherapy (HIPEC) the only type of treatment I will need for my cancer?

HIPEC is one type of treatment for patients with cancers in their abdominal and chest cavity. It may be your primary treatment option. Or your healthcare provider may use it alongside other cancer treatments, such as radiation therapy or chemotherapy.

When should I call my healthcare provider?

After HIPEC, call your healthcare provider if you experience:

• Fever above 101 F (38.3 C).
• Nausea and vomiting that doesn’t improve.
• Severe swelling or drainage around your incision site.
• Worsening pain.

A note from Cleveland Clinic

HIPEC is a cancer treatment that involves circulating chemotherapy drugs inside your body at the time of cancer surgery. It may be a good treatment option for cancers that affect your abdominal or lung cavity. Some of these cancer types include ovarian cancer, colorectal cancer or gastric cancer. Before HIPEC, your surgeon removes as many visible tumors as possible. Then HIPEC can destroy cancer cells that are invisible to the naked eye. You will follow up with your healthcare provider after one to two weeks. Often, full recovery takes three months or longer.