Cancers affecting the lining of the abdomen are challenging to treat because reaching that area with radiation or traditional chemotherapy is difficult. Hyperthermic intraperitoneal chemotherapy (HIPEC) can be an effective alternative for these hard-to-treat cancers. After surgery to take out the removable tumors, a powerful dose of a heated chemotherapy drug is pumped through the abdominal cavity to destroy the remaining cancer cells.

Heating the chemo agent makes it better at killing cancer cells, while direct delivery to the abdominal cavity allows for a more concentrated dose where it's needed. The procedure effectively removes all the visible cancer in some patients; for others, HIPEC blunts their cancer enough to allow doctors to manage it as a chronic illness.

Only a small number of hospitals in the country offer HIPEC, and UCSF is one of them. Our world-class team of gastrointestinal surgical and medical oncologists have the experience and expertise to perform state-of-the art procedures that provide new hope for patients with abdominal or metastatic cancer.

Who may benefit

HIPEC is for patients with tumors in the abdominal cavity. The cancers most commonly treated with HIPEC include:

Whether you're a candidate for HIPEC depends on where your cancer originated, how widely it has spread, and whether you're healthy enough to undergo the procedure. Your UCSF surgical oncologist will talk to you about whether you could benefit from HIPEC.


Conventional chemotherapy is usually delivered either intravenously (into a vein) or orally. This means the drug travels throughout the body, is diluted, and can cause side effects throughout the body. These limitations mean that HIPEC has several advantages:

  • It reaches areas that traditional chemotherapy can't easily reach and goes directly to the cancer cells.
  • Patients undergo only a single treatment rather than multiple sessions over weeks or months.
  • The drug is delivered straight to cancerous tissues in the abdomen, and most of it stays in the abdominal cavity, reducing toxic effects to the rest of the body.
  • It results in cancer cells receiving a bigger dose of chemotherapy than they would get from traditional "systemic" chemotherapy.


HIPEC is done during surgery to take out the tumors. While you are still under anesthesia and before the incision is closed, the surgeon will insert a catheter (a thin, flexible tube) into your abdominal cavity. The catheter is connected to a machine that heats the drug to 103 F (39 C) and pumps it into your abdominal cavity. The drug's higher temperature causes blood vessels to expand, so the medicine penetrates tissues more deeply. You'll be lying on a special cooling blanket that prevents your body from overheating.

To ensure the drug reaches all parts of the abdomen, it is circulated with a pump and manually. After one to two hours (possibly longer if your cancer is advanced), the surgeon drains the drug from your abdomen, rinses the area with a saline solution and then closes the incision.


The length and challenges of your recovery depend on the extent of your surgery. You may be in the hospital for a few days or up to two weeks. Initially, it may take some time to digest food taken in by mouth. Occasionally nutritional support may be delivered intravenously or through a feeding tube temporarily during this time.

Recovery at home may take another number of weeks, depending on your surgery. Your surgical oncologist will continue to monitor your cancer and determine whether additional chemotherapy is needed in consultation with your medical oncology team.