Cancers affecting organs or tissues in 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 cures 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 team of gastrointestinal oncologists has 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:
- Appendix cancer
- Colon cancer
- Liver cancer
- Ovarian cancer
- Pancreatic cancer
- Peritoneal cancer
- Stomach cancer
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 doctor 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.
- 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 allows the patient to receive a bigger dose of chemotherapy.
HIPEC is done immediately following surgery to take out removable 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, the surgical team gently rocks you back and forth. 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, you may be unable to digest food taken in by mouth. Nutritional support may be delivered intravenously or through a feeding tube.
Recovery at home may take another four to 12 weeks, depending on your surgery. Your oncologist will continue to monitor your cancer and determine whether additional chemotherapy is needed.
Call your doctor if you experience any of the following:
- Fever above 101 F (38.3 C)
- Persistent nausea and vomiting
- Severe swelling or drainage around your incision site
- Worsening pain