Intraperitoneal chemotherapy is a type of cancer treatment that involves administering anticancer drugs into your peritoneal cavity. It’s a much less common treatment than intravenous (IV) chemotherapy, but it’s still used in some people for certain types of cancers within their peritoneal cavity.
The peritoneal cavity is the area of your abdomen that contains your stomach, intestines, and liver. Intraperitoneal chemotherapy directly targets cancer cells in this area.
This article will take a closer look at intraperitoneal chemotherapy, including how and why it’s administered and what side effects are most common with this treatment.
Although intraperitoneal chemotherapy is used less often than IV chemotherapy, it’s still used in some people to treat cancers that affect their abdominal region, including:
The goal of intraperitoneal chemotherapy is to kill any cancer cells that may remain in your abdomen, usually following surgery. It’s typically only prescribed for masses that are less than a ¼ inch or 2.5 centimeters in length.
Compared with traditional or systemic chemotherapy, there are some important advantages.
Systemic chemotherapy is administered through a vein. The chemo drugs have to travel through your entire body to eliminate the cancer, even when the cancer cells are confined to a particular area.
Some areas of the body — including the peritoneal cavity — are harder to penetrate than others. Systemic chemotherapy isn’t usually as effective on cancers in this region.
In contrast, intraperitoneal chemotherapy directly targets cancer cells in your peritoneal cavity. Since the drugs don’t have to pass through the rest of your body, they can be given in higher doses than traditional chemotherapy.
But the intraperitoneal chemotherapy drugs still get absorbed into your blood. This means the chemo can also reach cancer cells that are located outside your abdominal cavity.
The downside, though, is that intraperitoneal chemotherapy may have more severe side effects, such as abdominal pain, nausea, and vomiting.
There are two types of intraperitoneal chemotherapy, which are described below.
Adjuvant (post-operative) intraperitoneal chemotherapy
Adjuvant intraperitoneal chemotherapy is typically administered several days after your cancer surgery.
During your cancer surgery, a surgeon may have placed an intraperitoneal access port under the skin in your upper abdomen. Sometimes, this port is put in place during a separate surgical procedure.
The port includes a reservoir and a thin tube that’s used to deliver chemotherapy to your intraperitoneal cavity. It’s small, but you should be able to feel it under your skin.
How adjuvant intraperitoneal chemotherapy is delivered
- You’ll receive detailed instructions prior to your first round of intraperitoneal chemotherapy. For example, you might be required to take medication at home the day before your treatment.
- At the treatment center, a nurse will administer preparatory medications, such as anti-nausea drugs, and IV fluid. They’ll give you the chemotherapy by inserting an access needle into your port.
- The chemotherapy infusion can last between 30 minutes to 3 hours. During this time, you might feel some abdominal discomfort or pressure. When it’s over, the nurse will remove the access needle and cover your port with a bandage.
- You may be asked to roll from side to side every 15 minutes for 1 or 2 hours after the treatment. This can help the drugs reach your entire peritoneal cavity.
- After the treatment is over and you’re comfortable, you should have someone you trust accompany you home. You might be given a prescription for medication to take at home over the following days.
Hyperthermic intraperitoneal chemotherapy (HIPEC)
Hyperthermic intraperitoneal chemotherapy (HIPEC) is a one-time chemotherapy treatment that’s administered during tumor removal surgery. It helps to ensure that all the cancer cells are eliminated from your abdomen.
How HIPEC is delivered
- A surgeon will first try to remove as much of the cancer as possible. If your cancer is advanced, this part of the procedure can take up to 8 hours or more.
- Next, the chemotherapy drugs are heated up using a perfusion machine and administered into your peritoneal cavity using a catheter — a thin, flexible tube.
- A surgeon may massage you or move you back and forth on the operating table to ensure that the chemo drugs reach your entire peritoneal cavity. This part of the procedure typically takes up to 2 hours.
- The chemotherapy is then drained, and your abdomen is rinsed with salt water before the catheter is removed and the surgical incision is closed.
- Following the procedure, you’ll stay at the hospital for up to 2 weeks to recover.
HIPEC is only given once, during surgery. In contrast, postoperative intraperitoneal chemotherapy can last for several weeks.
A doctor or healthcare professional will let you know the schedule for your intraperitoneal chemotherapy treatment.
A sample intraperitoneal chemotherapy schedule for ovarian cancer includes 1 or 2 days of treatment, followed by 5 days of rest at home. Each new cycle starts a week after the previous one for up to six cycles.
The side effects are typically different for adjuvant intraperitoneal chemotherapy versus HIPEC. Aside from the method that’s used, side effects can also vary based on the types of chemo drugs that are used.
A doctor can help you understand what types of side effects you may have with intraperitoneal chemotherapy.
Some of the most common side effects of adjuvant intraperitoneal chemotherapy include:
- abdominal pain, pressure, or cramping
- nausea and vomiting
- kidney damage
- decreased appetite
- constipation or diarrhea
Some of the most
- gastrointestinal issues
- pleural effusion (fluid buildup around your lungs)
- blood clots
- a decrease in bone marrow and blood cells that can lead to infection, anemia, and bleeding
If you’re struggling with side effects of treatment, be sure to talk with a doctor. They might be able to prescribe additional medications to help ease your symptoms.
Get medical attention if you experience severe side effects, such as:
- blood in your urine or stool
- high fever
- inability to eat or drink
- nausea or vomiting that doesn’t go away with medication
- pain, redness, or swelling around your port
- severe abdominal pain
Intraperitoneal chemotherapy is an uncommon form of treatment for cancers that affect your abdominal area. It involves directly infusing chemotherapy drugs into your peritoneal cavity.
Compared with traditional chemotherapy, intraperitoneal chemotherapy involves a higher dose that’s more likely to eliminate cancer cells in your abdomen. It’s typically used during or after surgery to remove a tumor.
A doctor can help explain whether intraperitoneal chemotherapy is right for you.