Hyperthermic (or heated) intraperitoneal chemotherapy (HIPEC) is a surgical cancer treatment. Doctors sometimes perform it on people with certain abdominal cancers because it’s not as toxic as traditional chemo.

HIPEC involves pumping heated chemotherapy drugs into your abdomen. These drugs have high concentrations, but unlike traditional chemotherapy, they’re part of a one-time treatment and don’t require using intravenous (IV) infusions into your bloodstream. Because of that, these toxic drugs are less harmful to noncancerous tissues outside your abdomen.

Keep reading about the HIPEC procedure, what cancers it can treat, its risks and side effects, and other useful information.

Healthcare professionals use HIPEC to treat cancers that originate or spread into your abdomen. These cancers can be hard to treat because they often reach advanced stages.

Cancers that doctors most often treat with HIPEC are:

They can also use HIPEC to treat cancerous ascites, or a buildup of fluid in the abdominal cavity, which can happen with some abdominal cancers.

Doctors usually treat ascites using abdominal tapping, which may require multiple procedures if the fluid continues to build up. One 2020 study showed that HIPEC can be an effective alternative to abdominal tapping for treating cancerous ascites.

Healthcare professionals typically perform HIPEC at the end of debulking surgery, a procedure to remove all visible tumors from your abdomen. They perform it through an incision in your abdomen. The procedure will take place in the operating room. A doctor will give you a general anesthetic.

The HIPEC procedure involves several steps:

  1. Your medical team will put a cooling blanket around your body to keep it at a safe temperature during the procedure.
  2. They will heat up chemotherapy drugs to 39°C (103°F) in a special device called a perfusion machine.
  3. They will insert catheters from the perfusion machine into your abdomen.
  4. The perfusion machine will deliver heated chemotherapy drugs into your abdomen for about 1 to 1.5 hours.
  5. After the procedure is complete, your doctors will remove catheters, rinse your abdomen with a salt solution, and close the incision.

HIPEC can be an effective treatment option for people with some abdominal cancers. A 2021 study showed that 95.6% of people with certain abdominal cancers who received HIPEC had remission as soon as 4 weeks after the procedure.

There are several benefits of HIPEC over traditional chemotherapy that explain its effectiveness and safety:

  • It’s a one-time surgical treatment instead of multiple IV infusions over the course of several weeks.
  • The majority of the drug stays inside your abdominal cavity, which reduces the harm to other body tissues.
  • It allows for a higher dose of chemotherapy.

However, research is still ongoing to determine whether HIPEC is effective for all abdominal cancers. For example, a 2020 research review did not show that HIPEC extended the survival of people with colorectal cancer. But a 2019 study found that HIPEC was relatively safer and more effective than similar procedures.

Your doctor can determine whether HIPEC has a good chance of success based on your specific cancer characteristics.

Although some experts consider HIPEC safer than traditional chemo, there are still some risks and side effects associated with this procedure. They may depend on how extensive the debulking surgery is and the chemotherapy drug the doctor uses in HIPEC.

Some of the risks of HIPEC are:

HIPEC can cause the following side effects:

Side effects may last for a few months after the surgery and are notably more intense than symptoms from system chemotherapy. It is important to manage the side effects to avoid complications.

You don’t typically need to have more chemotherapy after HIPEC. This is because HIPEC can replace the typical course of chemo treatment with a one-time surgical procedure.

So, what happens after you have HIPEC?

After HIPEC, you will most likely stay in the hospital for 1 to 2 weeks. During that time, your digestive system will go through a recovery period from the high dose of chemotherapy drugs.

Your medical team will check you for fluid loss and test your electrolytes and blood glucose levels. Initially, you’ll get your nutrition via a feeding tube or IV, but you may start on a solid diet before the discharge.

It’s common to feel tired and weak for 2 to 3 months following the surgery and HIPEC. Although it’s important to rest a lot during the recovery period, it’s also a good idea to maintain light activity like getting up and moving around. Remaining active can help you overcome fatigue and prevent some possible complications of surgery.

It’s also important to maintain a balanced diet. Your doctor may recommend contacting a dietitian to ensure you get professional advice on your eating habits. Most insurance companies cover appointments with the dietitian, but make sure to confirm this with your provider.

Doctors use HIPEC to only treat certain abdominal tumors.

Whether HIPEC is appropriate for you depends on the following factors:

Your doctor will help you decide whether HIPEC is appropriate for you and whether you can take it before or after a traditional chemo course, which they might suggest trying to increase the odds of treatment success.

HIPEC is a surgery to treat certain abdominal cancers. It involves pumping heated chemotherapy drugs inside the abdomen. It’s less toxic than traditional chemo because it’s a one-time procedure that doesn’t require IV infusions into the bloodstream.

Although research is still ongoing, some experts generally consider it an effective treatment for many abdominal cancers. Doctors usually perform it at the end of debulking surgery that removes visible tumors from your abdomen.

Although it’s safer than traditional chemotherapy, it has some risks and side effects. Your doctor will help you decide whether this option is appropriate for your condition.