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Heated Intra-operative peritoneal Chemotherapy (Hyperthermic interperitoneal chemotherapy, hot “chemo bath”, HIPEC) is a technique used to treat certain types of colorectal and ovarian cancers that have spread to the lining of the abdomen. It involves circulating heated chemotherapy through the abdomen.

HIPEC involves using a using a heated chemotherapy solution that is circulated throughout the abdominal cavity while the patient is in the operating room.

The theory behind HIPEC is that cancerous cells are unable to withstand as much heat as healthy cells. Also, putting the chemotherapy on top of tumors is thought to  be more effective than systematically delivering it through the bloodstream. The fluid goes throughout the abdomen to treat any tumor cells that may remain after surgery.

The father of the procedure is Dr. Paul Sugarbaker in Washington Hospital Center in Washington,D.C.

For additional information about HIPEC, see the other sections of this document.

NOTE: This procedure is controversial. We strongly advise that you talk to get a second opinion from an NCI designated Comprehensive Care Center offsite linkbefore considering HIPEC. If you want to talk with other survivors visit the Colon Cancer Alliance’s My CRC Connections offsite link online community.

The Procedure

The incision is large. Sometimes surgeons start with a small laproscopic entry to see what is happening in the abdomen before proceeding with the larger incision.

Once inside the body, the surgeon removes any visible tumors (“debulking surgery”).

Next, the patient is connected to a series of catheters and a pumping device that bathes the entire abdominal cavity with the chemotherapy drugs. The circulatory part of the process takes from 90-to a maximum of 120 minutes.

The entire process can last for eight hours or more.

The patient is generally hospitalized for 7 – 10 days. 

For information about maximizing a stay in the hospital, click here. For additional practical information about hospitals, see the documents in "To Learn More.". 

Post Surgery

After surgery, expect to be moved to an intermediate ICU for a few nights, likely with a drain. The wound may be open

Some people may be moved into an ICU and even put on a ventilator.

You will receive pain medication to reduce and possibly eliminate the pain. (For information about pain, click here.)

You will be encouraged to walk the first day in a regular room to avoid blood clots.

You will likely gain weight from the liquid – up to 20 pounds. Because of this you will be given a diuretic to help remove the liquid.

Expect to be on an i.v. diet for the first days.

Psychological issues may come up, such as depression. If so, hospitals that perform this procedure generally have social workers to help if necessary.

Full recovery can take up to 6 – 8 months.

To Prepare For HIPEC Surgery

There will be rigorous pre-op testing which generally includes:

  • Blood work
  • CT/pet scan to learn your Peritoneal Cancer Index (the higher the score the more cancer in the abdomen. 39 is the maximum score)
  • Recent endoscopy/colonoscopy
  • Assessment of likelihood for completeness of cytroeduction
  • Performance status evaluation

Patients are not permitted to eat or drink the night before surgery. Bowel prep is usually not necessary, but it is up to the surgeon. 

Insurance For HIPEC

Medicare and insurers generally pay for the operation. The heated treatment may not be covered, although it may be if it is merely described as chemotherapy.