HIPEC

What is HIPEC?

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is an alternative method of delivering chemotherapy, used alongside surgery to treat different types of cancer, particularly peritoneal cancer that has spread from the appendix, colon, or stomach. Unlike traditional chemotherapy that is delivered intravenously, HIPEC delivers heated chemotherapy directly into the abdomen to destroy cancer cells and small tumours that cannot be seen with the naked eye. The surgery to remove the larger parts of a tumour is usually performed under epidural anaesthesia.

Why is HIPEC performed?

The purpose of HIPEC is to treat certain stage IV abdominal cancers and other types of cancer, such as; colorectal cancer, gastric cancer and stage IV ovarian epithelial carcinomas. It is used to kill cancer cells and small tumours that cannot be seen during surgery. Traditional chemotherapy or radiation therapy offers limited success for those with advanced abdominal cancer, so patients are often those who are looking for an alternative treatment to traditional chemotherapy and radiation.

HIPEC has many advantages over traditional chemotherapy in the treatment of advanced abdominal cancer, as it has fewer side effects. The high doses of chemotherapy are unable to cross what is known as the peritoneal plasma barrier, which minimizes the body’s exposure to chemotherapy. The treatment is also more likely to be successful because the chemotherapy circulates throughout the abdomen destroying any cancer cell in its path. 

What happens during HIPEC?

At first, the surgeon removes any visible tumours from the abdomen during what is called cytoreductive surgery. Then heated chemotherapy (HIPEC) is delivered directly into the abdomen to destroy any tumours that are not visible and to destroy any remaining cancer cells. The solution is about the same temperature as a warm bath and circulates in the abdomen for about 90 minutes.

Preparing for HIPEC

The doctor will check that the patient is in otherwise good health to go through with the operation and a dietician will see the patient before the surgery to make sure they are eating enough calories and that they are following a balanced diet.

Aftercare

Cytoreductive surgery with HIPEC can last an average of 8-14 hours, depending on the extent of the tumour. Patients typically remain in the hospital for 10-12 days, following the operation. It is not uncommon for patients to feel tired post-operation, but it is important for patients to move around and keep active. A dietician works with the patient to ensure they receive adequate nutrition. A follow-up appointment will be issued 1-2 weeks after the operation and CT scans should be performed every 6 months for the first two years after the operation, then annually to ensure that the tumours do not return.