What is HIPEC?

Chemotherapy is usually thought of as being given intravenously, however HIPEC delivers chemotherapy directly into the abdominal cavity. Giving chemotherapy straight into the abdomen allows for direct drug to tumor contact, which increases its efficacy.  In addition, since only some of the drug is absorbed into the blood stream, HIPEC can use much higher concentrations of the chemotherapy than would be possible with intravenous therapy, while minimizing many of the side effects on the rest of the body.

HIPEC also uses heat to improve the effect of the chemotherapy.  Tumor cells are more sensitive to heat than normal cells.  Temperatures of 41-43 degrees Celsius (similar to having a fever) disrupt tumor cells and allow more chemotherapy to enter, while normal cells remain undamaged.

The HIPEC procedure involves 3 steps:

  1. First, the surgeon removes all visible cancer deposits in the abdomen.  This is called debulking or cytoreductive surgery, and may involve bowel resection, splenectomy, etc. as needed to remove all sites of tumor.
  2. The chemotherapeutic drug is mixed into heated fluid and circulated through the abdomen for approximately 90 minutes using a pump device.  The HIPEC pump circulates the chemotherapy through the abdomen and maintains the fluid at a temperature of 41-43 degrees.
  3. Following administration of the chemotherapy, all of the fluid is suctioned out.  The operation is then completed and the abdomen is closed.

Most patients will need additional intravenous chemotherapy after HIPEC to help prevent a recurrence.