Michigan Medicine
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Ann Arbor, MI 48109

Used with surgery, this treatment targets abdominal cancers that have spread into the abdomen

The biggest threat cancer poses happens when it spreads throughout the body. One particularly tricky spot is cancer that’s spread to the lining of the abdominal cavity (peritoneum and/or peritoneal cavity). These advanced cancers are notoriously difficult to treat. Surgery alone is rarely successful, and traditional chemotherapy yields limited results.

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is a process in which heated chemotherapy is pumped directly into the abdomen after surgery.

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What kinds of cancer can be treated with this procedure?

The most common tumors treated by HIPEC are:

  1. colorectal cancers
  2. appendix tumors such aspseudomyxoma peritonei
  3. low-grade appendiceal mucinous neoplasm

Other cancers treated by HIPEC are:

  1. mesothelioma
  2. adrenal cancer
  3. ovarian cancer
  4. liver cancer
  5. pancreatic cancer

Is HIPEC used for diseases other than cancer?

HIPEC is also an effective palliative therapy for people with malignant ascites, or an accumulation of fluid buildup in the abdomen. This is a side effect of having tumors lining the peritoneum. A one-time HIPEC treatment can replace repeated visits for paracentesis for some patients.

How do you know if you qualify?

Some people have metastatic cancer that is spread in the body in the typical way, which is through the blood stream. For those people, standard chemotherapy is by far the best.

Most of what this process treats are intra-abdominal cancers that, for reasons that aren’t totally clear, sometimes metastasize not by getting into the blood stream and going to different organs, but actually spilling over into the abdominal cavity.

We rely on CAT scans and MRI scans to show us the location and distribution of the tumors, which can help us decide if someone qualifies for HIPEC.

The HIPEC process

First, surgeons remove all visible tumors from the abdomen. This is known as cytoreductive surgery. While the patient is still in the operating room, a heated chemotherapy drug is pumped through the abdominal cavity. Surgeons rock the patient back and forth on the operating table for about 2 hours to ensure direct contact with all of the remaining cancer cells.

Delivering the chemo this way also means that it does not get absorbed systemically. It goes right to where the tumor cells are and doesn’t have the kind of systemic side effects that can come with traditional chemotherapy.

What patients should know

This operation can be very long. Depending on how many tumors need to be removed, the tumor removal portion of the operation can take anywhere from a couple of hours to as many as eight or nine hours, and chemotherapy application takes another two hours.

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