Intraperitoneal chemotherapy is a treatment for cancers in the abdomen or belly area. This treatment delivers anti-cancer drugs directly into the peritoneal cavity, the area in the belly that contains the liver, stomach, and intestines.

During intraperitoneal chemotherapy, doctors fill the peritoneal cavity with anti-cancer drugs and fluids. This allows them to give higher doses of the necessary drugs while minimizing side effects to the rest of the body.

Doctors may recommend intraperitoneal chemotherapy for people with cancers of the ovary, stomach, colon, rectum, pancreas, or appendix.

This article explains what intraperitoneal chemotherapy is and what a person can expect if they receive this treatment. We will also look at the benefits of this treatment and any potential side effects.

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Intraperitoneal chemotherapy is a cancer treatment where doctors inject chemo drugs directly into a person’s peritoneal cavity.

Traditional intravenous (IV) chemotherapy is ineffective in treating cancers in the belly, as the drugs cannot always reach the affected areas. With intraperitoneal chemotherapy, the drugs go directly to the site of the cancer and can penetrate deeper into any tumors.

Intraperitoneal chemotherapy is only effective on small tumors measuring 2.5 millimeters (mm) or less. Doctors will surgically remove as many tumors as possible and reduce the size of any that remain before beginning intraperitoneal chemotherapy.

There are two types of intraperitoneal chemotherapy: hyperthermic intraperitoneal chemotherapy and intraperitoneal chemotherapy.

Doctors usually use hyperthermic intraperitoneal chemotherapy during surgery to reduce the size of the tumors. They heat the chemical cocktail to temperatures between 42–43°C, and the treatment lasts 1–2 hours.

After this initial treatment, doctors often recommend systemic chemo through a vein. However, depending on the location and stage of their cancer, a person may undergo repeat intraperitoneal treatments.

Intraperitoneal chemotherapy is an effective treatment for people with cancers in the belly area. These include:

During the surgery to reduce the size of any tumors, surgeons insert a catheter connected to an access port into the abdominal cavity. They attach the access port near one of the ribs or the pelvis, depending on which part of the peritoneal cavity they are targeting.

The port lies under the skin while the catheter reaches the targeted area. During treatment, doctors inject the chemotherapy drugs into the port, and they seep into the abdominal area.

Doctors may administer intraperitoneal chemotherapy as an inpatient or outpatient procedure. The number of treatments and types of medication may also vary from person to person, depending on the type of cancer they have.

A doctor will explain what will happen during treatment. Most people with ovarian cancer have several cycles of intraperitoneal chemotherapy with rest periods in between.

Before

Before starting any chemotherapy, it is important to ensure the person undergoing treatment can get home safely. Some people feel sick after treatment, and knowing someone will help them home can be reassuring.

A person can wear loose-fitting, comfortable clothes to help minimize the feeling of discomfort associated with bloating. Eating light meals the evening before and on the morning of the treatment can also help with this.

Depending on how long the treatment will last, some people may wish to prepare snacks and drinks to take into the treatment room.

During

People having intraperitoneal chemotherapy will need to lie down during treatment, although they can walk to and from a bathroom if necessary.

Doctors mix most chemotherapy drugs with a saline solution, which flows into the abdominal cavity via the access port and catheter. A healthcare professional will inject a needle through the skin and access port, to connect them. They may also tape the needle in place.

Once the fluid has reached the belly area, doctors usually ask people to shift their position or roll from side to side once every 15 minutes for about an hour. This helps distribute the chemotherapy drugs around the area, allowing them to bathe as many organs as possible.

After

After intraperitoneal chemotherapy, doctors usually advise people to rest, drink plenty of fluids to keep hydrated, and eat small, regular meals.

People should check the area around the access port and alert their doctor if there is any redness or swelling. After the original incision for the port has healed, most people can bathe and carry out everyday activities as normal.

According to the American Cancer Society (ACS), the number of treatments a person will have depends on their cancer type, the treatment goals, the chemo drugs, and how the person responds to them.

Most chemotherapy cycles include a treatment period followed by a rest period. During the rest period, a person’s liver and kidneys break down the chemotherapy drugs and excrete them with other bodily waste.

Some of the most common side effects of intraperitoneal chemotherapy, such as bloating, or the need to urinate more frequently, may be due to excess fluid in the abdomen.

Other common side effects of chemotherapy include:

Everyone reacts differently to chemotherapy, but some warning signs need medical attention. A person should contact a doctor if they experience the following symptoms after intraperitoneal chemotherapy.

  • soreness, swelling, or leakage around the access port
  • nausea or vomiting that lasts longer than 24 hours
  • a fever of 100.4°F or higher
  • diarrhea lasting longer than 24 hours
  • severe constipation
  • constant or severe stomach pain
  • being unable to eat or drink for more than 24 hours

Studies show that people who undergo hyperthermic intraperitoneal chemotherapy and start regular intraperitoneal chemotherapy immediately after surgery have a better chance of survival than those who do not.

The ACS notes that people with ovarian cancer, who undergo intraperitoneal chemotherapy, live longer than those who only undergo traditional intravenous chemotherapy.

However, everyone responds differently to chemotherapy. A person can discuss with a doctor about how effective chemotherapy may be for their cancer.

Intraperitoneal chemotherapy is a treatment for cancer in a person’s abdomen. The chemo drugs go directly into the peritoneal cavity, bathing the whole area with the medication.

Doctors usually recommend intraperitoneal chemotherapy after people have had surgery to reduce or remove any tumors, as it is more effective against smaller tumors.

Intraperitoneal chemotherapy can have side effects, such as bloating and the need to urinate more often. If a person feels extremely unwell, develops a fever, or has soreness around their access port, they should call a doctor right away.