HIPEC – Hyperthermic Intraperitoneal Chemotherapy

Treatment Overview

HIPEC is a unique two-step cancer treatment that involves both surgery and chemotherapy drugs.

In the first step, your surgeon removes visible tumors from your abdomen. The second step involves using chemotherapy to target any remaining cancer cells. Using special equipment, warmed chemotherapy fluid is circulated throughout your abdomen, allowing the medication to directly reach remaining cancer cells. Once this is done, the fluid is carefully removed, and your surgery is completed.

HIPEC is a complex procedure, so after a short stay in the recovery room, you’ll likely be transferred to an intensive care unit (ICU) for a few days for close monitoring. Then, you will be moved to a regular surgical unit for 1 to 3 weeks as you continue to heal.

What to Expect

At the Providence Swedish Cancer Institute, we’ll guide you through the planning stages of your procedure through to discharge, recovery, and future treatment if needed. Your care team is here to support your physical healing, emotional well-being, and personal goals, so you can move forward with confidence.

About a week before surgery, we'll schedule a pre-admission visit to:

Assist with any remaining pre-surgical lab work or tests
Review what will happen during your surgery
Explain potential side effects
Discuss medications and post-surgery care, including in-home help or equipment if needed

You'll receive information to prepare for your hospital admission. If you have any questions after your pre-admission appointment, you can reach out to your nurse or care coordinator, who will be happy to help.

Following your procedure, you’ll likely have an IV, a urinary catheter, and a tube to drain fluid from your abdomen. You will be encouraged to start moving to avoid complications like pneumonia or blood clots. Your care team will help you by supporting you and managing your pain. Before you go home, your care team will give you instructions on caring for yourself, monitoring your recovery, and what activities to avoid, like lifting heavy objects.

HIPEC offers several important advantages over traditional chemotherapy. Because the chemotherapy is delivered directly into your abdominal cavity — rather than through an IV or pill — it stays localized, which typically means fewer side effects.

Heating the chemotherapy helps the medicine penetrate tissue more deeply, making it more effective at killing cancer cells. And unlike standard chemotherapy, which often involves multiple treatment sessions, HIPEC is usually a one-time procedure.

As with any procedure, there are risks and potential side effects, including:

Pain and discomfort at the treatment site
Mild swelling or bruising
Abdominal pain

Your care team will answer your questions and talk with you about risks, as well as help you manage any side effects.

You’ll have several follow-up appointments after your procedure for the first few weeks. This helps us monitor your healing and manage any complications. As time goes on, your appointments will be less frequent, but regular checkups are required so that we can continue to manage any of your ongoing treatment needs and watch for any signs of recurrence.

Services are also available to help you through every treatment stage.

Learn more about our supportive care services.

Frequently Asked Questions

HIPEC can treat a number of abdominal cancers, including cancer of the appendix, colon, rectum, stomach, liver, ovary, and pancreas. It can also be used to treat advanced cancers that have metastasized to the abdominal area.

Every person’s diagnosis is different, and your surgeon will talk with you about whether HIPEC is the right option for you. The decision depends on several factors — including the type of cancer you have, the stage of your cancer, and your overall prognosis. Because HIPEC is a major surgery, your general health is also important. Your care team will evaluate things like your heart, lung, and kidney function to ensure the treatment is safe for you.

It can take up to 12 weeks to recover from HIPEC, including the time you spend in the hospital. You’ll likely feel tired and weak at first, though pain should be manageable with oral medications. A dietitian can help you come up with a nutrition plan to keep you nourished, as you might not have much of an appetite. You might feel constipated because of the pain medications or because you’re not moving around or eating your usual diet. If it becomes uncomfortable, your care team can help.

As you continue recovering, you’ll have some follow-up appointments so your care team can follow your progress.

It can take several weeks to recover from HIPEC, and you’ll likely need help at home during that time, especially in the first few weeks. Some people need a homecare nurse to assist with dressing changes and incision care. You may also need help getting in and out of bed, walking, or managing daily tasks.

Since you shouldn’t lift anything heavy or do anything strenuous as you heal, having someone help with meal preparation and housework can make a big difference in your recovery.

Not everyone experiences side effects from heated chemotherapy, but the most common ones include feeling bloated, constipation, diarrhea, fatigue, nausea and vomiting, and swelling as your body retains some fluid for a while.

Although it’s rare, sometimes the HIPEC can weaken your immune system, which in turn increases your risk of getting an infection.

You will likely have pain, but your care team will help you manage it in the hospital and at home.

Your care team will talk with you about your individual outlook. HIPEC can relieve symptoms and improve quality of life for people with advanced cancer. In some cases — particularly with early-stage disease — it may be used with curative intent, but this is less common. In most cases, the goal of HIPEC is not to cure cancer, but to slow its progression and help you feel better for longer.