Hyperthermic intraperitoneal chemotherapy (HIPEC) surgery is a two-step procedure that treats certain cancers in the abdomen. Cancerous tumors are surgically removed, and then heated chemotherapy drugs are applied directly inside the abdomen to eliminate the remaining cancerous cells.

Fabian Johnston, M.D., M.H.S., HIPEC expert and chief of the Division of Gastrointestinal Oncology at Johns Hopkins, explains what to expect during HIPEC surgery and the benefits of this procedure.

What is HIPEC surgery?

HIPEC surgery involves delivering high doses of chemotherapy into the abdomen to treat cancer that has spread beyond the organ from which it originated. Abdominal cancers that have spread to the lining of the abdominal cavity (peritoneum) can be difficult to treat through traditional chemotherapy. HIPEC surgery provides a more effective treatment option.

HIPEC: What You Need to Know | Fabian Johnston, M.D.

What types of cancer does HIPEC surgery treat?

HIPEC surgery can treat diseases, fluid build-up and cancers in the abdomen. The most common cancers treated with HIPEC include:

• Adrenal cancer
• Appendix cancer
• Colon and rectal cancer
• Gastric (stomach) cancer
• Liver cancer
• Mesothelioma
• Ovarian cancer
• Pancreatic cancer
• Peritoneal cancer

How is HIPEC surgery performed?

HIPEC surgery involves two stages:

Cytoreductive Surgery

Cytoreductive surgery is the first stage of HIPEC surgery. While you are under anesthesia, your surgeon will make an incision in your abdomen to view all visible cancerous tumors and diseased tissue.

HIPEC Procedure

The second stage is the HIPEC procedure. After your surgeon removes all visible tumors and diseased tissue from the abdomen, he or she will insert a catheter containing the chemotherapy drugs, which are pumped into your abdominal cavity. The catheters are connected to a perfusion machine, which heats the chemotherapy drugs and flows them through your abdomen for one to two hours. Your surgeon will drain the remaining chemotherapy from the abdomen and rinse the abdomen with a salt solution before the incision is closed.

The amount of time the procedure takes may vary depending on how much cancer has spread throughout the abdomen. Advanced stage cancer may take longer to treat with surgery.

Am I a candidate for HIPEC surgery?

This depends on where your cancer originated and the severity of disease or cancer spread. Your doctor will determine if you are healthy enough to undergo the procedure.

What are the benefits of HIPEC surgery?

HIPEC surgery inserts high doses of chemotherapy directly into the abdomen, where traditional methods of chemotherapy cannot effectively reach.

This innovative procedure can improve long-term outcomes and provide more treatment options for patients who have been diagnosed with inoperable or advanced stage cancer.