Medically reviewed by Mali Schneiter, D.O., MBA • Tennessee Oncology Women’s Health Center
Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is a specialized cancer treatment used in combination with surgery to treat certain cancers that have spread within the abdomen. It is most often considered for select patients with cancers such as ovarian/primary peritoneal/fallopian tube cancer, appendiceal cancer, colorectal cancer, mesothelioma, and other malignancies that involve the peritoneum (the lining of the abdomen).
HIPEC is a procedure that requires expertise, careful patient selection, and coordinated care before, during, and after surgery. Outcomes are closely tied to experience and a comprehensive approach to cancer treatment. Because of its complex and highly individualized nature, it is performed at specialized centers with close collaboration among gynecologic oncologists, surgical oncologists, medical oncologists, and supportive care teams. Our hospital system partners – such as Ascension Saint Thomas Midtown in Nashville and others like it – work closely with our surgeons to make HIPEC a smooth, efficient and safe process in order to deliver expert care. With their partnership, Tennessee Oncology‘s gynecologic oncology team has performed more than 50 HIPEC cases (as of publish date), making it a high performing team in the procedure.
What Is HIPEC?
HIPEC is not a single treatment, but a two-part process that combines:
- Cytoreductive surgery: removal of visible tumors from the abdomen
- Heated chemotherapy: circulation of chemotherapy directly within the abdomen
Unlike traditional chemotherapy, which is delivered through the bloodstream, HIPEC allows chemotherapy to be applied directly to the area where cancer cells are present.
How The HIPEC Procedure Works
Step 1: Cytoreductive Surgery
The procedure begins with surgery to remove as much visible cancer as possible from the abdominal cavity. This may involve removing tumors from the peritoneum and, in some cases, portions of affected organs. The goal of this step is to reduce tumor burden and leave behind only microscopic cancer cells.
Step 2: Heated Chemotherapy
After the surgical portion is complete, a heated chemotherapy solution is circulated throughout the abdominal cavity for a set period of time, typically 60 to 90 minutes. The chemotherapy is warmed to enhance its effectiveness.
Heating the chemotherapy helps:
- Improve the ability of the drug to penetrate tissues
- Increase cancer cell sensitivity to treatment
- Limit exposure to the rest of the body compared to intravenous chemotherapy
Once the chemotherapy circulation is complete, the solution is removed, and the incisions are closed.
Why Heat Matters
The use of heat is a key component of HIPEC. Cancer cells are more vulnerable to higher temperatures, and heat can enhance the cytotoxic effects of chemotherapy. This combination allows for higher local concentrations of chemotherapy while minimizing systemic side effects to the whole body.
Who May Be A Candidate For HIPEC?
HIPEC is not appropriate for all patients or all types of cancer. An individual’s candidacy depends on several factors, including:
- Cancer type and stage
- Extent and location of the disease within the abdomen
- Overall health and ability to tolerate major surgery
- Prior treatments and response to therapy
A multidisciplinary team evaluates each patient to determine whether HIPEC is a safe, effective option.
Recovery And What To Expect
Recovery from HIPEC surgery can be more involved than standard abdominal surgery. However, early recovery from surgery programs have minimized this impact. Hospital stays may range from a few days to two weeks, depending on the extent of surgery and individual recovery. Patients may experience fatigue, kidney problems, temporary digestive changes, or other side effects as their body heals.
After recovery, additional treatments such as systemic chemotherapy may still be recommended as part of an overall cancer care plan.
The Importance Of Specialized Care
HIPEC is a complex procedure that requires expertise, careful patient selection, and coordinated care before, during, and after surgery. Outcomes are closely tied to experience and a comprehensive approach to cancer treatment.
At Tennessee Oncology, HIPEC is performed as part of a personalized care plan, with close collaboration among gynecologic oncologists, surgical oncologists, medical oncologists, and supportive care teams. Our hospital systems such as Ascension St. Thomas Midtown in Nashville work closely with our surgeons to make HIPEC a smooth, efficient and safe process in order to deliver expert care.
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This content is intended for educational purposes only and does not replace medical advice. Treatment decisions should always be made in consultation with a qualified healthcare provider.
