Intraperitoneal chemotherapy: procedure and side effects

Intraperitoneal chemotherapy is a treatment for cancers of the abdomen or stomach. This treatment delivers anticancer drugs directly into the peritoneal cavity, the area of ​​the belly that contains the liver, stomach, and intestines.

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

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 the treatment of stomach cancers, because drugs cannot always reach the affected areas. With intraperitoneal chemotherapy, the drugs go directly to the cancer site and can penetrate deeper into any tumors.

Intraperitoneal chemotherapy is effective only 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 starting intraperitoneal chemotherapy.

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

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

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

Learn more about chemotherapy here.

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

During surgery to reduce tumor size, surgeons insert a catheter connected to an access port in 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 sits under the skin as 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 medications can also vary from person to person, depending on the type of cancer they have.

A doctor will explain to you what will happen during the treatment. Most people with ovarian cancer have several rounds intraperitoneal chemotherapy with rest periods in between.


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

A person can wear loose, comfortable clothing to help minimize the feeling of discomfort associated with bloating. Take light meals the day before and the morning of the treatment can also help with that.

Depending on the duration of the treatment, some people may wish to prepare snacks and drinks to take to the treatment room.


People receiving intraperitoneal chemotherapy need to lie down during treatment, although they can walk to and from the toilet if necessary.

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

After fluid reaches the belly area, doctors usually ask people to change positions or roll from side to side once every 15 minutes for about an hour. This helps distribute the chemotherapy drugs to the area, allowing them to bathe as many organs as possible.


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

People should check the area around the port and alert their doctor if there is any redness or swelling. Once the original port incision has healed, most people can swim and perform their daily activities as normal.

According to American Cancer Society (ACS)The number of treatments a person will receive depends on their type of cancer, treatment goals, chemotherapy 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 chemotherapy drugs and excrete them along with other body wastes.

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

  • pain, 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 that lasts 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 reacts differently to chemotherapy. A person can talk to a doctor about the effectiveness of chemotherapy for their cancer.

Intraperitoneal chemotherapy is a treatment for cancer in a person’s abdomen. Chemotherapy drugs enter the peritoneal cavity directly, bathing the entire area with the drug.

Doctors usually recommend intraperitoneal chemotherapy after surgery to shrink 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 pain around their port, they should call a doctor immediately.

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