What Exactly Is HIPEC? A Clear Introduction for Patients and Families
Medicine Made Simple Summary
HIPEC is a special cancer treatment used when cancer spreads inside the abdomen. Many patients and families hear the word for the first time and feel confused or frightened. HIPEC is not the same as regular chemotherapy. It is a heated medicine given directly inside the abdomen after a surgery that removes visible cancer. This article explains what HIPEC really is, how it works, why it is used, who benefits from it and what patients can expect. By the end, you will understand HIPEC in simple, practical and reassuring language.
Understanding HIPEC from the Basics
HIPEC stands for Hyperthermic Intraperitoneal Chemotherapy. It combines two treatments in one. The first is a surgery where the doctor removes all visible cancer inside the abdomen. This is called cytoreductive surgery. The second part is giving warm chemotherapy directly inside the abdomen. This warm chemotherapy is HIPEC. It targets cancer cells left behind after surgery. Because the medicine stays inside the abdomen instead of entering the bloodstream, the treatment focuses exactly where it is needed. Suggested image: Simple diagram showing surgery followed by heated chemotherapy inside the abdomen.
Why HIPEC Is Different from Regular Chemotherapy
Regular chemotherapy travels through the bloodstream. It reaches the whole body. HIPEC does not. It stays inside the abdomen. The chemotherapy is heated to around forty-two degrees Celsius. Heat makes the medicine stronger and helps it enter tiny cancer cells more easily. This allows the doctor to use a higher dose safely because the rest of the body is not exposed to the same level of the drug. The goal is to kill hidden cancer cells that are too small to see during surgery.
Understanding What the Abdomen Is and How Cancer Spreads There
The abdomen contains many organs such as the stomach, intestines, liver, appendix, ovaries and peritoneum. The peritoneum is a thin layer that covers these organs. Some cancers spread to this layer and form small deposits. These cancers are called peritoneal cancers. They often spread like fine seeds inside the abdomen. Regular chemotherapy may not reach these seeds well. HIPEC helps by delivering medicine directly to the area where these cells hide. Suggested image: Illustration showing organs inside the abdomen and the peritoneal lining.
Which Cancers Are Commonly Treated with HIPEC
HIPEC is not used for all cancers. It is used mainly when cancer spreads inside the peritoneum. The most common cancers treated with HIPEC are appendix cancer, colorectal cancer, ovarian cancer, stomach cancer and peritoneal mesothelioma. Doctors recommend HIPEC only after checking whether the cancer is limited to the abdomen. If cancer has spread to distant organs like lungs or bones, HIPEC may not help. This is because HIPEC works inside a closed space and targets cancer inside the abdomen only.
Why Heat Is Used During HIPEC
Heating chemotherapy improves its power. Cancer cells are weaker when exposed to heat. Their surface becomes more open, allowing the medicine to enter easily. Heat also improves blood flow to the tissues, helping the drug reach more areas. The combination of heat and chemotherapy creates a strong effect on cancer cells, while normal cells tolerate the heat better. This makes the treatment more selective and effective.
What Happens During Cytoreductive Surgery
Before HIPEC can be given, the surgeon removes all visible tumors. This step is very important. The better the surgeon can remove visible cancer, the more effective HIPEC becomes. The surgery may take several hours because the doctor carefully removes cancer from the peritoneum and sometimes from affected organs. This procedure is carefully planned. It is done only in hospitals where trained specialists and advanced facilities are available.
How HIPEC Is Given After Surgery
Once the surgery is complete, the surgeon places tubes inside the abdomen. Warm chemotherapy flows through these tubes and circulates inside the abdominal cavity. The medicine is gently pumped in and out for around ninety minutes. The abdomen is like a closed bag during this time. The warm medicine touches every surface where cancer cells may remain. After the treatment, the medicine is removed and the tubes are taken out. The surgeon then closes the incision.
Why HIPEC Is Done Only Once
HIPEC is usually a single treatment given during the same operation as the cancer removal. It is not repeated weekly or monthly like regular chemotherapy. Because the dose is high and the medicine stays inside the abdomen, one session is usually enough. Some patients may need regular chemotherapy afterward, depending on their condition. But HIPEC itself is a one-time treatment.
Recovery After HIPEC Surgery
Recovery depends on how extensive the surgery was. Some patients stay in the hospital for one to two weeks. The body needs time to heal from the surgery and the effects of chemotherapy. Patients gradually start drinking water, then soft foods, and then normal food. Pain is controlled with medicine. Energy slowly returns. Full recovery may take several weeks. This is normal because HIPEC combines major surgery with strong treatment. Suggested image: Recovery timeline diagram.
Possible Side Effects and How They Are Managed
HIPEC is generally well tolerated because the drug stays inside the abdomen. But side effects can occur. These may include tiredness, abdominal discomfort, temporary low blood counts, nausea or slow bowel movement. Some patients may feel weak for a few weeks. Doctors monitor the patient carefully. Most side effects improve as the body heals from surgery. Because HIPEC is targeted, long-term side effects are less common than with regular chemotherapy.
How Doctors Decide If HIPEC Is Right for You
Doctors evaluate several factors before recommending HIPEC. They check the type of cancer, how far it has spread, the patient’s age, overall health, kidney function and whether the cancer is limited to the abdomen. They also check if the cancer can be removed completely during surgery. If the cancer cannot be removed well, HIPEC may not give benefit. A special score called PCI (Peritoneal Cancer Index) helps doctors decide whether HIPEC will work.
Benefits of HIPEC for the Right Patient
When used correctly, HIPEC can improve survival, reduce the chances of cancer returning inside the abdomen and help patients live longer and better. Many people who had no other options in the past now receive HIPEC with meaningful outcomes. The treatment is supported by studies and used worldwide in specialised cancer centres.
Limitations of HIPEC You Should Know
HIPEC is not suitable for everyone. It is not useful for cancers that have spread outside the abdomen. It requires major surgery, so the patient must be strong enough. It must be performed by a trained team with experience in complex cancer surgeries. Understanding limitations helps set realistic expectations and avoids false hope.
Why Experience and Hospital Choice Matter
Because HIPEC is a demanding procedure, choosing a hospital with trained surgeons and a fully equipped cancer team is crucial. Hospitals with experience have better results and safer outcomes. They also have skilled nurses, intensive care units and proper postoperative support. Patients should ask their doctor how many HIPEC procedures they perform each year.
Conclusion
If you or your family member has been advised HIPEC, speak with an experienced surgical oncologist to understand whether the treatment is suitable for your condition. Ask about benefits, risks, recovery and expected outcomes. HIPEC can offer hope and extended life for selected patients. Taking the time to understand the treatment clearly will help you make a confident and informed decision.
