What to Ask Your Surgeon About HIPEC: Key Questions Before You Say ‘Yes’

Medicine Made Simple Summary 

HIPEC is a major cancer treatment, and deciding whether to undergo it can feel overwhelming for patients and families. Many people do not know what questions they should ask their surgeon before agreeing to the procedure. This article explains, in simple language, the most important questions you must discuss. These questions help you understand whether HIPEC is right for you, what the surgery involves, its risks, expected outcomes, recovery time, costs and long-term care. By the end, you will feel confident, prepared and fully informed before making this important decision.

Why Asking the Right Questions Before HIPEC Matters 

HIPEC is not a routine surgery. It combines a big operation with heated chemotherapy inside the abdomen. Because it is both complex and specialised, it is essential to ask your surgeon clear and specific questions. These questions help you understand if you are a good candidate, what benefits you can expect, what risks are involved and how experienced the hospital team is. Asking early prevents confusion later and helps you make informed choices. Suggested image: Patient and surgeon during consultation.

Understanding HIPEC Before Asking Questions 

Before you ask detailed questions, it helps to understand the basics. HIPEC is used when cancer has spread inside the abdominal cavity. First, surgeons remove visible tumour deposits through a procedure called cytoreductive surgery. Then heated chemotherapy is circulated inside the abdomen to kill microscopic cells. Because the medicine stays inside the abdomen, it targets cancer directly. With this foundation, the upcoming questions will make more sense.

Question 1: Am I the Right Candidate for HIPEC? 

This is the most important question. Not all patients qualify. Your surgeon will check if your cancer is limited to the abdominal cavity, whether it can be removed completely and whether your overall health is strong enough to handle major surgery. The type of cancer also matters. Cancers like appendix, colorectal, ovarian, gastric and peritoneal mesothelioma respond better to HIPEC. Understanding why you qualify—or do not qualify—helps you avoid false expectations.

Question 2: What Is the Extent of My Cancer Spread? 

Ask your surgeon to explain the Peritoneal Cancer Index (PCI), which measures the spread of cancer inside the abdomen. A lower PCI means better chances of complete tumour removal. A higher PCI means surgery may be harder or unsafe. Knowing your PCI score helps you understand your condition clearly. Suggested image: Simplified PCI scoring diagram.

Question 3: Which HIPEC Drug Will Be Used for My Case and Why? 

Different cancers require different chemotherapy drugs during HIPEC. Your surgeon chooses the drug based on cancer type, behaviour and response patterns. Ask why that particular drug is recommended, how it works, and what side effects are expected. This gives clarity on how personalised the treatment is.

Question 4: How Experienced Are You With Cytoreductive Surgery and HIPEC? 

This is a crucial question. HIPEC outcomes depend heavily on surgeon experience. You should ask how many cytoreductive surgeries and HIPEC procedures your surgeon performs each year, how many years of experience they have and their typical outcomes. Experienced surgeons handle the procedure more safely, with fewer complications and better results. Suggested image: Icon-based diagram highlighting surgeon experience.

Question 5: What Is the Goal of HIPEC in My Case? Cure or Control? 

For some patients, HIPEC aims to remove cancer fully and achieve long-term control. For others, the goal is to slow the disease, reduce symptoms or extend life. Knowing the goal helps you form realistic expectations. Ask whether the procedure is meant to cure, control or manage the cancer.

Question 6: What Are the Risks and Possible Complications? 

Every major surgery has risks. HIPEC may cause bleeding, infection, temporary bowel problems or rare complications like leakage. The surgeon should explain each risk clearly and tell you how often they happen in their own practice. Understanding risks reduces fear and helps you prepare mentally and physically.

Question 7: What Is the Expected Success Rate for My Cancer Type? 

Success rates vary depending on cancer type, spread, response to chemotherapy and PCI score. Ask for information based on your specific case rather than general statistics. Your surgeon can explain expected survival, recurrence patterns and long-term quality of life.

Question 8: How Long Will the Surgery Take and What Should I Expect on the Day? 

HIPEC operations often last six to twelve hours depending on how much tumour must be removed. Asking about the step-by-step process helps you and your family understand the flow. Your surgeon will explain the pre-surgery preparation, the length of the operation and what happens immediately afterward in the recovery room.

Question 9: What Will My Recovery Look Like? 

Ask how long you will stay in the hospital, when you can drink water, when you can walk and how soon you can resume daily activities. Recovery after HIPEC is slower than routine surgery. Most patients take several weeks to regain strength. Knowing this helps your family plan support at home.

Question 10: Will I Need Chemotherapy Before or After HIPEC? 

Some cancers require chemotherapy before surgery. Others may need chemotherapy after HIPEC. Ask your surgeon how chemotherapy fits into your overall treatment plan. Understanding the full timeline helps you prepare emotionally and practically.

Question 11: How Will You Manage My Pain and Nutrition After Surgery? 

HIPEC affects digestion and appetite. Patients may need a specialised diet for several weeks. Ask whether you will receive support from a nutritionist. Pain management is also important for early mobility. Knowing this gives comfort and reassurance.

Question 12: What Tests Do I Need Before Surgery? 

HIPEC requires detailed preoperative testing. This may include blood tests, CT scans, PET scans, kidney tests and cardiac evaluations. Knowing the list of tests helps you plan time and finances. Suggested image: Pre-surgery preparation chart.

Question 13: What Will the Total Cost Be and What Does It Include?  

Cost depends on hospital, city, surgeon experience, drugs, ICU stay and duration of surgery. Hospitals should provide a written cost estimate. Ask whether the package includes surgery, drugs, ICU, room charges, tests and follow-ups. Clear financial understanding reduces stress.

Question 14: Is My Insurance Likely to Cover HIPEC?

Some insurance policies cover cytoreductive surgery and HIPEC. Others need additional approvals. Ask which documents are required, what part of the cost is covered and whether cashless treatment is possible. Understanding this ahead of time avoids last-minute shocks.

Question 15: How Should I Prepare Physically and Mentally Before the Operation? 

Ask your surgeon about recommended diet, exercise, breathing practices or medical treatments before surgery. Patients who enter surgery strong and well-prepared recover better. Emotional preparedness also matters. Discussing fears and expectations helps you stay calm and confident.

Conclusion

If you are considering HIPEC, schedule a detailed consultation with a trained surgical oncologist. Use these questions as a guide during your appointment. Understanding your eligibility, expected outcomes and the surgeon’s experience helps you make the best decision for your health. Take the first step today with clarity and confidence by having an informed conversation with your doctor.