Which Cancers Can HIPEC Treat? And Who Is Eligible?
Medicine Made Simple Summary
HIPEC is a special cancer treatment used during abdominal surgery. It is not suitable for every type of cancer. HIPEC is mainly used for cancers that spread across the inside of the abdomen, such as appendix cancer, colorectal cancer, ovarian cancer, stomach cancer and peritoneal mesothelioma. The treatment works best when most visible tumors can be removed during surgery. This guide explains the cancers that respond well to HIPEC, how eligibility is determined and what factors doctors consider before recommending it. HIPEC is used for abdominal cancers that spread across the peritoneum. Eligibility depends on cancer type, spread pattern, overall health and whether surgeons can remove visible tumors.
Understanding Why Only Certain Cancers Are Suitable for HIPEC
HIPEC stands for Hyperthermic Intraperitoneal Chemotherapy. It is a heated chemotherapy wash delivered directly inside the abdomen during surgery. To understand which cancers HIPEC can treat, it helps to understand what makes a cancer suitable in the first place. HIPEC works only in the abdominal cavity.
This means it is effective for cancers that spread across the peritoneum, the thin lining that covers abdominal organs. These cancers often behave differently from cancers that spread through the bloodstream. Instead of forming a single big tumor, they scatter small cancer deposits across surfaces inside the abdomen.
These deposits cannot always be removed completely with surgery alone, and regular chemotherapy may not reach them well. HIPEC directly reaches these scattered cancer cells by washing the abdominal cavity with heated chemotherapy. Because of this, only cancers that spread within the peritoneum are good candidates for HIPEC.
Cancers Commonly Treated With HIPEC
HIPEC is not a one-size-fits-all treatment. Below are the cancers most commonly treated with HIPEC, explained in simple language.
Appendix Cancer
Appendix cancers often spread mucus-producing cancer cells inside the abdomen. This condition, called pseudomyxoma peritonei, leads to thick mucus buildup that affects organs. HIPEC is one of the most effective treatments for this type of cancer. It helps remove disease and prevent future buildup. Many long-term survivors of appendix cancer have undergone CRS and HIPEC.
Colorectal Cancer
When colorectal cancer spreads, it can sometimes travel to the lining of the abdomen instead of the liver or lungs. This pattern is called peritoneal metastasis. HIPEC can help selected patients with this condition, especially when the cancer has not spread outside the abdomen. If surgeons can remove all visible tumors, HIPEC may help improve survival.
Ovarian Cancer
Ovarian cancer often spreads within the abdominal cavity early in the disease. For certain patients, adding HIPEC during surgery after chemotherapy can improve outcomes. HIPEC is particularly useful when the cancer responds to chemotherapy but still leaves microscopic disease behind.
Stomach (Gastric) Cancer
Some stomach cancers spread to the peritoneum. HIPEC may be used in selected patients, especially if the spread is limited. The treatment may help reduce recurrence. Doctors carefully select gastric cancer patients because stomach cancer can behave aggressively.
Peritoneal Mesothelioma
This rare cancer affects the lining of the abdomen itself. HIPEC is one of the main treatments for peritoneal mesothelioma. Many patients experience improved survival with CRS and HIPEC because this cancer stays within the peritoneal space.
Pseudomyxoma Peritonei (PMP)
PMP is a condition usually caused by appendix tumors. Thick mucus fills the abdomen and continues to grow. HIPEC plays a major role in treating PMP. It helps remove both mucus and tumor cells and reduces the chance of recurrence.
These cancers share one key feature: they mainly spread inside the abdominal cavity. This is why HIPEC works well for them.
Cancers Not Suitable for HIPEC
HIPEC is not helpful when cancer spreads through the bloodstream or to areas far outside the abdomen. Examples include:
- Lung cancer
- Breast cancer
- Kidney cancer
- Pancreatic cancer
- Prostate cancer
- Cancers with widespread distant metastases
These cancers do not spread primarily to the peritoneum, making HIPEC ineffective.
How Doctors Decide Who Is Eligible for HIPEC
Doctors look at several factors before recommending HIPEC. Not every patient with abdominal cancer is eligible. The decision is based on a combination of cancer biology, physical condition and surgical possibility.
1. Type of Cancer
Only cancers known to spread across the peritoneum are considered. The cancer must respond to treatment delivered inside the abdomen.
2. Location of Spread
The cancer should be mainly within the abdominal cavity. If it has spread to the lungs or bones, HIPEC is usually not beneficial.
3. Peritoneal Cancer Index (PCI)
The PCI is a scoring system used during scans or surgery. It measures how much cancer is spread across the peritoneum.
- A low PCI means less spread and better outcomes.
- A very high PCI may mean the cancer cannot be removed surgically.
If the surgeon believes they cannot remove all or most visible tumors, HIPEC is not advised.
4. Overall Health and Fitness
HIPEC is a long and demanding surgery. Patients must be medically stable enough to handle it. Doctors assess:
- Heart function
- Lung capacity
- Kidney health
- Nutrition levels
- Strength and stamina
Good general health supports better recovery.
5. Response to Chemotherapy
Some cancers require chemotherapy before surgery. If the cancer responds well, HIPEC may offer additional benefit.
6. Whether Complete Cytoreduction Is Possible
The surgeon must be confident that they can remove most visible tumors. If major organs are heavily involved or disease is too widespread, CRS and HIPEC may not be possible.
Why Not Everyone With These Cancers Is Eligible
Even among patients with appendix, ovarian or colorectal cancer, not everyone qualifies. There are several reasons this might happen.
- The tumor burden may be too high
If cancer covers too many organs or areas, surgery may not be safe or useful. - The cancer may be too aggressive
Some fast-growing cancers may not respond well to HIPEC. - The patient may not be medically fit
HIPEC surgery can last several hours. Weak heart or lung function increases risk. - The cancer may have spread outside the abdomen
This makes local treatment less effective. - Each patient is evaluated individually. HIPEC is only recommended when doctors believe it can make a meaningful difference.
Benefits of HIPEC for Eligible Patients
For patients who qualify, HIPEC offers several important advantages.
- Targets cancer directly where it spreads
- Combines surgery and chemotherapy in one treatment
- Uses heat to increase effectiveness
- Allows higher drug concentration in the abdomen
- Reduces full body side effects
- May improve survival in selected cancers
- Can reduce recurrence of disease
Because HIPEC is a one-time treatment, it also reduces the burden of repeated chemotherapy sessions.
Understanding Patient Experiences and Outcomes
Outcomes vary depending on cancer type, stage and how completely the surgeon can remove tumors.
- Appendix cancer and PMP
Many patients achieve excellent long-term survival, especially when treated early. - Ovarian cancer
HIPEC may improve survival when used during interval debulking surgery after chemotherapy. - Colorectal cancer
Selected patients may benefit when disease is limited to the peritoneum. - Peritoneal mesothelioma
HIPEC often provides meaningful extension of life. - Stomach cancer
Carefully chosen patients may see reduced recurrence.
Although outcomes are improving, HIPEC is not a cure for all patients. It works best when disease is limited and surgery is extensive.
What Patients Should Discuss With Their Doctor
Important questions include:
- Is my cancer type suitable for HIPEC?
- Has the cancer spread outside the abdomen?
- What is my PCI score?
- Can complete cytoreduction be achieved?
- What are the expected benefits in my specific case?
- How long will recovery take?
- What risks should I be aware of?
- How many HIPEC procedures has the hospital performed?
Understanding these factors helps patients make confident decisions.
Conclusion
If you or your loved one has been diagnosed with a cancer that might qualify for HIPEC, it is important to consult a specialist who regularly performs CRS and HIPEC. Discuss your eligibility, understand the PCI score, and ask whether complete tumor removal is possible. Early evaluation can open treatment options that may not be available later. Speak with your oncology team to determine whether HIPEC is appropriate for your condition.
